World AIDS Day: Giving HIV-positive sex workers access to family planning

1 December 2016
A peer to peer knowledge sharing among sex workers in a café
A peer to peer knowledge sharing among sex workers in a café

Ma San San Aye, a woman in her forties with short hair, picked up the ringing mobile phone and spoke for a few minutes. “Sorry, it’s one of my peers,” she apologized with a smile, and continued the conversation. It was about her life, full of harsh struggles. She said she had had faced difficult and trying times as a sex worker before landing at her current job as a peer educator. “In those days, life was harsh. I was arrested and got a two year sentence in 2005. It was like hell. Other inmates looked down on us, just because we were sex workers. We were marginalized. I felt dejected then.”

After the release from jail, the worst came. San San Aye found herself HIV positive. “I was in despair beyond description. I just shut myself up, stayed at home, shunned all visitors, and cried, cried, cried for a month.” However, she was found a way forward. She received antiretroviral treatment (ART) from an NGO, and later became a peer educator. Her personal life changed for better, too. She married a man who understood her challenges in life, and who gave her a sense of worth.

Now, San San Aye has been a peer educator for Myanmar Anti-Narcotic Association (MANA) for almost four years. She works for MANA’s HIV Prevention Project, funded by UNFPA, the United Nations Population Fund. The initiative takes an integrated approach to HIV prevention on the one hand, and sexual and reproductive health on the other. As part of offering treatment and care for key populations such as female sex workers, it includes a new focus on reducing unintended pregnancies as well as improving access to antenatal, delivery and post-natal care, including ART.

This new integrated approach will help strengthen the health system to provide sexual and reproductive health services to sex workers, including family planning, maternal health care and HIV prevention. Dr. Daw Ni Ni Khaing, UNFPA HIV and AIDS Program Officer, explains: “The program ensures that poor, vulnerable, most at-risk, and geographically remote populations have access to high-quality health services, including reproductive health care and services to prevent and treat HIV.”

San San Aye agrees: “Traditionally, female sex workers have been regarded as a kind of pleasure commodity. Now, the attitude should be changed. Female sex workers also have feelings. They also breathe, live, get married, and die like other people.” She tells a story about how she helped a young female sex worker:

“The girl, from an outlying suburb of Yangon, first worked as a housemaid, was raped by her landlord, and later became an HIV positive sex worker. When I found her, I shared my knowledge on sexual and reproductive health, HIV, and basic human rights. The girl is better now. But there are many more sex workers who need knowledge and help. I am always ready to help them, because I want them to feel like human beings again.”

In 2016, has UNFPA invested over US$200,000 into HIV prevention through four local partner organizations: National AIDS Program, Myanmar Anti-Narcotic Association, Alliance on HIV/AIDS, and Aye Myitta Association.