ID: HR19-722

Presenting author: Ni Ni Tun

Presenting author biography:

Dr. Ni Ni Tun is working with an international Non-government organization, Medical Action Myanmar, as a medical director, supervising the prevention and treatment program of HIV, TB, malaria and malnutrition program. Furthermore, Nini is the lead for HIV research for the Myanmar Oxford Clinical Research Unit.

Integrated community based Harm Reduction Activity in Northern Kachin state, Myanmar, a new strategy for improving access and linkages to treatment and care

Ni Ni Tun, Thida Yamin Pyone, Min Thant Htun, Frank Smithuis

Issue
In Myanmar, Kachin state, heroin use is contributing to dual epidemics of injecting drug use and HIV infection. One of the major challenge is that people who inject drugs (PWID) are difficult to access as they do not gather in shooting galleries, but rather share drugs in small groups in their village homes. In addition, the area itself is remote.
Setting
Putao is one of the north-most townships in Kachin state and known for its access to Himalayas. The area is very remote and difficult to access even for the regular health care. However, similar to other areas in Kachin State, drug use is high in Putao.
Project
With the funding support of USAID and Global Fund, MAM has started a harm reduction project in Putao in the late 2017. A new strategy of community- based intervention using mobile clinic teams and integration with the networks of existing Malaria Community Health Workers (CHWs) is established. Malaria CHWs are already well known by the community and are in place in their remote villages providing malaria and basic health care. With the integration model, CHWs are being trained and mobilized on HIV related activities, including health education, referrals for HIV testing and counseling, Needle and syringe exchange and referral for Methadone maintenance therapy and Antiretroviral therapy. CHWs are regularly trained and monitored by MAM mobile team which includes doctor, counselor and peer educator.
Outcome
MAM has achieved harm reduction program effectively within the short time frame, reaching more than 1200 intravenous drugs users with the community acceptance and support. Community based service delivery integrated through existing community health workers in rural Kachin state, is feasible. This approach provides for better early identification, linkages to care and reduction in transmission of HIV among PWIDs in in hard hit rural areas of Myanmar.