# data[].attributes.headline
POST 1: Prevalence, prevention and stigma of HIV in affected populations in South East Asia

# data[].attributes.subject
POST 1: Prevalence, prevention and stigma of HIV in affected populations in South East Asia

# data[].attributes.body
We chose this topic because of the relevance in our countries as they account for the majority of HIV infections in the South East Asia Region (with the addition of Nepal) according to the WHO report in 2010.

# data[].attributes.body
HIV stigma was prevalent in our region. People from all our states harboured hostile views towards people with HIV. In some countries it is believed to be a punishment from God. Even relatives and children of HIV positive individuals are harshly stigmatised as shown in the video.
In Mynmar, HIV prevention is connected to a “cultural queasiness”. A dis-ease of the emotions, transmitted through the existence of HIV prevention work and linking HIV transmission with ‘bad behaviour’.

Video showing stigma affecting children of HIV postitive parents in  Myanmar
https://www.youtube.com/watch?v=eKhwwVuUoag

# data[].attributes.attachment_link.title
Thailand - Stigma and discrimination in healthcare

# data[].attributes.body
Thailand’s 100% Condom Program, which began in 1991 to offer condoms free of charge nationwide, particularly to sex workers and brothels, is widely credited with averting a generalised HIV epidemic in the country.

In Myanmar condom use is associated with sex work and infidelity.

Video shows prevention interventions done by peer worker:
https://www.youtube.com/watch?v=Yi0cgFXrcyI

India’s HIV/AIDS prevention programme is running out of condoms, amid delays to its government funding. India provides free condoms under its community based HIV/AIDS prevention programme that targets high risk groups, including sex workers and injecting drug users. The Avahan India AIDS Initiative was implemented to provide HIV prevention services to key populations including female sex workers (FSWs) who carry the burden of India’s concentrated HIV epidemic. The belief that HIV could not be prevented contributed to inconsistent condom use, while in other areas, low levels of condom access were a more important barrier to consistent condom use.

# data[].attributes.body
While, in general, the most at risks population remain people who inject drugs, MSM and sex workers, we found that a population that was particularly affected by HIV were in fact young people/ adolescents.

In Myanmar in 2018, young people (aged 15-24 years) accounted for 55% of new infections.

In 2018, around half of new HIV infections in Thailand occurred among people aged 15-24.

The region of Papua in Indonesia has by far the highest prevalence of HIV in the country at 2.3%, a high proportion of which are said to be young women.

Factors effecting HIV prevalence among young people in our region includes:

-          Lack of sex education
-          Negative attitudes towards condoms

-          taboos regarding adolescent sexuality,

-          cultural emphasis on purity and virginity,

-          and poor access to HIV services and information

# data[].attributes.body
With one of the highest HIV prevalence in Asia and the Pacific, Thailand accounts for 9% of the regions total population of people living with HIV, but many efforts have been made to combat new diagnoses such as the awareness campaign “PrEP in The City" which was created to increase the uptake specifically amongst transgender women.

# data[].attributes.attachment_link.title
ไม่ว่าคุณจะเป็นใคร ทำความรู้จักเพร็พวันนี้ #เพร็พเดียวอยู่

# data[].attributes.body
Myanmar

"Aye Myanmar Association." 2017. https://www.amamyanmar.org/.

​Aung, Poe Poe, Claire Ryan, Ashish Bajracharya, Naanki Pasricha, Zaw Win Thein, Paul A. Agius, Than Tun Sein, et al. 2017. “Effectiveness of an Integrated Community- and Clinic-Based Intervention on HIV Testing, HIV Knowledge, and Sexual Risk Behavior of Young Men Who Have Sex With Men in Myanmar.” Journal of Adolescent Health 60 (2): S45–53. https://doi.org/10.1016/j.jadohealth.2016.09.006.

Aung, Tin, Ethi Paw, Nyo Me Aye, and Willi McFarland. 2014. "Coverage of HIV Prevention Services for Female Sex Workers in Seven Cities of Myanmar." AIDS and Behavior 18 Suppl 1 (0 1): S37-S41. https://doi.org/10.1007/s10461-013-0523-z. https://pubmed.ncbi.nlm.nih.gov/23695521, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867543/.

