ID: 171

Type of submission: Oral

Conference track: Practice

Topics: Creating Enabling Environments; Punitive Laws and Law Enforcement

Presenting author: Dr Htwe Kyu

Presenting author biography:

Dr Htwe Kyu is a founding member and Program coordinator of the local NGO Sao Mon which aims to raise awareness among police forces and community members about drug dependency, harm reduction and HIV-related issues. Previously, Dr Htwe Kyu worked with UNODC Myanmar Care International and MSF

Drug use and HIV in Myanmar: embedding harm reduction in law enforcement practices

Dr Htwe Kyu, Khyn Hla Munn, Geraldine Cazorla, Dr Sai Lone Tip, Eamonn Murphy

Scaling up needle and syringe programmes is urgently needed to tackle HIV among people who inject drugs (PWID) in Myanmar. Despite a growing awareness of the role of police in reducing the impact of HIV, a disconnect remains between law enforcement policy and practice, resulting in police crackdowns that hinder PWID access to harm reduction (HR) services.

Accounting for 28% of new infections due to the sharing of non-sterile equipment, PWID are most affected by HIV in Myanmar. In Kachin and northern Shan States, nearly one in two PWID tested HIV-positive in some townships.

With funding support from 3MDG, in late 2014 Sao Mon, a local NGO, and UNAIDS initiated a series of trainings on 'Drug use and HIV' for police and government staff. The in-service training curriculum was designed by a member of the Law Enforcement and HIV Network, who formerly served as a police officer in Australia. It provides evidence-informed and practical guidance to embed HR in law enforcement practice. Trainings were conducted monthly in high drug-use areas and involved a broad range of local stakeholders to encourage multisectoral cooperation.

Between September 2014 and October 2016, nearly 1000 police and government staff were trained which resulted in: substantial gain in knowledge about HIV, drug dependency and HR (average pre-test at 54.6% and post-test at 83.2%, yielding a difference of +28.2%); better understanding of how police activities can negatively impact the delivery of HR services; and increased awareness of health service providers where drug users may be referred. Involving different stakeholders contributed to strengthening of community linkages, improving coordination and creating a climate of mutual understanding. As a result, HR partners reported fewer difficulties when conducting activities. The approach taken to involve law enforcement has helped to strengthen rather than hinder the HIV response.