During the 3rd UPR cycle in November 2021, Thailand received 278 recommendations from 106 States, of which it supported 218 and noted 60. Recommendations touching directly on the rights of people living with HIV (PLHIV) and people who use drugs (PWUD) clustered around four commitments: to move away from a punitive approach to drug use and consider abolishing or imposing a moratorium on the death penalty for drug-related offences; to expand harm reduction and non-discriminatory access to healthcare; to end stigma and discrimination against PLHIV and key populations, including in workplaces; and to review criminal penalties applied to drug consumption.

Since the 3rd UPR, Thailand has adopted the Narcotics Code B.E. 2564 (2021), which introduced treatment-oriented pathways and incorporated harm reduction into the drug-dependence framework, and has consolidated the principle that “people who use drugs are patients.” In parallel, Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) have been integrated into the Universal Health Coverage benefit package (in 2020 and 2022 respectively), and HIV self-testing kits have been registered and progressively made available.

However, this assessment shows that Thailand has partially implemented a small number of recommendations and persistently failed to implement most of the recommendations relevant to PLHIV and PWUD. Drug use and possession for personal use remain criminalised. As of December 2025, drug-related offences accounted for 70.34 per cent of the prison population, and 72.96 per cent of prisoners under sentence of death had been convicted of drug-related offences. Among women, that figure rises to 98 per cent. The National Human Rights Commission of Thailand (NHRCT) has documented shackling, chaining and coercive drug testing in treatment facilities and public workplaces. HIV-related stigma continues in healthcare and workplaces, and the abrupt 2025 freeze of US foreign assistance, including PEPFAR and USAID funding, has placed the community-led HIV response for key populations, particularly PWUD, sex workers, transgender people, and men who have sex with men, under serious strain.