Myanmar has one of the biggest Aids epidemics in south-east Asia. Of the 230,000 people living with the virus, almost 126,500 who are in urgent need of antiretrovirals, still have no access to treatment.
People who use drugs are massively affected by HIV: at national level, 26.3% are infected. In Kachin state, access to prevention and treatment services is even more difficult for them than elsewhere because of the armed conflict and the discrimination which they suffer. Almost half of them are infected with HIV. Sex workers are the other group of people most affected by the epidemic. They also suffer a great deal of discrimination and are rarely included in awareness building or screening and treatment programmes. So, in certain towns and regions, the rate of screening for Aids amongst sex workers is only 28%, and inclusion in prevention activities is 15%.
Since 2014, Doctors of the World has worked with the sex worker community in Rangoon. The association operates with peer educators in mobile clinics to prevent, screen for and treat HIV. It has also set up a fixed clinic where over one thousand sex workers are seen every year. In addition to antiretroviral treatment, they can receive counselling and be screened for other diseases such as tuberculosis. Doctors of the World also works with other local organisations and support groups to offer nutrition activities to sex workers, as well as income generating activities for those who wish. Otherwise, we work closely with the Ministry of Health to support its decentralisation policy and the national plan to combat HIV.
In Kachin state, in the north of the country, Doctors of the World works with drug users, who are particularly susceptible to infectious diseases. They are provided with prevention material (condoms, sterile needles). There is screening for HIV, Tuberculosis and Hepatitis. Educational workshops on health and antiretroviral treatment are provided to try to involve users in prevention activities.
Doctors of the World currently manages four clinics in collaboration with a team of health professionals and peer educators. There, the association conducts prevention and awareness raising activities and provides substitution treatment by methadone. It also reinforces its training activity with the local authorities and civil society stakeholders. The objective is to develop harm reduction activities in Kachin, to reduce violence against drug users and to promote the methadone substitution programme.
Since May 2016, Doctors of the World, in partnership with the Metta Development Foundation, conducts an innovative programme. Doctors of the World is building the capacity of Metta with regards to harm reduction and they in turn will support our teams in community approaches to prevention. This will allow a larger number of people to be reached in the areas where we work.