Adapting the HIV response to the changing world of sex work in Myanmar

There is a need to reform laws on sex work in Myanmar and raise awareness of the challenges sex workers face, according to senior representatives of government, sex worker networks and international organizations. The recommendations were made during the National Seminar on Collaboration for the HIV Response with Sex Workers in Myanmar, which took place in Nay Pyi Taw from 21-22 September.

HIV prevalence among the general population in Myanmar has declined from 0.94% in 2000 to an estimated 0.54% in 2014. However, prevalence among female sex workers (FSW) has remained considerably higher, ranging from 3.5% in Mawlamyaing, 7% in Yangon and Mandalay to 13% in Pathein.

In his opening speech, Dr Than Win, Deputy Director General, Department of Public Health, Ministry of Health, said that new trends observed around sex work require innovative models of services and cost-effective strategies such as mobile HIV care and treatment services, and phone and web-based interventions.

The rapidly changing political and economic landscape in the country has created an emergence of hidden or ‘hard-to-reach’ sex workers in economic corridors such as border areas and mining towns, or via telephone and more recently web-based or social media channels. As they are anonymous, many sex workers may not be reached by HIV prevention programmes. In response to these trends, non-governmental organizations have started implementing mobile testing and out reach services in massage and beauty parlours. Other innovative approaches such as sending prevention and testing messages via web-based and social media channels were discussed in the seminar.

Dr Htun Nyunt Oo, Programme Manager, National AIDS Programme, Ministry of Health stressed that government priorities include intensifying advocacy efforts to reduce stigma and discrimination; strengthen peer education activities and promote the mobilization and participation of sex workers in policy making, planning and programming. This seminar included strong involvement from community representatives with 20% of the audience comprised of the representatives of sex worker networks. The event was the first to provide an open platform for the direct collaboration between sex workers and a wide range of stakeholders, including the law enforcement sector.

However, major challenges and barriers still need to be addressed to effectively expand the HIV response for sex workers. Eamonn Murphy, UNAIDS Country Director, emphasized that recent achievements should be reinforced to fast-track and sustain the HIV response, through the creation of a positive enabling environment; further engagement in the decentralization process; and the scaling-up of testing and treatment activities.

National and regional perspectives echoed these priorities. Nadia Rasheed, Team Leader, HIV, Health & Development, Asia-Pacific – UNDP Bangkok, highlighted that bringing together government, civil society, sex workers, law enforcement partners  and agencies from the United Nations is crucial to effectively respond to violence against female, male and transgender sex workers.

Police Lieutenant Colonel Lam Tien Dung, Senior Lecturer at the People’s Police Academy showed how concrete policy measures, such as ending detention centres for sex workers in Vietnam, have been critical in promoting a public health and rights-based approach to sex work. Civil society representatives from Thailand and Cambodia also shared examples on how innovative interventions such as engaging police and brothel owners in the HIV response and use of mobile technologies have led to reduced stigma and discrimination towards people working in the entertainment sector.

It is expected that the recommendations will pave the way for further policy engagement and programme implementation and will serve to inform the development of the new National Strategic Plan on HIV (2016-2020).

More than 100 representatives from the Ministry of Health, National AIDS Programme, Ministry of Home Affairs, Ministry of Social Welfare, Relief and Resettlement, sex worker networks, local, national and international non-governmental organizations, development partners and UN agencies took part in the meeting. The seminar was organised by UNAIDS in collaboration with the Ministry of Health, National AIDS Programme. Financial support was provided by the 3MDG Fund.

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