This posting turns to governmental responses to the epidemic. There were only two topics in four abstracts presented by the government of Myanmar in Toronto – prevention of mother to child transmission and TB/HIV. The second of the papers below reports that: “The standard four-pronged strategy of PMTCT was applied.” This is, er, misinformation ... read on

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CDC1621 - Operational research: improving awareness on PMTCT of HIV among pregnant and nonpregnant women at Magwae township, central Myanmar S. Mu1, M. Thwe2, W. Mar2, K. Phyu31Socio-Medical / Public Health Research, Department of Medical Research, Yangon, Myanmar, 2National AIDS Control Program, Department of Health, Yangon, Myanmar, 3East Hangon Hospital, Department of Health, Yangon, Myanmar Issues: According to the UNGASS 2001, Myanmar National AIDS control program (NAP) was launched in 2003,starting from the border areas which is now expanding gradually to the central and lower part of the country. With the aim of supporting the program, this OR on PMTCT was conducted as a collaboration between NAP and HSR division, Department of Medical Research (lower Myanmar). Insighted into the objective of raising the awareness regarding PMTCT among the pregnant women, before and after design was adopted. Vigorous health education on HIV/ AIDS and PMTCT activities at AN clinic were imparted through mass, invidual and group discussion and community dialogue. The perception on PMTCT and AN practice increased significantly. However VCCT practice was not satisfactorily inproved. Description: The division and Township health authorities and community leaders were advocated before the study was accomplished.Multistage sampling was used to select the sample of 200 pregnant women and 100 nonpregnants according to WHO sample size determination. Quantitative mthod was used among pregnants and Qualitative IDI was used for the nonpregnants. After base line data was collected,various methods: mass health talks, individual and group discussions and community dialogue were made.The same questionnaires and guided themes were used for the post intervention data collection. Lessons learned: The perception on HIV/AIDS, PMTCT program at AN clinic and attitude towards voluntary counseling and blood testing seemed to significantly improved; 44% to 89% in urban and 22% to 05 in rural.Although they possed positive attitude, more than half of them were reluctant to take VCCT program . That revealed of existing social stigmatization on AIDS even in urban. Recommendations: Overview of the study called upon: 1. To initiate the community mobilization regarding prevention of AIDS. 2. To conduct furthur research among the babies born to HIV + mothers incollaboration between the pediatrician and researchers.

CDC0516 - Lessons from application of community based model in prevention of mother to child transmission of HIV (PMTCT) programme in Myanmar M. Thwe, W. Mar, K. Oo, S. Nwe Khin, T. Aung, A.M. SoeNational AIDS/STD Control Programme, Department of Health, Yangon, Myanmar Issues: First AIDS case was recorded during 1991. About 70% of country’s population resides in rural areas where financial, infrastructure, and communication resources are limited. Ante-natal(AN) care coverage is low in rural areas. Community based PMTCT was used as model in providing PMCT services. Description: The project started in 2000-2001 and currently covering 68 out of 324 townships in Myanmar. PMTCT activities were integrated into the primary health care services at the Maternal and Child Health(MCH)Centers, Rural Health Centers (RHC) and sub-centers that are linked to the referral hospital located at township level. The standard four-pronged strategy of PMTCT was applied. Package of service includes explanation about PMTCT to the pregnant women by Basic Health staffs (BHS), offering voluntary counselling and confidential testing services (VCCT), testing for HIV at nearest hospital, providing single dose nevirapine to mother and baby pairs, and counselling for feeding options. During the period of last 5 years, pregnant women reached yearly by the program have increased dramatically with 193 in 2000 to 115,384 in 2005. Although VCCT acceptance rate is still low, about 50% since 2003, proportion of nevirapine coverage to both mothers and babies were high, 85.7% in 2001 and 92.78% in 2005.Observed MTCT rate at 18 month was 9.53%. Lessons learned: Impact of the project heavily depends on AN care Coverage, quality of counselling services, and efforts exerted on the Community mobilization. Inability to provide HIV testing service at primary care level has limitted the success of project. Recommendations: 1.Community mobilization element should be seriously taken into account for the success.2.Issues on stigma and discrimination should be addressed in the project design. 3.VCCT service should be available at primary care level. 4.Further operation research is needed to explore the reasons for low utilization of services.