Here they are.

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Promoting greater involvement by conducting assessment of
self-help groups among PLHIV in Myanmar
Keywords -Advocacy, Capacity building
Mr Aung Myo Htut1, Mr Zaw Zaw Naing2, Ms Naw She Wah3, Mr
Kyaw Zay Ya4, Mr Thiha Kyaing5, Mr Thura Myint Lwin6, Ms Khaing
Mar Swe7, Ms Aye Mya Thida8
1Greater Involvement of People Living with HIV/AIDS Alliance,
2Greater Involvement of People Living with HIV/AIDS, 3Greater
Involvement of People Living with HIV/AIDS, 4Greater Involvement
of People Living with HIV/AIDS, 5Greater Involvement of
People Living with HIV/AIDS, 6Greater Involvement of People
Living with HIV/AIDS, 7Greater Involvement of People Living with
HIV/AIDS, 8Greater Involvement of People Living with HIV/AIDS
The GIPA Project Initiative Group and the International HIV/AIDS Alliance
carried out an assessment of PLHIV self-help support groups
(SSGs) by a team of PLHIV lead by a national consultant in Myanmar
between June and August 2006. It is very first ground breaking
move for GIPA. A working definition of SSGs was framed with
emphasis on self-help and self-management i.e. groups which have
activities, management and resources of their own. A very first directory
of PLHIV SSGs in Myanmar, that documented a broad range of
services usually carried out voluntarily by the groups’ members, has
been shared among SSGs. It has been analyzed that most common
activities are on home visits and clinical accompaniment and other
common activities include health talks, home based care, group
gatherings, income generation and counseling.
The assessment recommended for building upon more involvement
of PLHIV in SSGs and promoting greater networking among the
SSGs for jointly addressing common concerns. It calls for promoting
collaboration among organizations supporting the SSGs to develop
a framework for it. It has highlighted to provide more comprehensive
capacity building support for organizational development like in areas
of leadership, management, governance and fundraising.

Bringing Buddhist Leaders for addressing Stigma and
Discrimination against PLHA in Myanmar leaders
Keywords -Access to care, Counselling
Mr Myint Swe
1Ratana Metta
Ratana Metta, Buddhism faith based organization, was formed in
2004 with experience and inspiration gained from 6th ICAP at Bangkok.
Drawing on regional best practice of Sanga Metta association
in Thailand and building upon collaborative work with 10 Buddhist
organizations, state Sanga association representatives, academics
in the field of Buddhist teaching, UNICEF and UNAIDS, a handbook
for Sanga and Buddhist organizations on HIV/AIDS prevention and
care and support was developed. The work of developing the handbook
and it’s follow through activities such as sessions of trainings
and range of discussions have brought the HIV/AIDS issue on the
agenda of Sanga and Buddhist organizations and helped reduce
stigma and discrimination towards PLHA who have been generally
consider previously as “the immoral and left untouched. The active
participation of Sangas up to the national level in HIV/AIDS prevention
and care and support program have tremendous impact on
advocating all level of FBO throughout the country.
“Monks did not accept offerings from us before. Now, they do accept
our offerings directly from our hands and even encourage us and
get involved in our gathering” (a PLHA)

International and Local Partnerships: An Effective
Response to the HIV Epidemic in Myanmar
Keywords -Capacity building, Partnerships
Ms Tin Tin Mar 1, Ms Myint Su 2, Ms Kelly Macdonald3, Mr Karl
Donning4
1Burnet Institute Myanmar, 2Burnet Institute Myanmar, 3Burnet
Institute Myanmar, 4Burnet Institute
Issues: Communities must identify and have ownership of the
HIV response if behavioural and attitudinal change is to occur
and be sustained. Over the past ten years in Myanmar, increasing
numbers of local community-based organizations have either
been created to respond to HIV or have developed HIV activities
in response to the epidemic. However, local NGOs have had limited
opportunity not only to learn about HIV best practice and acquire
technical skills, but also to develop organizational capacity.
This has resulted in poor institutional infrastructure and systems
to support program implementation and raises questions about
effective ways to develop community-based responses.
Project: Burnet Institute Myanmar has pioneered a holistic approach
to build capacity of local NGOs in response to HIV. Local
NGOs develop their own response which is backed by technical
support and mentoring in management and organizational development;
and HIV technical training. The process is iterative;
allowing participants to understand community needs and to reflect
learning back into their organization.
Results: Burnet has created models for learning and implementation
that not only create effective partnerships for civil society
growth, but also impact upon the HIV epidemic.
Lessons Learned: Capacity development is a long-term commitment

