Community Voices: "By taking every opportunity we had to explain our activities, people started to understand."

In cities in Kachin State, HIV prevalence among people who inject drugs (PWID) is nearly 50%.[1] Metta Development Foundation (Metta) is working to increase access to harm reduction services such as the Needle Syringe Exchange Program (NSEP) at drop-in center locations to reduce transmission of HIV and other viruses by sharing contaminated needles and syringes.

Harm reduction “is an evidence-based approach to HIV prevention, treatment and care for people who inject drug[s]” and is part of a broader strategy to address the high HIV prevalence among PWID in Kachin State. These services are supported by the USAID HIV/AIDS Flagship (UHF) Project, funded by USAID under PEPFAR through UNAIDS Myanmar, with project implementation support and management for partner organizations, as provided by Community Partners International (CPI).

To increase awareness and local ownership of harm reduction services, Metta works with Local AIDS Committees (LACs) for HIV prevention at all project sites. At the start of project implementation, Metta holds meetings with community members—including elders, village administrators, religious leaders, and young people—to create awareness about drug dependency and harm reduction issues. Following meetings, interested individuals form LACs and develop action plans, which Metta helps facilitate.

From advocating for the construction of methadone maintenance treatment (MMT) clinics to conducting health education sessions at schools, LAC members play an active role in sensitizing communities on these issues and increasing access to harm reduction services. These LAC-led awareness campaigns and activities are significant in communities resistant to this approach due to misunderstandings about harm reduction programs such as NSEP.

We recently spoke with U Myint Thein Win, Director of the LAC at Inn Metta, about challenges to project implementation and how community perceptions of PWID have changed over time in this area. Keep reading below.

How has your community been affected by either HIV/AIDS or drug use?

U Myint Thein Win: I was born and raised in Indawgyi. Since I was young, the number of people who use drugs in my community has been slowly increasing. This made me unhappy. I felt powerless and upset whenever I thought about the drug issue.

How does the LAC support Metta?

U Myint Thein Win: Since the staff members are usually young, we, as older people, support them with health education and harm reduction services in places such as the Indawgyi Area and the countryside. We also help connect staff members to local authorities.

What are some challenges to implementing projects?

U Myint Thein Win: When Metta began implementing project activities, there were many misunderstandings about activities like NSEP and supporting people who use drugs and their families[2]. However, we used all the opportunities to talk to people, even if it was just a group of four or five. By taking every chance we had to explain Metta’s activities, people started to understand.

How have Metta and the LAC helped shift community perception about PWID?

U Myint Thein Win: Speaking of my own experience, it took time for our views of people who use drugs to change, even though the committee participated in attending seminars and workshops held by Metta. We assisted people who use drugs and understood the facts about drug dependency, but it was hard to change our mindsets. Even I had to put a lot of effort into changing my mindset. It was difficult to change even ourselves, but changing the community around us was also challenging. However, over two years, people around us began to understand the activities of this organization and started to have empathy for people who use drugs.

[1] According to the Myanmar Integrated Biological and Behavioral Survey (IBBS) PWID, 2014, HIV prevalence among male PWID respondents in Bamaw and Waingmaw were 45% and 47%, respectively.

[2] Metta provides support to PWID through the drug user network group. At drug user network group meetings facilitated by Metta, members learn about harm reduction services and provide support to one another. Members also actively coordinate public awareness campaigns to change public perceptions of PWID. These campaigns aim to reduce discrimination against PWID and increase community acceptance of harm-reduction services. Metta also provides health education to family members of PWID to create an enabling environment without stigma and discrimination within the family.

This interview has been translated and edited. The views and opinions expressed within this interview are those of the interviewee and do not necessarily reflect those of PEPFAR, USAID, UNAIDS, Community Partners International, or Metta Development Foundation.
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USAID funds the USAID HIV/AIDS Flagship (UHF) Project under PEPFAR through UNAIDS Myanmar. Community Partners International provides project implementation support and management to partner organizations. The UHF Project supports Metta Development Foundation’s drop-in centers in Kachin and Northern Shan States.