Fletcher, Gillian. 2011. “The Cultural Queasiness Factor: Intersections of Gender, Sexuality and HIV Prevention in Burma/Myanmar.” Asian Studies Review 35 (2): 189–207. https://doi.org/10.1080/10357823.2011.575204.

Htat, H. W., K. Longfield, G. Mundy, Z. Win, and D. Montagu. 2015. "A Total Market Approach for Condoms in Myanmar: the Need for the Private, Public and Socially Marketed Sectors to Work Together for a Sustainable Condom Market for HIV Prevention." Health Policy Plan (1460-2237 (Electronic)): i14-22.

“HIV and AIDS in Myanmar | Avert.” n.d. Accessed April 8, 2021. https://www.avert.org/professionals/hiv-around-world/asia-pacific/myanmar.

Médecins du Monde. 2018. "Médecins du Monde - Harm Reduction in Myanmar" https://www.youtube.com/watch?v=Yi0cgFXrcyI.

Mon, Hnin Su. 2016. “Sex Work, Beyond the Choices: An Exploratory Qualitative Study of Female Sex Workers in Yangon, Myanmar.”

Phyu Phyu Thin Zaw, Edward McNeil, Kyaw Oo, Tippawan Liabsuetrakul, and Thien Thien Htay. 2021. “Abstinence-Only or Comprehensive Sex Education at Myanmar Schools: Preferences and Knowledge among Students, Teachers, Parents and Policymakers.” Sex Education 21 (1): 75–90. https://doi.org/10.1080/14681811.2020.1749043.

Phyu, Phyu, Thin Zaw, Tippawan Liabsuetrakul, Edward Mcneil, and Thien Thien Htay. 2013. “Gender Differences in Exposure to SRH Information and Risky Sexual Debut among Poor Myanmar Youths.” http://www.biomedcentral.com/1471-2458/13/1122.

PLUS, 5. 2020. "Sezar Yaung Chi HIV/AIDS Foundation Myanmar" https://www.youtube.com/watch?v=eKhwwVuUoag.

Swe, Lin Aung, and Abdul Rashid. 2013. “HIV Prevalence among the Female Sex Workers in Major Cities in Myanmar and the Risk Behaviors Associated with It.” HIV/AIDS - Research and Palliative Care 5 (August): 223–30. https://doi.org/10.2147/HIV.S50171.

Thein, Si Thu, Tin Aung, and Willi McFarland. 2015. “Estimation of the Number of Female Sex Workers in Yangon and Mandalay, Myanmar.” AIDS and Behavior 19 (10): 1941–47. https://doi.org/10.1007/s10461-015-1169-9.

Thwe, M. 2004. "HIV/AIDS Education and Prevention in Myanmar." AIDS Educ Prev 16 (3 Suppl A): 170-7. https://doi.org/10.1521/aeap.16.3.5.170.35524.

Veronese, Vanessa, Emily Clouse, Andrea L. Wirtz, Kaung Htet Thu, Soe Naing, Stefan D. Baral, Mark Stoové, and Chris Beyrer. 2019. “We Are Not Gays.. Don’t Tell Me Those Things": Engaging ‘hidden’ Men Who Have Sex with Men and Transgender Women in HIV Prevention in Myanmar.” BMC Public Health 19 (1). https://doi.org/10.1186/s12889-018-6351-3.

Veronese, Vanessa, Zaw Min Oo, Zaw Win Thein, Poe Poe Aung, Bridget L. Draper, Chad Hughes, Claire Ryan, Alisa Pedrana, and Mark Stoové. 2018. “Acceptability of Peer-Delivered HIV Testing and Counselling Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Myanmar.” AIDS and Behavior 22 (8): 2426–34. https://doi.org/10.1007/s10461-017-2022-0.

WHO - World Health Organization (2010) HIV/AIDS in the South-East Asia Region. Available at: https://www.who.int/hiv/pub/surveillance/Searo_HIV-AIDS_HIV_report2010_2.pdf (Accessed: April 12, 2021).

World Bank. 2017. “Myanmar Living Condition Survey. Poverty Report.”

Thailand

Amendra, Aurora. 2021. "How The Pandemic Has Upended The Lives Of Thailand's Sex Workers." Goats and Soda, February 3, 2021. https://www.npr.org/sections/goatsandsoda/2021/02/03/960848011/how-the-pandemic-has-upended-the-lives-of-thailands-sex-workers?t=1617976187932.

