HIV/AIDS Prevention Among Migrant Workers in Thailand’s Seafood Industry

1. HIV/AIDS Prevention Among Migrant Workers in Thailand’s Seafood Industry Presenter: Brahm Press Organization: Raks Thai Foundation

2. Profile of Fishermen and Related Populations

3. Ethnic Groups of Myanmar Present in Fishing Industry • Mon – the majority, primarily fishermen and seafood processors • Burmese (Burman) – high presence generally, fishermen and on docks • Tavoy – high presence in the south close to border, mainly fishermen • Karen – concentrated in specific areas, primarily on docks and as processors • Rakhine – low presence generally, and in specific areas

4. Location by Ethnic Group

5. Language Issues among Migrants in Seafood Industry • Mon – speak and read own language (low literacy), learn Thai quickly • Burmese – speak and read Burmese (low literacy generally) • Tavoy – own language, but can speak and read Burmese (low literacy) • Karen – own language, can speak and read Burmese (literacy levels uncertain)

6. Registration of Male Laborers from Myanmar 2001 & 2003 *Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn, Songkla

7. Numbers of Registered and Estimated Myanmar Males Selected Provinces - 2003 *63% of National Total for Fisheries

8. Registration of Female Laborers from Myanmar 2001 & 2003 *Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn, Songkla

9. Numbers of Registered Myanmar Females Selected Provinces - 2003

10. Vulnerability to HIV/AIDS

11. High Mobility of Fishermen As assessed in the scope of research

12. Considerations that Increase Fishermen’s Vulnerability • Extended time at sea – from two weeks to two months to two years (boat type) • Docking at various ports - including international (Myanmar, Indonesia, Malaysia, Bangladesh…) • Perception of risk - different types of sex-workers (karaoke, brothel, waitress) • “Sweetheart” relations – no condom

13. Drinking in Groups Seeking Commercial Sex Sub-Culture Norms of Fishermen Penis Enhancement Beliefs about Women and HIV Inconsistent condom use

14. Lack of Familiarity - Feeling / Unnatural Issues of Intimacy and Trust Inconsistent Condom Use Drunk / forgetting Stigma of condoms / Beliefs about women Access to condoms Misinformation and beliefs about HIV

15. Sample Rates of HIV among Fishermen General prevalence in Thailand was 1.8%; male STI patients in urban areas was 2.5% in 2000. (UNAIDS) Source: MOPH

16. Sample Rates of HIV among “Sex Workers”- 2002 *36% in 2000 Prevalence rates of 6.7% for sex workers in urban areas in 2000. (UNAIDS) Source: MOPH

17. Public Health Services Barriers to Health Attitude of Providers Registration Status Language Fear of Arrest Location / Transportation Self-medicate / Traditional Remedies Clinics (Expensive) / NGO Clinic (Limited Services) No Treatment / Complications

18. HIV/AIDS Prevention Interventions

19. Three Levels of Migrant Programming CSEARHAP Advocacy and Capacity Building for Govt CIDA/CARE Canada Migrant Network Support AMN to Advocate Rockefeller Foundation PHAMIT Scale up interventions GFATM

20. PHAMIT(Prevention of HIV/AIDS Among Migrant Workers in Thailand) • Funded by The Global Fund (Round II) • RTF in partnership with: CAR, PATH, MAP, Empower (CM), TBCA, Stella Maris, and MOPH • Goal: To reduce the number of new HIV infections among migrant workers in Thailand and contribute towards the reduction of HIV/AIDS in the sub-region (Thailand, Cambodia and Myanmar).

21. PHAMITObjectives • Migrant workers and related populations use condoms consistently during casual sex and practice reproductive health care.

22. PHAMITObjectives • Health system is favorable for migrant workers to receive health prevention and treatment services that are suitable for migrant workers.

23. PHAMITObjectives • There is a supportive environment for migrant workers and their dependents.

24. PHAMITObjectives 4. Political factors support migrant workers health and treatment at the national and inter-country level

25. Activities Small group trainings IEC / BCC materials Peer education & Volunteer networks Reproductive health education Condom distribution Target Groups Fishermen Seafood processors Sex workers (direct and indirect) Youth Wives of migrants “Gatekeepers” Promote Healthy Behaviors (Condom use and RH)

26. Activities Health services provided in the language of migrants Mobile health activities at communities and work places Work with health service providers to influence attitudes Work with owners to improve access to health services Improve Health Service Delivery System for Migrants

27. Activities Development and support of community groups and activities (cultural & social) Education activities for migrant children Improve sanitation Develop alternatives for recreation Community Development and Social Supports

28. Activities Advocate at various levels for changes in policies that infringe on basic rights (health, labor, children…) Sensitize government officials and public to migrant issues through media, research, case studies and site visits… Influence Policy from Provincial to International Levels

29. The Start...