YANGON, 14 January 2014 (IRIN) – Despite a decreasing prevalence of HIV/AIDS among commercial sex workers, health workers say the stigma associated with prostitution and the harsh laws against it are undermining sex workers’ access to HIV-related services.
“Myanmar has made remarkable progress, given the limited resources it’s had [to combat HIV]. Resources are usually misspent by targeting the general community [rather than at-risk groups]. However, the country’s national strategy has included some very strong targeting,” said Eamonn Murphy, the country coordinator for the Joint UN Programme on AIDS (UNAIDS).
Myanmar currently allocates just 3.9 percent of its budget to health, but the figure will rise to 5 percent in 2014, which represents a fourfold increase since the end of military rule in 2011.
The Global Fund to Fight AIDS, Tuberculosis and Malaria resumed operations in Myanmar in 2011 and in September 2013 provided US$160 million for HIV services [until 2016] – an increase of $90 million.
According to the Myanmar Ministry of Health, there are 200,000 people living with HIV/AIDS, and approximately 15,000 people die of AIDS-related illnesses every year.
“Prevalence has been decreasing in all risk groups other than drug users,” Anne Lancelot, director of the Targeted Outreach Programme at Population Services International (PSI) confirmed.
Surveys reveal that in 2008, prevalence among sex workers stood at 18.4 percent, whereas 7.1 percent of sex workers were HIV positive in 2012.
While government data estimates that there are currently 60,000 sex workers in Myanmar, PSI puts the real number at closer to 80,000. The national HIV infection rate is 0.5 percent, making HIV/AIDS a concentrated epidemic, said Murphy, adding, “However there have been quite a lot of deaths due to a lack of access to treatment.”
Laws curb access to health services
The stiff penalties for commercial sex work contained in Myanmar’s Suppression of Prostitution Act (1949) are a major barrier to accessing HIV treatment. The punishment is one to three years in prison for sex workers, but clients are not punished under the law.
“Very harsh laws are in place against sex workers, instead of the mobilizers, the traffickers and the gangs who push women into sex work,” said Sid Naing, the country director for Marie Stopes, an international NGO working to improve sexual and reproductive health.
Even possessing a condom could be used as circumstantial evidence of prostitution until 2011, when the Ministry of Home Affairs issued a directive to the contrary, yet according to UNAIDS most of the public are unaware of the directive.
“People are still not comfortable about carrying large amounts of condoms because they could be targeted as sex workers,” PSI’s Lancelot noted.