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Children - 2.4 HIV/AIDS in Cambodia
HIV was first detected in Cambodia in 1991 and in less than a decade has become one of the most serious epidemics in the region. (9) This is a very diffuse epidemic reported from every region and every social class in Cambodia. Results from the 1999 Surveillance Survey indicate that approximately 170,000 Cambodians are now infected with HIV, giving an adult HIV prevalence rate of around 3.5%. (10) More men than women are currently reported to be infected, but infections amongst women are increasing as is incidence of transmission from mother to child. (11) The main mode of transmission is currently through heterosexual sex, but there is still little known about men who have sex with men and intravenous drug use in Cambodia.
Prevention efforts have been underway for some years in Cambodia, drawing on lessons learned in other countries. Costly antiretroviral treatment is beyond the reach of nearly all Cambodians, but care and support projects for people with HIV/AIDS and their families have been piloted, and people with HIV/AIDS are becoming more involved in the response. As the epidemic has become more visible, there is a move to scale up and adapt some of these initiatives which among other things help poor people not to waste family resources on inappropriate treatment, and which significantly reduce the level of discrimination in the community. (12) A high level of collaboration has been shown between government and NGOs particularly for home-based care. Even so, it is recognised that there are still many significant and basic gaps in the overall response, and that HIV is one of the most serious of the many pressing issues that Cambodia needs to address.
Facts
Poverty, gender issues, political conflict, migration, high levels of STD, trafficking in women and girls and widespread unsafe commercial sex are seen as contributing factors in the spread of the HIV epidemic in Cambodia.
Most Cambodians still do not have access to HIV counselling and testing, to safe blood, or to drugs for HIV-related infections.
Other major gaps are appropriate IEC development and support for community mobilisation in the rural areas.
Most resources to Cambodia currently go through NGOs. Government activities are therefore often restricted to the formulation of policy and strategy, which they are often unable to implement.
Footnotes
(9) UNAIDS. "The HIV/AIDS/STD situation and the national response in the Kingdom of Cambodia" 2000
(10) Report on Sentinel Surveillance in Cambodia, NCHADS/MoH, 1999
(11) Cambodian Ministry of Wonem's and Veterans' Affairs. "Workshop Report of the National Workshop on Women and AIDS in Cambodia, December 1999"
(12) CWilkinson, David. An evaluation of the MOH/NGO Home Care Programme for people with HIV/AIDS in Cambodia. AIDS Alliance 2000