A Woman’s Sad Tale Embodies Myanmar’s HIV Problems

Feb 6, 2018

Seventeen years ago, the husband of a Myanmar woman named Hnin, who asked that her full name not be used, found the secret of her nightmares; a condom hidden in her wallet. It proved what he had suspected for months – that his wife had become a prostitute.

Half a year earlier, the husband had broken his leg in an accident during their trip to Yangon from the countryside. The cost of the surgery shocked the poverty-stricken family. All the burdens came to Hnin, a housewife who had never worked. To pay the astronomical debts, she told her husband she had found a job as a nurse.

But he had suspected Hnin of different, more ominous work. Then he found the condom. He punched her in the face and continued to beat her over the next few years. Her elegant face that he had fallen in love with 10 years earlier had turned into a symbol of shame. At the same time, however, he had no job and relied on her “shameful work” to afford the rent and their children’s education. When he learned that she had contracted HIV, he abandoned the family.

Hnin is emblematic of the growing problems of prostitution and exploitation of sex workers in Myanmar. According to a study by the World Health Organization, “Myanmar is experiencing a generalized epidemic [of HIV], considered one of the most serious in Asia.” HIV infection among sex workers has risen significantly, from about 5 percent in 1992 In Myanmar’s major cities, HIV prevalence among women sex workers was 24.6 percent and 13.7 percent in Yangon and Mandalay respectively in 2016 -- representing some of the highest HIV prevalence locations in the Southeast Asia and Pacific region.

The country's low financial investment in public health appears to be a major barrier to the success of HIV testing, prevention, and treatment program, according to the WHO, and government policy on condoms appears to contribute to problems, partly because of social stigma and partly because of severe penalties for women found with them.

Even after having contracted HIV, Hnin said in an interview that she supported her three sons by being a sex worker for nearly 10 years. “Every day I was praying to escape from that kind of life,” she said. The children lived with her mother in another state. They knew nothing about their mother’s life in Yangon.

The condom that destroyed her marriage has been a mystery for Hnin until today. “I didn’t take condoms. In our country, it’s very dangerous for a woman to take a condom because it would be an evidence of prostitution to get arrested,” she said: “Maybe one of my customers put it there though they mostly do not use condoms.”

In Myanmar, the penalties for sex workers are tough, according to the 68-year-old Suppression of Prostitution Act, which only applies to women. While customers, however, are not prosecuted, female sex workers can be sent to prison for up to three years.

A condom tucked in a handbag, heavy makeup, a revealing skirt, sometimes something as simple as an eye contact is enough to send a woman to prison. Hnin said: “There is a motto among us: when a policeman just pokes a woman, she would spend six months in prison.”

A 2000 directive states that condoms should no longer be used as evidence of sex work. But most people, including police, are not aware of the directive.

Afraid to use condoms, female sex workers are most at risk to be infected with HIV. Myanmar has one of the highest HIV rates in Asia. According to UNAIDS data released in 2016, there are around 77,000 female sex workers in the country.

“Not even using a condom, but just having a condom is difficult, because society held the misbelief that keeping a condom meant doing something unfaithful,” said Than Naing Oo, Program Manager of Targeted Outreach Program (TOP), which is an HIV prevention program of Population Services International (PSI).

Since 1996, PSI has implemented a condom social marketing program distributing their own brand Aphaw condoms at a subsidized price of 50 percent of the retail value. Sex workers are the target group. According to PSI data released in 2015, Aphaw has accounted for 80% of condoms sold in Myanmar.

Hnin learned about HIV prevention and got free treatment from these international NGOs. She became a peer educator for sex workers and was called a “golden sister”. After finding a position in an NGO helping people living with HIV, she quit the sex industry.

However, Hnin still finds herself in an awkward position because of the illegality of sex work. “Once we went to give sex workers health education. Police just came and arrest us all,” she laughed bitterly.

Though women’s rights are constitutionally protected in Myanmar, sex workers are seen as an exception in reality. Vulnerable to discrimination, violence and health issues, sex workers have no access to public services because their work is illegal.

“Sex workers are also women. They are also somebody’s daughter, somebody’s wife, and somebody’s mother,” Dr. Soe Naing, the director of the International HIV/AIDS Alliance, said: “They also have rights to be respected and protected by the law.”

Susanna Hla Hla Soe, a member of parliament of Myanmar, is trying to promote the decriminalization of sex work. “The sex industry is increasing. We can’t avoid that,” she said: “If it becomes legal, we could solve the problems of sex workers abuse and the transmission of HIV.”

Hla Hla Soe is proposing an amendment to the current law to the parliament this year. But changing the law is not easy Since Myanmar's political reforms began, some lawmakers have called for changes to the law on sex work. However, it does not seem to be a high priority while the new government has a large economic reform agenda centered on building infrastructure. In 2013, another member, Daw Sandar Min, proposed decriminalizing sex work, but his proposal was overwhelmingly rejected.

“In our country, there are too many things to review, repeal, rebuild and renew,” Hla Hla Soe said, “This is in our list. But no one knows when it will happen."

As a lucky one to leave the profession, 47-year-old Hnin said she doesn’t know whether she regrets getting into the sex industry to save her ex-husband 17 years ago. “Life is unknown. But finally I learn, when life goes down, the most important thing is to keep hope and dignity,” she said.

Deng Yang holds a master’s degree from the University of Hong Kong’s Journalism and Media Studies Center.