Healing From Social Suffering:Women’s Experience in a
Jingpo Community in China hit hard by AIDS
Keywords -Gender,Community resistance
Mr Zhixiang Xu1, Ms Donghua Xia2,
1Colorful Yunnan Women’s Group, 2Asia-Pacific Council of AIDS
Service Organizations
At one of the most drug abuse afflicted regions, the border area
between Myanmar and China, indigenous women try to reduce
the harms of heroin abuse using all possible means. This paper
reports an ethnographic case study of eleven married women living
with drug abusing husbands in a Jingpo hilltribe village.
According to women’s account, this paper demonstrates how Jingpo
women justfied their ‘suffering’ experiences, how they chose
to survive and resume normality of everyday life. This research
associates women’s experience with gender, and social, cultural,
political and historical contexts and shows how these wider contexts
may sustain drug abuse or fuel the spread of HIV. Throughout
a decade of everyday life devastated by drug, Jingpo community
underwent gender transformation – women went beyond
victimhood, forged an alliance to struggle as ‘warriors’ against
their subordination to men. Their collective response indicates
that a community-based drug abuse rehabilitation approach is a
drug users-friendly alternative to the government-operated drug
detoxification, that is, to quit drug by being with supportive family
members, friends in the community. The findings also suggest
that a holistic community-based drug abuse/AIDS resilience approach
should be developed to mobilize community resources
and rebuild community’s hope for change.

A Consortium of NGOs working together to deliver a
Continuum of Prevention, Treatment and Care
Keywords -Partnerships,Resource mobilisation/allocation
Ms Kari Kenna Sann1, Dr Hlaing Min Swe2, Dr Moe Moe Aung3
Dr Kyaw Hlaing4, Prof Khin Nyo5, Ms Khin Oo May6, Ms Ni Ni
Hla7, Dr Zin Tway Si8, Dr Zaw Htoo9
1Myanmar NGO Consortium on HIV/AIDS, 2HIV/AIDS Manager,
Save the Children in Myanmar, 3Programme Manager, Marie Stopes
International Myanmar 4Assistant Programme Coordinator,
CARE Myanmar,
Myanmar is one of the hardest hit countries by the HIV epidemic
in Asia where it is officially estimated 360,000 people are currently
HIV infected, but the actual number may be significantly
higher. Obtaining access to HIV testing, treatment for sexually
transmitted infections, ART treatm

ent and care and support for
people infected and affected by HIV is a challenge in this isolated
and resource-poor environment. The complex impacts of
the epidemic call for a comprehensive and concerted response.
It is difficult to change behaviour if people cannot access testing.
Similarly, people are less inclined to be tested if treatment,
care and support services are unavailable. Since 2003 four large
NGOs (Save the Children, Marie Stopes International, CARE and
the Myanmar Nurse and Midwife Association) agreed to combine
their respective areas of expertise, to deliver a comprehensive
continuum of prevention, treatment, care and support to communities.
This presentation outlines the Consortium model including
the principles and minimum service standards that underpin the
collaboration. Lessons learned from three years of working in
Consortia are also presented, highlighting both the strengths and
challenges of this innovative model.

Community Initiative for Care of AIDS Orphans and
Vulnearble Children
Keywords -Access to care,AIDS Orphans
Ms Mya Thwe 1
1Myitta Kyaemone
Myitta Kyaemone, a community based organization, was formed
in 2002 to provide effective and holistic support to orphans and
vulnerable children of HIV/AIDS within their families and communities.
As an integrated approach, we provide education, health
and nutrition, psychosocial support, social inclusion and economic
strengthening activities in a fisherman and migrant community
off Andaman coast in Myanmar. Born from community initiative,
organization is mostly supported with financial, time and manpower
contributions from community members. In four years, we
have provided OVC with a safe, structured environment where
they can go to school, receive emotional support and supervision
of adults, an opportunity to learn how to interact with other
children, and develop social networks. We had also successfully
advocated for the children’s rights to education, property and
protect exploitation of children in workplace. Adult PLHIV, supported
through our activities, are now contributing back to the
community by fostering orphans, and volunteering at communal
activities.