Hasan, Md Kamrul. “AIDS-Related Stigma in Thailand.” Millennial Asia 3, no. 2 (2012): 187–206. https://doi.org/10.1177/097639961200300204.

"HIV/AIDS Data Hub For The Asia Pacific". 2021. HIV/AIDS Data Hub For The Asia Pacific. https://www.aidsdatahub.org/country-profiles/thailand.

"HIV And AIDS In Thailand". 2020. Avert. https://www.avert.org/professionals/hiv-around-world/asia-pacific/thailand.

Rojanapithayakorn, Wiwat. 2006. "The 100% Condom Use Programme in Asia." Reproductive Health Matters 14 (28): 41-52. https://doi.org/10.1016/S0968-8080(06)28270-3.

Srithanaviboonchai, Kriengkrai, Suwat Chariyalertsak, Jiraluck Nontarak, Sawitri Assanangkornchai, Pattapong Kessomboon, Panwadee Putwatana, Surasak Taneepanichskul, and Wichai Aekplakorn. 2017. "Stigmatizing Attitudes toward People Living with HIV among General Adult Thai Population: Results from the 5th Thai National Health Examination Survey (NHES)." PloS One 12 (11): e0187231-e0187231. https://doi.org/10.1371/journal.pone.0187231. https://pubmed.ncbi.nlm.nih.gov/29145519, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690635/.

"Thailand HIV Factsheet". 2020. Unaids.Org. https://www.unaids.org/en/regionscountries/countries/thailand.

Weniger, Bruce G., Khanchit Limpakarnjanarat, Kumnuan Ungchusak, Sombat Thanprasertsuk, Kachit Choopanya, Suphak Vanichseni, Thongchai Uneklabh, Prasert Thongcharoen, and Chantapong Wasi. 1991. "The Epidemiology Of HIV Infection And AIDS In Thailand". AIDS 5 (Supplement): 71-86. doi:10.1097/00002030-199101001-00011.

ไม่ว่าคุณจะเป็นใคร ทำความรู้จักเพร็พวันนี้ #เพร็พเดียวอยู่. YouTube. YouTube, 2020. https://www.youtube.com/watch?v=OQT0pVHVFFg&t=1s.

India

"PrEPMAP: Your Guide to PrEP in Asia and the Pacific." 2018. APCOM Foundation. https://www.prepmap.org/prep_status_by_country#india.

Bharat, Shalini, Peter Aggleton, and Paul Tyrer. 2001. India: HIV and AIDS-Related Discrimination, Stigmatization and Denial. Vol. 3. Geneva: UNAIDS Geneva, Switzerland.

Cousins, Sophie. 2015. "India’s HIV Prevention Programme is Running Out of Condoms." BMJ: British Medical Journal 351: h6066. https://doi.org/10.1136/bmj.h6066. https://www.bmj.com/content/bmj/351/bmj.h6066.full.pdf.

Ekstrand, Maria L, Jayashree Ramakrishna, Shalini Bharat, and Elsa Heylen. 2013. "Prevalence and Drivers of HIV Stigma among Health Providers in Urban India: Implications for Interventions." Journal of the International AIDS Society 16: 18717.

Misra, Gunjika, Damodar Sahu, Umenthala S Reddy, and Saritha Nair. 2019. "Correlates of HIV Prevalence among Female Sex Workers in Four North and East Indian States: Findings of a National Bio-Behavioural Survey." International Journal of STD & AIDS 30 (2): 120-130. https://doi.org/https://doi.org/10.1177%2F0956462418799018.

Press Trust of India. 2018. "India has Highest Number of Children, Teens with HIV in South Asia: Report." The Hindu, November 30, 2018. https://www.thehindu.com/sci-tech/health/india-has-highest-number-of-children-and-adolescents-living-with-hiv-in-south-asia-unicef-report/article25631057.ece#.

Sagade, Jaya, and Christine Forster. 2018. "Recognising the Human Rights of Female Sex Workers in India: Moving from Prohibition to Decriminalisation and a Pro-Work Model." Indian Journal of Gender Studies 25 (1): 26-46. https://doi.org/https://doi.org/10.1177%2F0971521517738450.

Santoshini, Sarita. 2016. "Right to Work: Sex Workers in India Organize to Fight Discrimination." September 23, 2016. https://www.bitchmedia.org/article/right-work/sex-workers-india-organize-fight-discrimination.

