Drugs and HIV / AIDS in Myanmar -- land of the "first inhabitants of the world".

Myanmar has an overall HIV infection rate of 67% among injecting drug users (IDUs) rising to 96% in some areas. Furthermore Myanmars response to the epidemic is seriously underfunded because the international community is reluctant to provide assistance in the current political situation. The World Health Organization estimates that over 400000 people already have contracted HIV although so far only 497 confirmed AIDS cases have been reported. During the colonial period opium use was widespread in the British colony of Burma. There were about 300000 opium addicts in 1930. The drug was produced on a large scale in the Shan states. A 1923 agreement reduced poppy cultivation but it has never been eradicated. Production was greatly increased in the 1960s in order to finance the Chinese Nationalists and to satisfy the demands of US troops fighting in Vietnam as well as the growing markets in the West. Recent official figures of registered addicts indicate about 54000 IDUs although the real figure is closer to 300000-400000 with the majority being young men. In 1989 the Drug Treatment Center in Myitkyina in Kachin state reported that 95% of the patients were HIV positive. In 1990 in Mandalay 72% of drug patients tested positive. By 1993 the average level of HIV prevalence among patients in the countrys 6 specialized drug treatment centers was 74%. In a 1994 national sentinel survey of 471 samples 67% of IDUs tested positive. HIV prevalence among IDUs ranged from 84% in Myitkyina Kachin state to 33% in Taunggyi in the Shan state. About 12% of pregnant women tested positive in September 1993 while an average 14% of male STD patients tested positive during 1992-94. The young age of IDUs is remarkable: in the 1993 national sentinel survey 46% of IDUs aged 15-19 tested positive. Only the Yangon Drug Treatment Center achieved a drop in infection rates among peer groups from 69% in March 1994 to 46% in September 1994. Targeted intervention within a national AIDS program is required to halt the further spread of HIV infection.