Lessons learnt of mobilizing environment for positive
norms (ME+N) to empowering MSM communities
Keywords -Community based,BCC
Mr Kyaw Thu1, Mr Saw San Sammy2, Mr Myo Min3
1International HIV/AIDS Alliance, 2Healthy Living Helping Society,
3International HIV/AIDS Alliance
In 2006, MSM partner groups of the Alliance Myanmar in 4 strategic
townships implemented peer education on MSM sexuality
and sexual health through the ME+N workshops. Feedbacks
from workshop participants, the immediate community members
and PE consulted affirmed range of invaluable experience and
confidence gained in mobilizing MSM and handling participatory
learning exercises.
For a variety of reasons, process documentation, a record, that
focuses more on the why-why not-how-how else questions were
given less priority. Information on such instances like -
- what were the questions and how were they answered,
- how did the participants react? Engage?,
- How did the facilitators and how else would other facilitators
modify and handle challenging scenarios? how was it incorporated
into the session?
- What might you do differently next time? were not recorded
Process documentation is a source of inputs for future activities,
active (continuum of why-why not-how-how else questions)
and an update tool(a tool to help participants reflect and
respond).
- It is to find how to support MSM partner groups for capacity
building of developing simple schemes to do the documentation
of different types of activities and producing their own tools
for recording information.

Experience of empowering MSM communities
through mobilizing environment for positive norms
Keywords -Community based,BCC
Mr Kyaw Thu1, Mr Myo Min2, Mr Saw San3
1International HIV/AIDS Alliance, 2International HIV/AIDS Alliance,
3Healthy Living Helping Society
In 2006, MSM partner groups of the Alliance Myanmar in 4 strategic
townships implemented peer education on MSM sexuality and
sexual health .The curricula of mobilizing environment for positive
norms workshops cover sexuality and identities of MSM with emphasis
on promoting safer sex practice in addition to capacity building
on organization development, participatory capacity assessment
, project design and proposal writings. The workshops able to mobilized
MSM from the respective communities who later grow into
range of resource person with variety of skills like facilitators,peer
educators and counselor and project managers or officers
Through the workshops, informal networks among the communities
have been linked and self help support groups have been formed.
The informal networks formed and the one-off and project wise activities
carried out by the mobilized communities affirmed success
of developing solidarity among the MSM from utilizing the Alliance’s
curricula.
Providing care and support including referral for VCCT , STI and OI
and counseling by the MSM in their respective communities proved
capacities built up through empowerment process.
Area to improve are identified as process documentation, a record,
that focuses more on the why-why not-how-how else questions, and
organization development

Common challenges in monitoring and evaluation (M&E)
among community based organizations (CBOs)
Keywords -Monitoring, NGO/CBO
Mr Maung Maung Sein
1International HIV/AIDS Alliance
The International HIV/AIDS Alliance is building the capacity and
mobilizing communities to increase the scale and coverage of
HIV/AIDS prevention and care services for most at risk populations
in Myanmar. A series of workshops on participatory capacity
assessment, project design, monitoring and data collection,
project review and organizational development have been carried
out to systematically build the M&E capacities of partner CBOs.
The workshops are followed through with on-going one-to-one
mentoring. Standardized indicators and data collection systems
have been introduced and are being used. However, challenges
remain. For a variety of reasons, documentation is often regarded
as one of the least important aspects of implementation, and
is usually given the least resources, both financial and human.
Little priority is given to building data collection, analysing and
report writing skills. Most CBOs do not have access to computers
and are not able to use computerised systems which necessitate
laborious data entry and recording systems. Another key
issue is double counting, both within CBOs and in overlap with
work of other organisations. The experience stresses the need
for simple and user-friendly data recording, documentation and
reporting formats for M&E which should be tailored for and with
the participation of the CBOs.

A Study on Monitoring System of Life skills Based HIV
Education Programmes in Myanmar
Keywords -Monitoring, Prevention
Dr Moe Moe Aung1, Dr Cam Escoffery2, Dr Kathy Miner3
1Marie Stopes International Myanmar, 2Rollins School of Public Health,
Emory University, Atlanta, Georgia, USA, 3Rollins School of Public
Health, Emory University, Atlanta, Georgia, USA
Objectives: HIV infection rate of 1.8 percent among young people in
some areas of Myanmar underscores the need to engage them in prevention.
To enhance young people’s ability to make safer choices and
avoid risk behaviours, different agencies in Myanmar implement life
skills ed

