Here is a bit of background on the AFP story on sex worker centres in Myanmar featured at http://www.hivinfo4mm.org/blog/_archives/2011/5/24/4823204.html.
It is nice that the PSI Deputy Director of Communications 'believes' that TOP has 'contributed significantly to the decline in HIV prevalence'. The [him] moderator is of the opinion that it is more important to think than to believe. Prevalence among female sex workers in Myanmar has halved from its approximate 30% plateau from 1998 to 2006. It suddenly dropped to about 15% in 2006 when the TOP programme was young and has stayed at almost the same level since.
There are many reasons for the apparent decline in prevalence. Death is one, though there is constant entry into sex work. Better data is another:in the early years of this century the sampling of sex workers was almost a convenience sample of women caught by the police. Programmes are a third reason. Attributing a decline in prevalence to the activities of a single transnational nongovernmental organisation programme is risky. Credibility is at stake.
[him] moderator
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One Woman's Fight to the Death Against the Spread of HIV in Myanmar
Anna Dirksen
PSI Healthy Lives
Tuesday, June 7, 2011
PSI's Deputy Director for Communications Anna Dirksen takes us behind a recent AFP story about the role of sex worker support centers in fighting HIV/AIDS in Myanmar.
The other week, AFP’s Alex Delamare wrote an article about a sex worker community center in Myanmar which is at the front lines of the country's HIV prevention efforts:
When Thida Win contracted HIV after selling her body on the Yangon streets, it was her fellow sex workers that she turned to, not Myanmar's crumbling health service.
The Top project, run almost entirely by those in the sex trade, gave her treatment, a place to be herself away from the dual stigma of HIV and prostitution -- and eventually a job.
"I am now a health worker for my community and I can forget I am positive. I am so proud to work for the programmes, I will work for them for my whole life," the 33-year-old told AFP.
Top and similar projects are a vital resource in army-dominated Myanmar, where a chronically underfunded health service, large itinerant populations and poor education fuel one of Asia's worst HIV epidemics.
"When I was diagnosed I was pregnant and they told me how to find a safe way for the baby. So the child is negative and I am so happy," Thida Win said.
The TOP Drop-in Center that was featured in the article was created as part of PSI’s TOP Project, which was created in 2004 by PSI Myanmar and with the support of USAID.
TOP's goal is to provide support to those most at risk of HIV in the country, specifically female sex workers and men who have sex with men. Through the project PSI created 18 TOP Drop-in Centers throughout the country. TOP is run by Habib Rahman a PSI Myanmar staff member and sociologist who has been working with these high-risk groups for more than 20 years. But each Drop-In Center itself is run by a member of the group it serves – the centers for female sex workers are run entirely by former or current female sex workers. Similarly, the ones for men who have sex with men are run by their peers. In many cases the same physical building will house the drop-in centers for both groups.
We have many incredible men and women running these drop-in centers, but since we don’t have time to introduce you to all of them, I thought I’d write about one in particular – a woman named Thandar Oo, who is 33 and runs our Yangon drop-in center, the largest one in our network.
Thandar was lucky growing up. Though her father died when she was just a girl, her mother was committed to Thandar’s education and did everything she could to make sure that Thandar could attend university. In her first year of university, Thandar’s mother also arranged for her daughter to be married. Thandar and her husband had two children together, but eventually Thandar’s husband lost his job and – unable to provide for his family – he left Thandar and his two kids so he could start life anew elsewhere.
It was around that same time that Thandar found out her mother was sick. So Thandar and her two kids moved back in with her mother, to take care of her. Neither Thandar or her mother had a job, and there was no income coming in to feed and support the family. So Thandar did the only thing she could do, she brought in income by selling herself for sex.
After a few years of sex work, Thandar met a woman who told her she should get tested for HIV. In 2005, she visited a TOP drop-in center and got tested. She was HIV positive. She was devastated. She thought her life was over. Eventually, through counseling and follow-up care provided by TOP, she came to realize that she had good years left. It was then that she decided to rededicate her life to helping other women like her.
She asked to become a TOP peer educator. As a peer educator she learned about HIV, STIs and other issues around women’s health. Then she set out on foot to visit brothels, karaoke bars and talk with girls on the street, teaching them how they could protect themselves and also giving them tips on how they might eventually get off the streets.
She did this for years, working her way off the streets altogether and becoming a full-time peer educator at the TOP center. Eventually though, HIV started taking its toll and she became too weak to walk the streets as an outreach worker. But that didn’t stop her. She learned basic computer skills from TOP and became the Director in Charge of the entire Center. More impressively, she also founded a group called The Saturday Club. The Club is for HIV-positive sex workers only. She started at her own Center, inviting the women to the center every Saturday to talk about everything and anything – from antiretroviral treatments to how it felt to be HIV positive and working the streets. That single club has since grown into a network of more than 500 women across the country – all of them HIV positive women in need of support.
Thandar has entirely changed the landscape for HIV-positive sex workers in Myanmar and has said numerous times that she will continue to help these women until the day she dies.
In terms of the impact of Thandar’s work and the work of the TOP project as a whole:
Last year alone, more than 57,000 female sex workers benefited from TOP. At the centers, women can access individual counseling, bathing facilities, group sessions on sexual health, English classes, life skills education, diagnosis and treatment of STIs, and voluntary counseling and testing for HIV. More importantly, they’re given a safe space away from the stigma and discrimination they often face in the streets.
Overall, the HIV epidemic among female sex workers has declined since 2004, when TOP was created. Though there are new firm figures as to how many sex workers currently work in the country, we believe TOP reaches a very large majority of these women and has contributed significantly to the decline in HIV prevalence.
http://www.psihealthylives.com/2011/06/one-womans-fight-to-death-against.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+HealthyLivesBlog+%28Healthy+Lives+Blog%29
