World AIDS Day: "We can live like other people."

Community organization New Life helps people living with HIV (PLHIV) in rural villages in Myanmar’s Mandalay Region. We talk to an HIV-positive client, a peer educator, and New Life’s co-founder about their experiences during Myanmar’s crisis.

“The counseling session…gave me the strength to survive.”

“In 2014, I fell ill,” explains Cho Mar*, 50, a disabled mother of three children who lives in a village near Pyin Oo Lwin in Myanmar. “I was tested and found out that I was HIV positive. They tested my husband and he was also positive.”

Cho Mar struggled to come to terms with the diagnosis. “I felt extremely depressed, and I thought about suicide,” she reveals. “There are no words to describe my feelings at that time.”

One of the first people she spoke to at the hospital after her diagnosis was a counselor from the community organization New Life. “The counseling session with the New Life volunteer gave me the mental strength to survive,” Cho Mar shares. “I realized there were many others like me living with HIV and that we can live like other people if we take the treatment regularly.”

New Life has continued to support Cho Mar until today. “New Life provided cash support when my husband was hospitalized. When I come for antiretroviral therapy follow-up, they support the transportation charges.”

Tragically, Cho Mar’s husband passed away two years ago. The family began to struggle financially when he had to give up his civil servant job due to poor health. “When he was alive, he was often hospitalized,” she explains. “After he passed away, I had to support my children. As I don’t own anything, I have to struggle for them. I’m working as a cook at a nearby farm. I earn 90,000 kyats each month (about $42). We are struggling with financial hardship.

“Most of our clients have lost their jobs since the coup and COVID-19.”

The impact of COVID-19 and the February 2021 coup and ensuing turmoil have plunged Myanmar into crisis. The UN estimates that at least half of the population has now fallen into poverty. As the health system struggles to sustain services, PLHIV risk delays in HIV diagnosis and interruptions in HIV treatment such as antiretroviral therapy (ART). These can be devastating for those with weakened immune systems, leaving them vulnerable to opportunistic infections. Falling incomes and collapsing livelihoods make it harder for PLHIV to afford the nutritious food that they need to maintain their health.

Co-founder and president of New Life Aye Aye Naing sees the impact every day. “Most of our clients have lost their jobs since the coup and COVID-19,” she confirms. We try to provide additional support to meet their needs.”

Inflation and the worsening security situation have also driven up costs. “We usually provide clients with 5,000 kyats (about $2.4) for transport costs for ART follow-up,” Aye Aye Naing explains. “But the actual cost is now as much as 20,000 kyat (about $9.5). We try to find donors to make up the difference.”

As a person living with HIV, Aye Aye Naing knows well the challenges faced by New Life’s clients. “In 2006, I fell seriously ill and was hospitalized for about 2 years with HIV and other opportunistic infections,” she reveals. “I could not breathe without oxygen support. I didn’t think I would survive. But I did, and I started on ART. I began volunteering at New Life and was later employed by the organization.”

With support from Community Partners International (CPI), New Life provides a range of essential services to more than 1,000 PLHIV. “As well as transport costs for ART follow-up, we support home-based care for sick patients, counseling services, nutrition support, medicine and other support for opportunistic infections, and referral services for hospitalization and viral load testing,” Aye Aye Naing confirms. “We also provide microloans to support income generation for our clients.”

“Even if I could not prevent HIV myself in my life, I will try my best for other women,”

New Life supports a network of peer educators who help to bring information about HIV prevention, testing, and treatment to key populations. Key populations are those at higher risk of HIV infection, such as people who inject drugs (PWID), men who have sex with men (MSM), female sex workers (FSW), and transgender people. These key populations bear a significant burden of Myanmar’s HIV epidemic. Data from 2019 reveal that 19% of PWID, 8.8% of MSM, and 8.3% percent of FSW tested for HIV were positive. That compares to an estimated HIV prevalence of 0.8% in the general Myanmar population aged between 15 and 49.

“During COVID-19, all the entertainment centers, including massage parlors and karaoke bars, closed,” reveals Than Than Aung*, 37, a New Life peer educator and sex worker who is also HIV positive. “All the sex workers lost their income. Then, the coup happened, and we faced more struggles.”

The situation means that Than Than Aung finds it difficult to carry out her outreach work providing HIV prevention, testing, and treatment information to fellow sex workers. “I can’t visit them because of COVID-19 and security restrictions,” she explains. “But I contact them by phone instead to counsel them. If a new worker comes to our house, I share HIV prevention information with them. If they want to take a test, I connect them with the hospital or with New Life.”

PLHIV must also contend with enduring stigma and discrimination around HIV. “I worry that, if people in my neighborhood know about my HIV status, my children will be rejected or humiliated,” explains New Life client Cho Mar. “I don’t mind for myself, but I do for my children. I did tell my brother about it, though, and he encourages and supports me.”

So far, Cho Mar has not faced difficulties in accessing ART, but she worries about the future. “We are still able to access ART through the hospital,” she confirms. “After the coup, I heard the hospital was closed and couldn’t provide any services. I had the drugs in hand for six months at that time. Now the hospital is open again but I think it could change anytime due to the instability. I heard about the situation elsewhere with many people displaced by conflict. I sympathize with the people living with HIV in these regions. If we face conflict here, I am concerned about accessing ART and other services. I don’t know what I will do.”

Despite the many challenges faced by PLHIV in Myanmar, New Life peer educator Than Than Aung is staying hopeful. “Even if I could not prevent HIV myself in my life, I will try my best for other women,” she says. “I want to tell those living with HIV not to give up on life. I hope we all can get access to ART. It would be wonderful if we could be cured.”

*Name changed to protect privacy.