Weiner, Renay, Micah Fineberg, Bridget Dube, Prabuddhagopal Goswami, Shajan Mathew, Gina Dallabetta, and Saul Johnson. 2018. "Using a Cascade Approach to Assess Condom Uptake in Female Sex Workers in India: a Review of the Avahan Data." BMC Public Health 18 (1): 897. https://doi.org/10.1186/s12889-018-5842-6. https://doi.org/10.1186/s12889-018-5842-6.

Indonesia

"“Dolly” Brothel Remains Open Despite Closure Of Red-Light Distri." 2014. Retail News Asia, June 20, 2014. https://www.retailnews.asia/indonesia-to-close-down-all-red-light-districts-by-2019/dolly-brothel-remains-open-despite-closure-of-red-light-distri/.

Boellstorff, Tom. 2004. "Playing Back the Nation: Waria, Indonesian Transvestites." Cultural Anthropology 19 (2): 159-95. https://doi.org/http://dx.doi.org/10.1525/can.2004.19.2.159.

Cempaka, Rissa, Brigitta Wardhani, Anak Agung Sagung Sawitri, Pande Putu Januraga, and Benjamin Bavinton. 2020. "Prep Use Awareness And Interest Cascade Among MSM And Transgender Women Living In Bali, Indonesia". Tropical Medicine And Infectious Disease 5 (4): 158. doi:10.3390/tropicalmed5040158.

Fauk, Nelsensius Klau, Anastasia Suci Sukmawati, Pius Almindu Leki Berek, Ernawati, Elisabeth Kristanti, Sri Sunaringsih Ika Wardojo, Isaias Budi Cahaya, and Lillian Mwanri. 2021. "Barriers to Hiv Testing among Male Clients of Female Sex Workers in Indonesia." International journal for equity in health 17 (1). doi: 10.1186/s12939-018-0782-4.

Fauk, Nelsensius Klau, Maria Silvia Merry, Theodorus Asa Siri, Fabiola Tazrina Tazir, Mitra Andhini Sigilipoe, Kristin Oktanita Tarigan, and Lillian Mwanri. 2019. "Facilitators To Accessibility Of HIV/AIDS-Related Health Services Among Transgender Women Living With HIV In Yogyakarta, Indonesia". AIDS Research And Treatment 2019: 1-10. doi:10.1155/2019/6045726.

Fauk, Nk Auid-Orcid, C. Y. Kustanti, D. S. Liana, N. Indriyawati, R. Crutzen, and L. Mwanri. 2018. "Perceptions of Determinants of Condom Use Behaviors Among Male Clients of Female Sex Workers in Indonesia: A Qualitative Inquiry."  (1557-9891 (Electronic)).

Hewat, Sarah. “Love as Sacrifice: The Romantic Underground and Beliefs about HIV/AIDS in Manokwari, Papua”. In Making Sense of AIDS: Culture, Sexuality, and Power in Melanesia, edited by Leslie Butt and Richard Eves, 150-167. Honolulu: University of Hawai’i Press, 2008.

Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS Data 2019. Geneva, 2019. URL: https://www.unaids.org/sites/default/files/media_asset/2019-UNAIDS-data_en.pdf

Joint United Nations Programme on HIV/AIDS (UNAIDS). Country Factsheet: Indonesia. 2019. URL: http://www.unaids.org/en/regionscountries/countries/indonesia

Joint United Nations Programme on HIV/AIDS (UNAIDS). The Gap Report. Geneva, 2014. URL: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf

Ministry of Health (MoH) Indonesia. Mathematic Model of HIV Epidemic in Indonesia, 2008–2014. Jakarta, 2008.

Morin, Jack. “It’s Mutual Attraction”: Transvestites and the Risk of HIV Transmission in Urban Papua.” In Making Sense of AIDS: Culture, Sexuality, and Power in Melanesia, edited by Leslie Butt and Richard Eves, 41–70. Honolulu: University of Hawai’i Press, 2008.

