World AIDS Day: “I visit patients’ houses secretly to look after them when they are too ill to go to hospital.”

Thiri, 37, who lives in Minbu, a rural township in Magway Region, central Myanmar, found out that she was HIV positive during a routine check-up while pregnant in 2013. She was afraid and alone. “I was so scared that others would find out that I had HIV, so I didn’t leave the house for a long time. I couldn’t tell my parents.”

“As I am also living with HIV, they trust me and can feel that I understand their situation.”

Thiri worried about the health of her unborn daughter. When she was born, her daughter was tested and was HIV-negative. Thiri was hugely relieved. However, soon afterward, her husband died. Grieving, coming to terms with her HIV status, and needing to care for her young daughter, Thiri faced many hardships.

During this period, she was visited by friends of her husband, who were members of the Myanmar Positive Group, a national grassroots support network of people living with HIV (PLHIV). “They came to me, gave me information about HIV, and encouraged me not to be sad.”

In 2013, antiretroviral therapy (ART) medication was not available in Minbu. Thiri had to travel nearly four hours north to the town of Pakokku, where she could receive treatment. She ran a small business but struggled to afford the cost of traveling to Pakokku and living there during treatment. Today, PLHIV can access free treatment in Minbu through Myanmar’s National AIDS Program.

In 2016, Thiri accepted a care provider and counselor role with the Myanmar Positive Group. “HIV is such a sensitive subject in Myanmar. When working with PLHIV, you must have a strong bond of trust and honesty. As I am also living with HIV, they trust me and can feel that I understand their situation. I want to share my experience to help them overcome their difficulties and gain acceptance from their loved ones like I did.”

“We make it easier for clients and their families when they are hospitalized.”

With technical and financial assistance from Community Partners International (CPI), the Myanmar Positive Group supports PLHIV with the cost of transportation to and from the hospital for treatment and to collect medication, and helps cover hospitalization expenses. The group also provides PLHIV with supplementary nutrition, including beans, rice, and cooking oil, to help clients maintain their health. Thiri supports the Myanmar Positive Group in its outreach to more than 600 PLHIV in Magway and Minbu townships. Her primary role is to provide counseling.

“I counsel clients before and after HIV testing to support them and help them come to terms with their diagnosis. As a care provider, I follow up regularly with my clients to check their health. I must ensure they understand and follow the medical checkup and treatment schedule. I explain to them how to live safely with HIV and prevent transmission. I encourage them to persuade their family members to get tested. By supporting some of the expenses, we make it easier for clients and their families when they are hospitalized.”

She also helps her clients to get medication from the local hospital. “Some of my clients only know the Myanmar traditional calendar. So, I use the regular and traditional calendar to tell them which day they must come to collect medicine.”

“If we take regular medication and follow what the doctor says, we can live just like other people.”

Sometimes, her clients ask her to counsel their families to help them understand and accept the diagnosis. “Some of my clients find it very difficult to tell their family that they have HIV. So, I ask them to bring the family members whom they trust most to me, and I explain to them what HIV is and that it is quite easy to prevent transmission. I emphasize that, as family members, their support to their loved one who has HIV is essential.”

The stigma associated with HIV in Myanmar means that Thiri has to be very discreet when working with her clients. “Most people in this town know that I work with the Myanmar Positive Group, so I have to be very careful when contacting patients. Mostly, I contact them by phone. Sometimes, I visit patients’ houses secretly to look after them when they are too ill to go to the hospital. I must check with them before I visit to ensure they are alone. I don’t ask people in the neighborhood for directions if I have difficulty finding the client’s home.”

​As a person living with HIV, Thiri is committed to supporting others who share her situation. “If I can overcome these challenges, I can help others. I tell my clients who are living with HIV that they don’t need to be scared or feel humiliated. If we take regular medication and follow what the doctor says, we can live just like other people.”

An estimated 240,000 people are living with HIV in Myanmar today, a prevalence of 0.8% in adults aged 15-49. While better outreach and access to care have led to significant reductions in HIV infections between 2010 and 2017, there is still a high number of new HIV infections in Myanmar each year. In 2018, there were an estimated 11,000 new HIV infections and 7,500 AIDS-related deaths. The grassroots activities of organizations like Myanmar Positive Group and individuals like Thiri are crucial in helping to prevent new HIV infections and providing care and support to people living with HIV.

Community Partners International (CPI) has provided technical and financial assistance to the Myanmar Positive Group since 2018 to support its work in the Magway Region, Ayeyarwady Region, Kayah State, and Shan State.

Names have been changed to protect privacy.