HIV prevention through outreach approaches:

Pyi Gyi Khin (PGK) is designed to increase involvement and empowerment of vulnerable target groups, such as men who have sex with men (MSM), Sex Workers and their clients. They are in need of  information on HIV transmission, safer sex practices, condom accessible and HIV testing and Service (HTS). People who want to know their HIV status  and/or  in  need  of  STI  and  OI  treatment  will  be  identified  through  and  outreach education and also Care outside facilities (COF) / awareness raising session providing by Pyi Gyi Khin.

For 2017, PGK’s KP center previously known as Drop-in center will be providing “friendly spaces" where MSM and sex workers can discuss personal issues, sharing experiences, access to available services such as counseling, STI information and minor illness. Male and Female Condoms, Lubricates are also freely be provided. Additionally, promotion of HIV Counselling and Testing (HCT) service and STI information has been providing and it will reach among MSM, Sex Workers and their clients who are the most at risk through drop-in centers. PGK is also providing to get as one stop HIV screening tests and trying to make HIV confirmation tests for suspect cases in 2016, the approval is under process conducting by National AIDS Program and it will success in 2017.

Consequently outreach program, financial support for transportation (or) small incentives will be provided to clients who are coming to get HTS from PGK and he/she will get the same incentives in different day if confirmation test is required to conduct again.  In project  sites,  a  two  ways  referral  system  has  been  linked  between  AIDS/STD  team/ Townships Hospital and PGK. This prevention package (minimum) will link with treatment, care and support for the clients who are in HIV positive results. Post-test counseling and necessary monitoring are able provided to clients and regular ART follow up and adherence services are providing through volunteers/ SHG network.

Continuum care and support for People living with HIV/AIDS (PLHA);

This component is combined with 2 key activities (1) Provision of ART (2)Care Outside Facilities (COF) former called (HBC), Support following up and adherence.

Provision of ART and support

Starting from 2017, PGK has planned to start implementing 18 Key Population Service Centers (KPSC) and 1 DIC with the funding from GF. At PGK’ KPSC, we will apply satellite approach for ART in order to NAP guideline, registered client will then be referred to the ART centers for ART initiation and choice of regime for ART treatment starting. In addition to the current available services through trained Medical Staff and staff will be focused on ART follow up and supports it will be linked with available services such as OI treatment, Care Outside Facilities (COF) previously known as (HBC), and necessary Lab investigation. PGK also provides clinical monitoring, adherence and follow up/ defaulter tracing regularly for clients according to the standard guideline, technical guidance by Clinicians.

PGK also provides require laboratory examination as per under care of Medical officer which includes basic tests related to ART, CD4 counts (both base line and follow up) and Viral load testing as well an emergency hospital care will be provided when required. This ART satellite model approach will lead to encourage us the establishment of ART Decentralized Site with the close collaboration of respective ROs and Team (NAP) in these respective townships.

COF previously known as HBC / support and regular follow-up

Tthis activity is a part of the case management model it will be done by assigned volunteers such as volunteers / self- help  groups.  Nutrition  support  also  will  be  provided  to  PLHIV  regularly  monthly  basis according to with nutritional criteria. This model is including comprehensive case monitoring which are started at register/ enrollment for clients and up to viral load tests and their results. Defaulter tracing, adherence counseling and awareness of ART and prevention activities will be regularly conducted and TB screening with standard questions will conduct to all ART clients.

Capacity building for Staff and volunteers

Capacity building component is a key element of the project implementation through skills transfer. The knowledge will be improved in ART , Counseling/ adherence, behavior change communication (BCC) and Human Right education/ Practice   monitoring   through   training,   workshops   and coaching   sessions.   Technical assistance and guidance will be given by NAP Team and possible other external resources.

Geography and Beneficiaries

The number of target beneficiaries is more than 10,000 Key Population will be reached package of services and 4,800 ART clients will be received ART and support necessarily . The achievement will be counted cumulatively in one year period, 2017 at the 19 project townships in different states and Regions in Myanmar.

Aung Ban is a small town in Kalaw Township in Southern Shan State, it is known as High Burden Township in NSP. It is serves as a transit point for both travellers as well as for truckers who transport all types of cargoes from Shan State to mainland and vice versa. There also exists a thriving cattle market where cattle traders from the Dry Zone (central part of Myanmar) come up to sell their cattle to market lays in Thailand. Many young people from all over the country travel to Mongshu to work in gem mines. This is the existing project area which was initiated since 3 DF Phase I, providing both of prevention, care and treatment services.

Lawksawk (Yat Saut) / Ba Htoo and  Nansang (NamSan)  are newly planned site for prevention and KPSC townships for 2017 in order to recommendation of RO, Taungyi. Previously up to 2016, PGK implemented the prevention in Shwe Nyaung Township for MSM, FSW activities, however it is station town under Taunggyi Township and it was able covered by Taungyi for prevention and ART activities started in 2017 because Taungyi KPSC is newly proposed in 2017 . Therefore, PGK’ Shwe Nyaung DC will be moved to new township, Yat Saut as DIC for more effective implementation and avoiding target overlapping. Nansang (Nan Sam), It is located in Eastern Shan State and half day hour drive from Aungpan and it will under PGK’ management for site administration .It is known as medium burden township mentioned in NSP-3, but it will be potential for high burden and drainage ART strategically. KPSC services Sex Workers /MSM and their clients will be provided and ART will be linked with under Taungyi Team.

Taunggyi is the capital of Shan State and home to a large number of traditional ethnic tribes, including the Intha and the Pa-O,Strong NAP team is located at there and It is also High-High burden criteria. Most of the local people are depending heavily on Team for ART and Sat- San- Htun General Hospital, it is the biggest one in the township.

Myingyan  is  located  in  the  dry  zone  in  Mandalay  Region  with  approximate  population 290,000 (ref: 2014 Census) where HIV/AIDS awareness programs and activities are still limited among traditional Burmese community. This is the existing project area which was initiated since Phase I providing both of prevention, care and treatment services.

Pakokku, Magway and Chauk are townships within Magway Region. It is situated on the west bank of Ayeyarwaddy River which are priority townships for implementation of KPSC  in Magway region. It is rapidly developing and there are many travellers to Monwya (the capial town of Sagaing Region), Saw and Gangaw (townships of Magwe region), Mintut and Kanpalet (townships of Chin state). Pakokku is a newly extended project, starting in 2014 , it is well set up now with focuing on Care & support and Prevention services for PLHA and KPs. Shwebo township is in Sagai Region which also requested as new site in 2017 with the recommendation NAP.

Pathein is the capital of the Ayeyawaddy Region, approximately 500,000 ( ref:2014 Census) people, which is the transit point of two popular beaches for foreigners & locals. The influx of large mobile populations, in high frequency, can be considered as one of the major factors that led to high HIV prevalence rate in these project areas. This is the existing project area which was initiated since Phase I providing both of prevention, care and treatment services. Hinthada, Myaungmya will be intended to open new KPSC for 2017, which are also High Burden area for HIV prevention and ART program.

Maubin is extended in 2014 with focus on Prevention services for Sex Workers and MSM it is also priority to KPSC.

Hpaan, Thahtone, Myeik, Dawei and Kawthaung these townships are known as High Burden Area for HIV program, proposed to National program for further negotiation. Total 5 out of 19 townships will be recommended by respective RO for joint KPSC implementation in 2017.