BURMA'S HEROIN USE, HIV RATE UP

RANGOON, Burma -- At sidewalk stalls where Burmese men socialize over cups
of fragrant black tea, proprietors in some towns have added a lucrative
sideline -- heroin -- and use the same syringe to inject as many as 40
customers.

The surreptitious practice, described by several Western diplomats and
doctors, illustrates how Burma, the world's foremost exporter of opium, has
developed its own domestic heroin habit, with potentially disastrous
consequences.

So many young Burmese are injecting heroin that some medical experts say
Burma, also known as Myanmar, has the world's highest rate of HIV infection
and AIDS contracted from dirty needles. By 1994, the Global Program on AIDS
of the World Health Organization reported, 74 percent of drug addicts in
Rangoon (also known as Yangon), 84 percent in Mandalay and 91 percent in
Myitkyina, in the north, had HIV, the virus that causes AIDS.

This compares with about one-third of New York City's 150,000 to 200,000
intravenous drug users who have HIV, said Donald Des Jarlais, research
director for the Chemical Dependency Institute at Beth Israel Medical
Center in New York.

The Burmese government has reported registering only 60,000 addicts, with
as few as 17,000 infected with HIV. Foreign medical researchers put the
total number of addicts closer to 500,000, and estimate that several
hundred thousand heroin injectors have become HIV-positive.

Another study, financed by the United Nations Drug Control Program, a terse
abstract of which was released by the Burmese Health Ministry, found drug
abuse prevalent in 1.7 percent to 25 percent of the population studied in
three dozen Burmese townships. With 88 percent to 99 percent of drug
abusers identified as male, the study implied that up to half of the men in
some townships could be addicted.

Both studies are cited in a new book, ``War in the Blood: Sex, Politics and
AIDS in Southeast Asia,'' by Dr. Chris Beyrer, an American epidemiologist
who has worked in the region and interviewed health workers, addicts and
people with AIDS.

``It's going to be one of those situations where people will say, `How
could the world not have known, because hundreds of thousands of people
have died there?' '' he said from his office at Johns Hopkins School of
Hygiene and Public Health in Baltimore.

Burma offers a harrowing example of drug-producing or transit countries
that find their own people growing addicted to heroin or cocaine intended
for foreign markets.

The military government's own AIDS statistics have been suspect since 1996,
when it wooed foreign tourists with a ``Visit Myanmar'' campaign that
portrayed the country as a vacation paradise.

Beyrer said he knew of Burmese researchers who were punished for being too
candid about the AIDS problem. Beyrer also said the military junta's
credibility was so suspect that even if they told the truth, many might not
believe them.

Although for years older hill people smoked opium to relax or as a
treatment for illnesses like malaria, it is younger, lowland Burmese who
are injecting opium's refined derivative, heroin.

Dr. Ba Thaung, director of the Drug Dependence Research and Treatment Unit
in Rangoon, said heroin is widely available, inexpensive and pure.
``Before, we had very few social problems, but now we have a lot of
problems connected to drug use,'' he said.

The relatively late arrival of AIDS in Burma has contributed to widespread
ignorance about the disease. By 1988, only a single case of AIDS had been
diagnosed. By 1989, doctors were discovering hundreds more Burmese infected.

Yet as late as 1995, a survey of 714 Burmese prison inmates found that only
11 percent knew that HIV could be contracted by injecting drugs.