© UNICEF Cambodia/Nicolas Axelrod
Cambodia has made substantial progress in preventing and mitigating the impact of HIV and AIDS, receiving a prestigious award at the Millennium Development Goal summit in September 2010. This has been achieved through targeted prevention programmes that increase awareness of transmission and promote condom use, and the expansion of comprehensive care and treatment services throughout the country. As a result of this combined effort, fewer people from the general population are contracting HIV, with the country’s 2010 prevalence rate estimated at 0.7 per cent among adults, compared with a high of around 2 per cent in 1997, according to government data. With a dramatic scale-up of care and treatment that started in 2003, