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

Profile of Fishermen and Related Populations

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

Location by Ethnic Group

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)

Registration of Male Laborers from Myanmar 2001 & 2003 * Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn, Songkla Totals All Categories Nationally Totals All Categories Eight Provinces* Total Fisheries Nationally ,123 84,826 50, ,812 45,560 27,465

Numbers of Registered and Estimated Myanmar Males Selected Provinces ProvinceAll Categories FisheriesEst. # of Myn Fishermen Chonburi3,1421,004- Chumporn5,2662,027- Pattani ,000 Phuket8, ,000 Ranong7,8262,6037,000 Samut Prakarn4,6731,2164,000 Samut Sakorn13,4358,769??? Songkhla1, ,000 Totals for Listed Provinces 45,56017,235*36,000 *63% of National Total for Fisheries

Registration of Female Laborers from Myanmar 2001 & 2003 * Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn, Songkla Totals All Categories Nationally Totals All Categories Eight Provinces* Total Fisheries Nationally ,865 53,319 27, ,979 31,938 18,977

Numbers of Registered Myanmar Females Selected Provinces ProvinceAll Categories Fisheries Samut Sakorn makes up 72% of all registered in fisheries Women under the fisheries category make up 50% of total Chonburi1, Chumporn1, Pattani Phuket4, Ranong6,3373,084 Samut Prakarn2, Samut Sakorn14,07211,492 Songkhla9667 Totals for Listed Provinces 31,93815,917

Vulnerability to HIV/AIDS

High Mobility of Fishermen As assessed in the scope of research

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

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

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

Province Chumporn3.9%4.9% Ranong7.6%10% Phuket8.9%9.3% Songkhla8.4%9.4% Pattani Samut Sakorn 9.5% 3% 4.5% - Sample Rates of HIV among Fishermen Source: MOPH General prevalence in Thailand was 1.8%; male STI patients in urban areas was 2.5% in (UNAIDS)

ProvinceDirectIndirect Chumporn21.1%7.1% Ranong-5.2%* Phuket14.8%3.1% Songkhla12.2%10% Pattani Samut Sakorn 23.5% 27% 5.5% 4.6% Sample Rates of HIV among “Sex Workers” Source: MOPH *36% in 2000 Prevalence rates of 6.7% for sex workers in urban areas in (UNAIDS)

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

HIV/AIDS Prevention Interventions

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

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). PHAMIT PHAMIT (Prevention of HIV/AIDS Among Migrant Workers in Thailand)

PHAMIT PHAMIT Objectives 1.Migrant workers and related populations use condoms consistently during casual sex and practice reproductive health care.

PHAMIT PHAMIT Objectives 2.Health system is favorable for migrant workers to receive health prevention and treatment services that are suitable for migrant workers.

PHAMIT PHAMIT Objectives 3.There is a supportive environment for migrant workers and their dependents.

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

Promote Healthy Behaviors (Condom use and RH) 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”

Improve Health Service Delivery System for Migrants 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

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

Influence Policy from Provincial to International Levels 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…