ID: HR23-706
Presenting author: Hau Suan Piang

Presenting author biography:

- Medical Doctor, graduated from the University of Medicine, Magway - Former Medical Coordinator at AHRN (Kale) - Project Manager at AHRN at the present.

Glimpses of Peer Leadership as the Prevailing Solidarity Model: a Road to Peer-led Harm Reduction!

Hau Suan Piang, Hein Thu Aung, Win Zaw, Khine Wut Yee Kyaw, Kyaw Soe Hlaing, Zaw Lin Oo, Murdo Bijl
Issue
Myanmar is one of the world's top heroin and amphetamine producers and has an estimated 93,000 PWID who are disproportionally affected by blood-borne infections and adverse effects of the country's economic deterioration and collapsing health system as a result of the COVID19 pandemic and brutal political crisis. In 2021 widespread lockdowns and mobie restriction of clients and harm reduction staff in Kale Project, promted the urgent need to innovate community peer-led responses to continue harm reduction services in chronic conflict-affected rural communities.
Setting
Kale, part of Sagaing region is located on the way to Tamu-Moreh India border from Mandalay, is situated on a major drug trafficking route and is the hub of cross-border trading activities. Asian Harm Reduction Network (AHRN) provides essential harm reduction services, including the distribution of needles and syringes (NS), condoms, overdose (OD)management, MMT, and HIV, TB, hepatitis testing services to people who inject drugs (PWID) through facilities-based and community-based models.
Project
Kale clinic-based interventions expanded community peer-led harmreduction interventions in a borderland area where an an estimated 2,000 PWID recide (14% HIV prevalence). In 2021 the project team pro-actively attracted and trained 21 residential peers to take lead in community-based harm reduction service delivery; distribution NS, OD management with naloxone, referral for HIV, TB and STI testing and treatment .
Outcome
In 2021 of the 1,409 PWID who accessed the Kale clinic, 304 (21%) PWID were reached and referred by peer outreach workers. The peer counsellor conducted 249 HIV tests, 32% of the total 773 PWID who received HTS. Peers distributed 601.200 NS, 60% of the total NS distribution in this project site. Peer-led community harm reduction enhanced a strong sense of ownership and solidarity. Key for the successful implementation of this model was providing training, sensitizing community acceptance, providing travel allowance and technical assistance.