ucation approach. This study describes Monitoring and Evaluation
(M&E) system of life skills based HIV education programmes implemented
by CARE, Save the Children (UK), Myanmar Red Cross
Society, and Pyinnya Tazaung.
Methodology: This qualitative research employed case study approach
combining semi-structured interview of the staff and documents
review.
Results: Agencies monitor the process and outputs of the programme
through qualitative and quantitative approaches. However, not all programmes
evaluate the outcomes including behavior change. Qualitative
information are neither systematically collected nor utilized to inform
the programme. Programme design influences M&E system and
reporting emerged as a pertinent monitoring mechanism across the
programmes.
Conclusion: Strengths of the programme include institutionalizing M&
E and using internationally recommended indicators and approaches.
Limited understanding about and lack of motivation for M& E hinder implementation
of M&E system. Agencies should evaluate M& E system,
strengthen communication and feedback mechanism, ensure the validity
and the utility of the information, and promote cross-learning.

Identifying risk factors that put MSM at risk to HIV, Super
Natural beings Festival,Myanmar
Keywords -Prevention, Peer support
Mr Maung Maung Kyaw1
1UNDP
Objectives: To identify HIV risk factors of MSM in Yadanagu Traditional
Nat Festival (festival for super natural beings) and use
these findings for future intervention
Method : 12 FGDs were undertaken among 112 MSM (referred
to as main-ma-shar, a derogatory word for homosexuals), as well
as Nat-ka-daw, who act as intermediaries between Nat (Super
Natural) and ordinary human and their disciples dominating the
scene.
Results: Their age ranged from 14 to 66 years. 84% has reached
secondary school education. 12.4% were government employees.
45% of them were mobile population for business. 90%
responded that the words HIV/AIDS was found to be familiar.
Only 50% had known the transmissible ways such as sex and injecting
drug use. 74% responded mosquitoes bite and tattooing
were also considered as risk factors. 70% said the main source
of information was mass media (TV, video, billboards). Almost all
had seen condoms but not sure about proper use, and requested
the availability of condoms with lubricants.
Conclusion: Factors from the findings, which could increase the
risk of MSM into HIV vulnerability. Peer groups education programme
accompanied by targeted and culturally appropriate IEC
materials through social mobilization and right-based approach
were undertaken.

Socio-sexual settings of Myanmar men who have sex with
men(MSM)
Keywords -Safer sex, Access to treatment
Mr Tin Aung Win Tin Aung Win
1Burnet Institute
Objectives: To map MSM socio-sexual settings for HIV prevetion
outreach in Myangyan
Methodology:
1.Focus group mapping of local socio-sexual locations
2.Observation of hihg-risk situations
3.Qualitative key informant interviews for sexual behaviours and local
categorisation of MSM
Results:
Participants defined MSM achouk(meaning dry) in various categories;
• Effeminate, transgender men apwint usually receptive partner in
sexual intercourse
• Masculine gay MSM are known as apone –partners can be straight
or gay men
• Versatile men (insertive and receptive sexual bahaviour )known as
england
• Bisexual men who can be insertive or receptive with males and
females known as hna phet chun
• Achauk gain employment as beauticians, dancers and performers
• Apwint worship nat and become head of nat dancers nat gadaw
• Sexual activities take place in known settings, cruising for partners
in park, dark places, and religious festivals. Few participants reported
regular partner; majority had casual partners.
• Less practice in consistence use of male condom
• No knowledge about female condom for anal sex
Conclusion: Socio-sexual mapping informs HIV prevention outreach
strategies for access and targeting services to high-risk groups.

The role of Myanmar NGOs in HIV prevention and care for
mother and children
Keywords -PMTCT, NGO/CBO
Dr Khine Nandar Sein Tun1, Ms Kelly Macdonald2, Mr Kim Benton3
1Burnet Institute, 2Technical advisor, 3Country representative
Objective: To highlight the role of national NGOs (LNGOs) in
comprehensive community-based PMTCT.
Background: PMTCT is provided in 28% of Myanmar’s townships
but there are difficulties in provision of services. In these
townships, LNGOs provide care and support services for HIV
positive individuals and families. Other than referring to ANC
services, LNGOs do not know how best to link with government
PMTCT services. Both the government and LNGOs need to work
together to address service delivery and uptake issues.
Findings
• Community midwives are primary implementers for PMTCT.
Many do not have time or resources to support activities such
as community advocacy; promotion of exclusive breastfeeding
and associated cultural barriers; men’s roles in PMTCT; stigma
and discrimination; and individual counseling and psycho-social
support. These can be done by LNGOs.
• Logistical constraints disconnect ANC and PMTCT services;
LNGOs can help to bridge these programmes.
• Primary focus of national PMTCT has been on HIV test-based
interventions. LNGOs are in a strong position to promote other
strategies to prevent parent-to-child transmission.
Conclusions: Providing comprehensive PMTCT is complex and
challenging in resource-limited settings. Local NGOs have wide
community networks and can serve as a link between PMTCT
services and communities.

