Only a few doctors in my class at medical school went into the field of infectious diseases, including HIV and AIDS. This is not because they fear infection but because they know that caring for the patient with HIV or AIDS brings the highest level of frustration -- they know most patients cannot afford anti-viral drugs.

The more data I see about HIV being a treatable disease, the more frustrated I become. It is excruciating as a doctor to know how to care for a patient but be unable to do so.

I now have 60 to 80 patients infected with HIV and about 40 patients in the AIDS stage. About half these patients cannot afford anti-viral drugs. Many of the HIV-infected patients are age 25 to 35 with incomes below 5,000 baht (US. 125) a month -- including 10 patients with no job at all who are supported by relatives or a non-profit organization.

Thailand's first epidemic of HIV happened in 1985, but the government did not acknowledge how dire the situation was until 1992, when 500,000 people were infected with HIV.

At first, we had success with a condom and education campaign, and the number of those infected with HIV began to decline. But just last year the number of new cases began to rise again. Now it is estimated that almost 1 million people are infected with HIV in Thailand, and the most common method of transmission is through heterosexual sex.

The government no longer subsidizes medicine for anti-viral therapy as they did when the standard treatment involved a mix of two drugs. The new, best medication is very expensive and the government can no longer afford to pay for the drugs. There is just too much demand. Frankly, only about 10 percent to 20 percent of the population can afford the anti-viral therapy -- even if I were infected with HIV, I could not afford the medicine.

We have petitioned the drug companies to lower the price of the anti-viral drugs, but they have not listened. I go with this information to organizations like San Francisco General Hospital's HIV/AIDS care unit and the World AIDS conference in Durban, South Africa. It's a chance to reach out to doctors, researchers and social workers to help me influence the drug companies.

This is not a profit issue, but a human one. If the drug companies can decrease the price of the remedies, then they can sell more drugs and profits will not decrease much. They disagree, for very silly reasons, saying that if they decrease the price in Thailand, people from other countries will flock to Thailand to buy the medicine. How many people will do that? That's not the real reason.

I also know that the country has the funds to help patients get treatment for such ailments as heart disease, but very few people will set up funds for HIV and AIDS. The prevailing attitude here is that the disease is something you brought on yourself, and it did not occur naturally. Some doctors view it as punishment. As a result many patients are abandoned and others don't care.

My priority is also to teach my students about the AIDS problem. This may not influence the AIDS epidemic now, but perhaps in the future it will help. I can inform my students about HIV and not let them walk away from it.

I am beginning to record data about the patients in my HIV clinic with the help of four other doctors in my unit, and we will use this to inform other organizations in the world. My mentor/professor is trying to push me into the AIDS Center of Thailand's Ministry of Health meeting. I feel like I should take the chance and go in.

And every time we treat a patient we try to educate them and their families, and the circle widens.

I'm not sure what more I can do. It's just the beginning of my efforts. I may fail, but at least I am trying.