Prabawanti, Ciptasari, Arie Dijkstra, Pandu Riono, and Gagan Hartana Tb. 2014. "Preparatory Behaviours and Condom Use During Receptive and Insertive Anal Sex among Male-to-Female Transgenders (Waria) in Jakarta, Indonesia." Journal of the International AIDS Society 17 (1). doi: 10.7448/IAS.17.1.19343

Riono, Pandu, and Stephen J. Challacombe. 2020. "Hiv in Indonesia and in Neighbouring Countries and Its Social Impact." Oral diseases 26 (1): 28-33.

Toomistu, Terje. 2019. "Embodied Notions of Belonging: Practices of Beauty among Waria in West Papua, Indonesia." Asian Studies Review 43(4): 581-99.

Toomistu, Terje. 2019. "Playground Love: Sex Work, Pleasure, and Self-Affirmation in the Urban Nightlife of Indonesian Waria." Culture, health & sexuality 21 (2): 205-18.

Waluyo, Agung, Gabriel J. Culbert, Judith Levy, and Kathleen F. Norr. 2015. "Understanding HIV-Related Stigma among Indonesian Nurses." The Journal of the Association of Nurses in AIDS Care: JANAC 26 (1): 69-80. https://doi.org/10.1016/j.jana.2014.03.001. https://pubmed.ncbi.nlm.nih.gov/24759060, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519004/.

World Health Organisation. Review of the National Health Sector Response to HIV in the Republic of Indonesia. 2017. URL: https://www.who.int/docs/default-source/searo/indonesia/hiv-country-review-indonesia2017-eng.pdf?sfvrsn=fb6566d3_2

World Health Organisation. WHO Implementation Tool for Pre-Exposure Prophylaxis (PrEP) of HIV Infection. Geneva, 2017. URL: https://apps.who.int/iris/bitstream/handle/10665/258509/WHO-HIV-2017.27-eng.pdf?sequence=1&isAllowed=y

# data[].attributes.body
Another population we focused on is that of female sex workers, who are considered at risk in all of our states. There are problems connected to recording data in such marginalised and stigmatised population, especially when based on self-presentation to services.

Sex Workers in India Organize to Fight Discrimination
https://www.bitchmedia.org/article/right-work/sex-workers-india-organize-fight-discrimination

How The Pandemic Has Upended The Lives Of Thailand's Sex Workers

https://www.npr.org/sections/goatsandsoda/2021/02/03/960848011/how-the-pandemic-has-upended-the-lives-of-thailands-sex-workers?t=1617976187932

“Dolly” Brothel Remains Open Despite Closure Of Red-Light Distri
https://www.retailnews.asia/indonesia-to-close-down-all-red-light-districts-by-2019/dolly-brothel-remains-open-despite-closure-of-red-light-distri/

Aye Myanmar Association (AMA) is a countrywide network of sex workers
https://www.amamyanmar.org/

# data[].attributes.body
Throughout our analysis we have noticed how the lack of proper sex education that reaches all our countries and the stigma and silences around sexuality are quite diffused. The prevention and care services in all of our states have received funds to improve and spread, bettering the quality of life of the more marginalised and at-risk populations. There is still more that can and should be done: sex education programmes should be available to all and based on a holistic approach that considers the multidimensionality of sexuality and how it is affected by culture, tradition and religion.

# data[].attributes.headline
POST 4: Transgender/ Third Gender population 

# data[].attributes.subject
POST 4: Transgender/ Third Gender population 

# data[].attributes.body
HIV prevalence among the transgender/ third gender population in our region is high:
Thailand - 11%
Indonesia - 24.8%
India - 17.5 - 41%
Myanmar 11-27%

One reason for this high prevalence is due to the high proportion of transgender/ third gender people working as sex workers (Approx 90% in India and 81% in Indonesia)

Video 1: Waria (Indonesia)
https://www.cultureunplugged.com/documentary/watch-online/play/8540/Wariazone

Video 2 & 3: Nat Kadaw (Myanmar)
https://www.youtube.com/watch?v=aGpFrHO0p7s

https://www.youtube.com/watch?v=ya39Dkv7-7o

Video 4&5: Hijra (India)

https://youtu.be/Z4tuHJey1i4

https://youtu.be/If3LqoE4SuY

# data[].attributes.body
We have taken into consideration different populations that were more at risk in our individual states. In particular, we have analysed: young people, sex workers and transgender individuals.

# data[].attributes.body
The prevalence of HIV in our states has changed quickly over the last 10 years due to the increase in preventative services that provide information and testing.