The cumulative results for 2021 are shown as a percentage of the annual target. The indicators on sex workers, men who have sex with men, and people who inject drugs reached, along with HIV counselling and testing and TB status assessed, are funded by GFATM only, whereas the others are funded by GFATM and other donors.
In 2021, the COVID-19 pandemic continued to cause much uncertainty around the world, including for people living with and affected by HIV. Moreover, in Myanmar, the political situation brought up many challenges in the way programmes were implemented in the country. In these times of crisis, PR-UNOPS and its implementing partners continued to work hard to preserve the continuation of essential health services while undertaking COVID-19 infection control measures so that the interventions were ensured not to be interrupted.
The third wave of COVID-19 has hit the country in 2021 and there have been many challenges in implementing the activities. Therefore, implementation approaches were adopted in line with the needs at the ground level and could continue to provide Antiretroviral Therapy (ART) to the People Living with HIV (PLHIV), and provision take-home doses to the majority of the Methadone clients. Clients were also allowed to access services at the nearby location in case of lock down or travel restriction, to assure the continuation of service.
By the end of 2021, 165,919 people living with HIV were receiving antiretroviral therapy (87% of the planned target for the year). The PLHIV’s access to ART was disrupted due to travel restrictions and insecurity in some States/Regions where people cannot cross townships to receive the treatment. In these cases, ARVs were delivered to the Township border so that clients could have easy access to them. Moreover, Multi-month Dispensing of ART was implemented to prevent disruption of ART in case of a full lockdown.
About 264,232 (26% of target) pregnant women received HIV counseling and testing and knew their test results, and 10% of HIV-positive pregnant women received antiretroviral drugs to prevent mother-to-child transmission of HIV (PMTCT) provided as part of a package of antenatal care services offered to all pregnant women at public health facilities in Myanmar. This represents 90% of those who tested positive but only 10% of the national estimate of positive pregnant women.
In 2021, in addition to ordinary outreach and Drop-in Center approaches, new innovative approaches such as online prevention consultation, community based testing (CBS) approaches were implemented. Although new innovative approaches were used, there were a high number of movement restrictions and gathering restrictions across regions that affected the achievement of HIV prevention programs. 13,235 (36% of target) men who have sex with men (MSM), 14,832 (40%) female sex workers (FSW) and 23,281 (87%) people who inject drugs (PWID) were reached with HIV prevention services. In total, 15,532 (46%) FSW and 15,567 (46%) MSM underwent voluntary HIV testing and received their test results and post-test counseling. About 19,300 (67%) PWID consented to HIV testing and received their test results.
At the end of 2021, 19,300 (67%) PWID had been enrolled in methadone maintenance therapy (MMT) in 86 MMT sites across the nation, and 79% of persons who enrolled in MMT continued the treatment for at least six months. To ensure uninterrupted MMT, implementing partners practiced take-home methadone dosages to reduce the frequency of visits to the MMT Centers by the clients while practicing physical distancing among the clients and infection control measures.
In terms of needle and syringe distribution to PWID, the equivalent of 471 (94% of target) needles and syringes per person were distributed in 2021. This high achievement was due to innovative approaches such as secondary NSEP distribution points and community based distribution approaches were developed and implemented as per HIV contingency plan on Covid 19 guidance.
In 2021, 40,716 (63% of target) of other vulnerable populations (OVP) consented to HIV testing and received their test results and post-test counseling.
About 47% of new HIV-positive patients started isoniazid preventive therapy (IPT). Moreover, 60% (61% of target) of HIV patients were screened for TB during their last visit. Amidst Covid, many of the HIV clinics were restricted from gathering and it was managed to reduce patient contact time as well as frequencies of visits. Therefore it affected the TB screening and IPT enrollment.
