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Background: Thailand National AIDS Committee endorsed Undetectable=Untransmittable (U=U) as a science which needs an urgent translation into actions to address pervasive stigma faced by people living with HIV (PLHIV). We aimed at humanising and demedicalising U=U by exploring a 'people-centered value' of U=U and translate them into efficient U=U communications., Methods: During August-September 2022, in-depth interviews were conducted with 43 PLHIV and 17 partners from various background in five regions of Thailand. Focus group discussions were made with 28 healthcare providers (HCPs) and 11 PLHIV peers. Thematic analysis was used for data analysis., Results: Among PLHIV, how U=U frees them up to 'live a full life' was valued highest. A great relief from sin, immorality, and irresponsibility was mentioned by all. U=U communications allowed PLHIV and their partners to love/be loved and enjoy intimacy and sex with pleasure again. HCPs and PLHIV peers almost always refer U=U value to 'physical health'. Common concerns were around increasing sexually transmitted infections with condomless sex. The people-centered U=U values, together with dismantling of power imbalance within healthcare system and sexual health skills empowerment among providers, were used to develop a humanised and demedicalised National U=U Training Curriculum. The Curriculum was highlighted in country's planned activities to address multi-level/multi-setting stigma and discrimination., Conclusions: U=U can be successfully humanised and demedicalised in designing efficient communications. At an individual level, U=U can address one's intersectional stigmatizing attitudes. At a policy level, national endorsement can initiate and sustain tangible actions and interest around U=U across country's leaderships.

Objectives: To describe and identify predictors of health-care seeking behavior among men with sexually transmitted diseases (STDs) in Bangkok, Thailand., Design: Cross-sectional survey., Methods: Men presenting with STDs were recruited from government clinics (n = 101), private clinics (n = 50) and pharmacies (n = 62). They completed interviewer-administered questionnaires on risk behavior, patterns of treatment-seeking for current and past STDs and attitudes toward health care., Results: Two-thirds of all subjects had had a previous STD. Approximately one-half believed a partner other than a sex worker was the source of their current infection. Of the sample, 39% of men seen initially at drugstores, 29% at private clinics and 19% at government clinics sought subsequent treatment; failure to respond to therapy was the primary reason for seeking additional care. Men attending drugstores were likely to be younger, have less education and income, and to practice riskier sexual behavior. Patients at drugstores and general private clinics received the least amount of counseling or STD testing, while those attending specialized private STD clinics received the most comprehensive services. Attitudes towards government clinics were uniformly positive regardless of the site of enrollment; conversely, about 50% of clients at drugstores felt that the advice and treatment they received were inadequate. Convenience, affordability and lack of embarrassment were associated with choice of treatment site., Conclusions: STD/HIV control in Thailand must focus on improved treatment and counseling at the point of first encounter in the health-care system, particularly in the private sector. Men may be dissuaded from attending government clinics because of lack of convenience. Syndromic case management, incorporation of STD care at other public clinics and the recognition that more men practice unsafe sex with partners other than sex workers could improve STD control.