Foreword

HIV is one of the priority public health issues in Myanmar. The country has been implementing a wide range of activities and services as national concern since 1989 with high political commitment.
A couple of years have passed since the last edition of the National guidelines for Clinical Management of HIV infection in 2014. During the time period, the WHO has published the Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infections: Recommendations for a Public Health Approach: Second Edition 2016.
In the meantime, Myanmar achieved major progress in expanding the coverage of HIV prevention among key populations and HIV treatment and care. Especially, antiretroviral treatment (ART) coverage doubled from 24% in 2012 to almost 50% in 2015. Part of this impressive achievement includes the shift of patients from private sector to the public sector – Government now manages nearly 56% of ART cases.
Despite the major progress, there remains a long way before accomplishing the vision of ending HIV as a public health threat by 2030. This vision is crucial in supporting Myanmar to achieve the Sustainable Development Goals (SDGs) and universal health coverage, by strengthening the leadership and enhancing public, private and community partnerships at all levels.
The Guidelines for the Clinical Management of HIV Infection in Myanmar: Fifth Edition augment and complement the 2014 Myanmar Guidelines published by the National AIDS Programme. In particular, it is recommended that all people living with HIV be provided with ART. With this recommendation, all limitations on eligibility for ART among people living with HIV are to be removed. The same once-per-day combination pill is now recommended for all adults living with HIV, including those with tuberculosis, hepatitis, and other co-infections. The Ministry of Health and Sports acknowledge the contribution of the Guidelines Drafting Team and the Peer Review Team, concerned programs including National Tuberculosis Program, and partner agencies.
These guidelines are for all healthcare personnel in the public and private sectors serving HIV patients in Myanmar. It should be stressed that the choice of the patients must be respected and a high degree of professionalism should be maintained at all times regardless of the situation or the premises. The guidelines are optimized for all health workers regardless of their experience or training and suitable for patients living anywhere in Myanmar to seek necessary treatment and care.
We are confident that these guidelines will be of immense help to further scale-up quality HIV treatment services throughout the country. The NAP is thus very pleased to issue the Guidelines for the Clinical Management of HIV infection in Myanmar, Fifth Edition.