In Myanmar, the military has controlled the country since 1 February 2021, abolishing the democratically elected government. The military arbitrarily detained and killed the activists, and people in civil-disobedience campaigns including —health_~— care professionals. A widespread people’s defense forces occur especially in Sagaing, Kachin, and the southern part to protect themselves against military oppressions. Sagaing and Kachin are high burden areas of drug use and HIV. MYANMAR Se eon m2 Myanmar Terrrist, Military cw Disobedience Movement Villages in Sagaing burnt down by the siltary Before the coup, Myanmar made tremendous progress in harm reduction interventions with milestones under the democratic governments (2010 to 2020). Comprehensive harm reduction services are implemented by non-governmental and community-based organizations. Heroin is the most commonly injected drug. The trend of HIV prevalence among PWID has decreased from 1998 to 2020, the latest known HIV prevalence is 19% among PWID, and 10% of PWID reported needle sharing in the past month according to the national reviews in 2019. A qualitative study was conducted through semi-structured questionnaires and in-depth interviews with 40 PWID and 5 staff working in the harm reduction programs in Sagaing and Kachin. It was operated online in August 2022 with high considerations for the security of the respondents. The study examined the situations in needle/syringe services, risky behaviors, overdose, and accessibility to treatment. 97% of drug users did needle sharing within the past month due to inaccessibility to syringe services, 56% of drug users responded they faced ART shortages in 2022. 68% of respondents witnessed or were aware of death cases of overdose in their vicinity. 86% of respondents knew about the arrest or death of friends and clients. These terrible outcomes will definitely lead to high HIV prevalence among PWID. The international communities should immediately address and explore the ways to support Myanmar's legitimate government (National Unity Government) and communities working for PWID. References * HIV Reviews (2019). National AIDS Program, Ministry of Health and Sports, Myanmar + News and Images Sources: BBC, Insecurity Insight, Reuters, Washington Post ‘+ National Unity Government of the Republic of the Union of Myanmar: https://www.nugmyanmarorg/en/ Dr. Thein Han MB, 8,,M.PA, DRS Humphrey Fellow, VCU (2020-2021): Substance use Prevention and Treatment International Certified Addiction Professional, ICAP | Treatment Myanmar detheinhan@gmallcom