In 2001, the International AIDS Society (IAS) awarded the 2004 international AIDS conference to Bangkok, Thailand, whose HIV prevention progress has long stood out against Asia’s looming catastrophe. But today, as an estimated 15,000 conference-goers plan their July stay in the continent’s colorful commercial-sex capital, they face a more serious dilemma than what to pack: Are they rewarding a newly savage Thailand, whose prevention policies now include mass murder? In February, the government literally took aim at its several million drug users, many of whom have HIV. So far, more than 2,000 Thais—traffickers, junkies and petty criminals—have been shot dead in the streets.

The brutal crackdown is intended to cleanse the nation of its drug users by December 5, the king’s 76th birthday. At its launch,Interior Minister Wan Muhamad Nor Matha announced that users and dealers would be “put behind bars or may even vanish without a trace. Who cares? They are destroying our country.” These terror tactics ar ehaving a cruel side effect: Fear of murder, arrest or cold-turkey lockdown has sent 37 percent of Thai drug users into hiding—and away from prevention and treatment, according to a study co-sponsored by the government’s own health ministry. Half of Thai injection drug users already have HIV—and represent a third of all new cases in the country. Indeed, while the immediate crisis is the bodies on Bangkok’s sooty curbs, rising infections will likely be the policy’s lasting legacy.

That Thailand is touted as a condom success story for all but evicting HIV from its $20 billion sex industry is only one of this story’s ugly ironies. Another, local advocates say, is that the massacre began just as the health ministry was showing a glimmer of support for needle exchange. “We’re slipping back in time,” said Karyn Kaplan of the Thai Drug Users Network (TDN), a peer-ed and lobby group. TDN’s Paisan Tan-Ud added, “If the government doesn’t kill us all, AIDS will.” 

The scandal has hardly been headline news, and international outrage, such as it is, has not focused mostly on HIVers. The human-rights lobby—the United Nations, Amnesty International, Human Rights Watch—has issued condemnations or sent observers. A U.S. embassy official anonymously said the Bush administration “has made it very clear we have serious concerns.” But the HIV bloc has been uncharacteristically quiet, although IAS, the world’s professional society for HIV scientists, health-care and public-health workers, has dutifully “expressed its concern,” said the group’s director, Joep Lange, MD.

Still, the irony of the international AIDS elite descending on the killing fields of Thailand is not entirely lost on conference organizers and delegates. What they must decide is whether a Bangkok gathering would endorse the slaughter or slow it—a murky matter of tactics, perception and conscience. Human Rights Watch’s Brad Adams said, “The question is how to get at the government — whether with a blunt instrument, like moving the conference — and whether the wrong people will be affected.”

Moving the conference has its backers. ACT UP/New York’s James Wentzy believes that unless the killings stop, “it would be unconscionable to hold an international AIDS conference in Thailand—and there would be hell to pay.” TDN’s Kaplan added, “What’s unconscionable is that the country will be in the IAS spotlight for its prevention successes.”

But other advocates such as Adams argue that it is precisely the spotlight that will focus global attention on the extermination policy. At presstime, IAS’ Lange was on the fence. “Threatening to move the conference at this stage is not the most productive way forward,” Lange told POZ. What else might work? He wouldn’t say.

Not surprisingly, Sombat Thanprasertsuk, MD, Thailand’s AIDS head, opposes a boycott. He said the conference “is for people to share experience and innovations. It is not just important to Thailand, but the whole world.” To groups mulling a stay away, he protested: “The conference has nothing to do with the drug action.”

The hard-pressed HIV community apparently agrees. So expect the show to go on—and the killings, too.