Ignorant until proved educated: Cautionary tales from HIV
prevention work in Myanmar
Keywords -BCC, Prevention
Ms Gillian Fletcher1
1ARCSHS
Objectives: To look at the ways workers (and recipients) speak
about the theories and the practice of HIV prevention education,
and to observe practice.
Methodology: Individual semi-structured interviews with a total
of 34 key informants (community members, field staff and senior,
national, NGO staff); field observation and background conversations
with 7 expatriates involved in the Myanmar aid industry.
Carried out over one year as PhD field work.
Results: Theoretical explanations of HIV prevention work referenced
‘two-way communication’ and ‘learning from each other’.
However observations and respondents’ descriptions of field
work showed a repeated presumption of ignorance in communities.
It was also presumed (by both trainers and community
members) that this ignorance required repeated repetition of
biomedical facts. These presumptions existed regardless of previous
trainings given or of the existence of public information
media. Interviews also revealed the complexity of trying to undertake
behaviour change (BC) work in Myanmar, where State
and cultural attitudes to sexual behaviour are highly traditional.
Conclusion: The research revealed a gap between the rhetoric
and the practice of HIV prevention work, leaving both trainers
and community members ill-prepared for responding to the real
life complications of BC. There is a need for greater innovation
and responsiveness in prevention work.

Participatory research in restrictive contexts to improve
outcomes for children affected by HIV
Keywords -AIDS Orphans, Community based
Mr Karl Dorning1
1Burnet Institute
Empowerment is seen as a key strategy to increasing owner

ship
over community based interventions for HIV prevention,
care and support. However, children are often ignored in empowerment
approaches. The UN Convention of the Rights of
the Child (CRC) suggests that children should be given a voice
in all matters that affect them (CRC Article 12). How do such ideals
receive the programmatic focus they depict and what are the
cultural and ethical constraints and opportunities for children’s
participation within the context of responding to HIV? This paper
describes a participatory evaluation designed to encourage the
inclusion of children in the design, implementation, monitoring
and evaluation of an orphans and vulnerable children’s intervention
in three geographic areas of Myanmar. It identifies specific
steps in involving children; results in terms of attitudinal shift of
staff and community towards children’s participation; and the impact
this might have on increasing opportunities for effective care
and support for affected children. Finally, the paper adds to a
growing body of knowledge on the response to the HIV epidemic
in Myanmar and suggests that empowerment approaches are
possible within politically restrictive contexts.

Realities of implementing PMTCT programs in Myanmar
Keywords -PMTCT, Community based
Dr Khine Nandar Sein Tun 1, Ms Kelly Macdonald2
1Burnet Institute Myanmar, 2Burnet Institute Myanmar
Objectives: To review operational constraints & suggest strategies
for comprehensive community-based PMTCT
Background: Myanmar’s PMTCT program started in 2001; by
2006 only 28% of townships had community and hospital-based
programs. In addition to increased coverage, greater attention to
the quality of services is required for effective prevention of HIV
transmission in children.
Issues: Barriers to effective and equitable uptake of services were
observed.
Community midwives, primarily implementers for PMTCT, have
received training. However, midwives are overworked and have
inadequate time and support for community advocacy, individual
counseling, feeding options, and post-natal care.
ANC was designed to link with PMTCT services, however poorly
conceived logistical practicalities inhibit these two programmes
working together.
PMTCT was designed around “choice of delivery” by mother, however
drugs are primarily accessed in hospitals therefore influencing
place of delivery and who can access PMTCT. Poor hospital
confidentiality inhibits mothers’ delivering in hospitals.
Primary focus of PMTCT has been on test-dependent interventions.
Weak linkages between reproductive health services and
PMTCT have contributed to low emphasis on primary prevention
strategies.
Conclusions: Apparently insignificant operational constraints
greatly influence the program’s success. These can be overcome
by upgrading existing basic health services and creating better
links between reproductive health services and PMTCT.