Globally, the prevalence of bloodborne virus (BBV) infections is high among people who inject drugs (PWID). In 2019, approximately 13% of PWID were living with HIV, 50% were hepatitis C virus (HCV) antibody positive, and 9% were hepatitis B surface antigen positive (indicating current infection) [1]. Needle and syringe programs (NSP) and methadone maintenance therapy (MMT) are important tools for preventing BBV infections. Evidence shows that the access to sterile needles/syringes can efectively reduce HIV and HCV infections, and with high coverage, the efectiveness is similar between lowand middle-income countries and high-income countries [2, 3].
Combination of the NSP and MMT use can further reduce HCV infections among PWID [4]. In Myanmar, BBV infections among PWID mirror the global epidemiology. Estimates from 2018 found that HCV antibody prevalence among PWID was 56%, HIV prevalence 19%, and HBV prevalence 7.7% [5].
Access to sterile needles and syringes is mainly through NSPs operated by non-governmental organizations (NGO), which provide free needles/syringes; in addition, pharmacies sell needles/syringes. However, access to sterile injecting equipment across Myanmar is inconsistent and inadequate. As a result, reports of receptive needle/syringe sharing are common, with 7–63% of PWID reporting the practice, depending on location [5]. In Yangon, the largest city in Myanmar, 36% of respondents reported receptive sharing in 2017–2018 [5]. Research in neighbouring countries such as Tailand and China, has found rates of sharing syringes of 18–31% [6–8]. Few studies have investigated access and barriers to needles/syringe services in Myanmar.
