HIV/AIDS Prevention Among Migrant

Workers in Thailand’s Seafood Industry

Presenter: Brahm PressOrganization: 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

2001

255,123

84,826

50,523

2003

134,812

45,560

27,465

Numbers of Registered and Estimated Myanmar Males Selected Provinces - 2003

Province All Categories

Fisheries Est. # of Myn

Fishermen

Chonburi 3,142 1,004 -

Chumporn 5,266 2,027 -

Pattani 849 764 10,000

Phuket 8,576 741 7,000

Ranong 7,826 2,603 7,000

Samut Prakarn 4,673 1,216 4,000

Samut Sakorn 13,435 8,769 ???

Songkhla 1,793 111 8,000

Totals for Listed Provinces

45,560 17,235* 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

2001

193,865

53,319

27,637

2003

112,979

31,938

18,977

Numbers of Registered Myanmar Females Selected Provinces - 2003

Province All Categories

Fisheries•Samut Sakorn makes up 72% of all registered in fisheries

•Women under the fisheries category make up 50% of total

Chonburi 1,489 198

Chumporn 1,744 317

Pattani 218 191

Phuket 4,331 174

Ranong 6,337 3,084

Samut Prakarn 2,781 454

Samut Sakorn 14,072 11,492

Songkhla 966 7

Totals for Listed Provinces

31,938 15,917

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 Sub-Culture Norms ofNorms of

FishermenFishermen

Drinking in Groups

SeekingCommercial

Sex

Penis Enhancement

Inconsistent condom use

Beliefs aboutWomen 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

InconsistentCondom

Use

ProvinceProvince 20002000 20022002Chumporn 3.9% 4.9%

Ranong 7.6% 10%

Phuket 8.9% 9.3%

Songkhla 8.4% 9.4%

Pattani

Samut Sakorn

9.5%

3%

4.5%

-

Sample Rates of HIV among Fishermen

Source: MOPHGeneral prevalence in Thailand was 1.8%; male STI patients in urban areas was 2.5% in 2000. (UNAIDS)

ProvinceProvince DirectDirect IndirectIndirectChumporn 21.1% 7.1%

Ranong - 5.2%*

Phuket 14.8% 3.1%

Songkhla 12.2% 10%

Pattani

Samut Sakorn

23.5%

27%

5.5%

4.6%

Sample Rates of HIV among “Sex Workers”-

2002

Source: MOPH*36% in 2000

Prevalence rates of 6.7% for sex workers in urban areas in 2000. (UNAIDS)

Public Health Service

s

Public Health Service

s

Clinics (Expensive) / NGO Clinic (Limited Services)

No Treatment / Complications

Attitude of Providers

LanguageRegistration StatusFear 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).

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

PHAMITPHAMIT Objectives

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

PHAMITPHAMIT Objectives

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

PHAMITPHAMIT Objectives

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

PHAMITPHAMIT 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

MigrantsActivities• 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…