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The stigma of HIV/AIDS in Little Burma

It’s low paid, difficult and often dangerous work. But Thailand’s fishing industry provides employment for tens of thousands of Burmese migrants who have fled their country in search of a better life.

Many of them work in Mahachai – nicknamed Little Burma – 45 kilometers southwest of Bangkok. Most dockworkers here earn the minimum wage of 200 Baht, or six dollars a day.

The workers face numerous hazards. About a third of them are not officially registered, making them targets for harassment by extortion gangs and the authorities.

They are poorly educated and dream of one day returning home. But many of them also enjoy new freedoms that were taboo in their own country, including sexual experimentation and multiple partners. And that makes them vulnerable to HIV, especially the younger workers.

The majority of HIV infections among Burmese migrant workers is among the 15 to 25-year-olds”, said Zayar Lin from Foundation for Education and Development. “That is because of two reasons, the first being that they want to explore more, the second is the low awareness of HIV and AIDS.”

He said the problem is you don’t really talk about these things in Burma, so when young Burmese come to Thailand, they have lots of opportunities to experiment, but they lack basic knowledge of how to protect themselves from Sexually Transmitted Infections (STIs). And they don’t know the dangers of HIV.

The Raks Thai Foundation runs a drop-in center, an informal place where Burmese migrants can safely access information about HIV/AIDS prevention and treatment.

Here Burmese migrants are shown how to use condoms and protect themselves from HIV and other sexually transmitted diseases. They can also access peer support services and counseling.

New is a Peer Support Counselor at The Buddy Center.

They need to know more, so they read information, education and communication pamphlets here so they will learn about the transmission of HIV and sexually transmitted infections, and how to prevent HIV and STIs.”

The center provides services and knowledge that most of the migrant workers and their families did not have access to in Burma, officially known as Myanmar.

Forty-two-year-old Tin Tin Aye has been coming to the center since her husband died of an AIDS-related illness seven years ago.

“I had heard about HIV but I had never seen or used a condom when I was living in Burma,” she said.

Migrant workers can also obtain referrals for health check-ups, treatment and support from a nearby clinic.

But despite Raks Thai being a “safe place” that offers anonymity, many Burmese still fear stigma and discrimination if they contract HIV.

When they are HIV positive they don’t want to tell their relatives, their husband or their wife, especially when they become very, very ill and nobody takes care of them”, said health advisor Dr Khin Thant Zin. “At that time they come to Raks Thai instead. Usually they are afraid of discrimination and stigma in their community, that’s why they come to us very late.”

International agencies have been working for many years to improve working conditions and legal rights for some 2.5 million Burmese migrant workers in Thailand, and have made strides in some areas.

Yoshiteru Uramoto is the Asia Pacific Regional Director of International Labour Organisation (ILO). He said that Thailand has done a good job compared to other Asian countries, but thinks the ideal situation would be if the migrant workers get integrated under the social protection scheme.

Fishing and non-commercial vessels is an area that we need to still give some attention,” he said. “But I think we are very much into introducing some institutional arrangements, legal measures. Humanitarian assistance is important, that’s the start, but we also need to have some institutions to protect migrant workers from all sorts of issues, and HIV is one of them.”

The 11th International Congress on AIDS in Asia and the Pacific (ICAAP 2013) will be held on 18-23 November 2013, in Bangkok, Thailand. The theme is “Asia/Pacific Reaching Triple Zero: Investing in Innovation”.