Two drug treatment centres (DTCs) for people who inject drugs (PWID) and are enrolled in methadone maintenance therapy (MMT), Yangon, Myanmar. Objectives: To determine, in PWID enrolled for MMT from 2015 to 2017, 1) testing uptake and results for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV); 2) risk factors for infection; and 3) retention in care and risk factors for loss to follow-up (LTFU). Design: Cohort study using secondary data. Results: Of 642 PWID, 578 (90.0%) were tested for HIV, HBV and/or HCV. Overall, 404 (69.9%) were infected: 316 (78.2%) had one infection and the remainder had dual/triple infections. Testing uptake was generally better in 2015 and 2016 than in 2017. Prevalence of HIV infection was 15-17%, for HBV it was 4-7%, and for HCV it was 68-76%. Age 30 years, being single and duration of drug use were independent risk factors for infection. Retention in MMT at 6 months was 76% and declined thereafter. Experimental use of drugs and needle sharing were independent risk factors for LTFU. Conclusion: PWID enrolled in MMT in Yangon had high rates of HIV, HBV and HCV, and retention in care declined with time. Ways to improve individual tracing, programmatic retention and linkage to care are needed.

Background: Maintaining essential HIV services has being a Global challenge during the COVID-19 crises. Myanmar has 54 million inhabitants. Neighbor of China, Thailand, India and Bangladesh it was impacted by COVID-19, but came up with a comprehensive and effective response, following WHO recommendations. The HIV Prevalence is 0.58% and it is concentrated among key population. A HIV Contingency Plan was developed to face this challenge. Methodology: The programme-based cross-sectional descriptive study with analysis of routinely collected data from MoHS data system, between 2019 and 2020 was conducted, comparing first six months of 2019 and 2020. Results: HIV outreach activities and HIV testing were slightly affected after detection of first COVID-19 case, till mid May 2020. After that, outreach activities resumed. Introduction of HIV self-testing was initiated. 72% of more than 21,000 PWID on MMT were receiving take home dose up to 14 days and 60% of ART patients were receiving 6 months ARV dispensing. Conclusion: Essential HIV services were maintained.

Background. Reports on worldwide drug use include some information on risk factors, but virtually no information on protective factors, which are an important component of prevention programs. Aims. This study investigated protective factors and biological sex differences associated with patterns of substance use among adolescents in Myanmar, a country in Southeast Asia. Method. Myanmar high school students ( N = 1,918; Mage = 15.35, SD = 1.07, range = 14-18; 56% female) completed a version of the Communities That Care survey validated for use in this population. Results. Latent class analysis revealed “Low Users” (38%), “Normative Users” (47%), and “Poly Drug Users” (15%) classes for males, and “Low Users” (80%), “Glue/Over-the-Counter Medication Users” (14%), and “High Users” (6%) classes for females. Univariate analyses indicated that belief in the moral order and positive family attachment differentiated profiles for both males and females; opportunities for prosocial family involvement, prosocial peer behavior, and opportunities to talk with teachers were additionally significant for males only. Logistic regression analysis comparing males in the “Low Users” and “Normative Users” classes indicated that opportunities for prosocial family involvement was protective after accounting for significant demographic and risk factors. In contrast, analyses comparing other classes of males or females found that once significant demographic and risk factors were controlled, protective factors did not discriminate classes. Conclusions. These data suggest that sex-specific prevention and intervention strategies may be more successful than universal approaches, and that attention to both risk and protective factors in prevention programming is warranted.

This study investigated sex differences in risk factors for alcohol and illicit drug use among high school students in Myanmar as part of a comprehensive substance abuse prevention approach. Participants ( N = 1,918; Mage = 15.35 years, SD = 1.07 years, range = 14–18 years; 44.3% male) were recruited from 10 high schools in Myitkyina Township, Kachin State, Myanmar. Study constructs were assessed with a version of the Communities That Care survey adapted for use in Myanmar. Structural equation modeling was used to determine the strongest risk factors for recreational and hard drug use. Multiple group analyses indicated that patterns of risk differed by sex. Poor family management practices and peer drug use were risk factors for all youth and all recreational drugs; depressed affect was an additional risk factor for glue/solvent use and misuse of over-the-counter medication. Additional risk factors were specific to sex and to particular substances. The model predicting hard drug use had no common risk factors across sex. Low perceived dangerousness of drugs elevated risk for female adolescents. Parental attitudes favoring drug use, peer drug use and peer antisocial behavior, and low school commitment elevated risk of hard drug use for male adolescents. These data suggest that as Myanmar develops substance abuse prevention strategies for youth, one of the subpriorities in the United Nations’ sustainable development goals, approaches that are tailored specifically to male and female adolescents in addition to universal approaches may be dual effective strategies in curbing drug use.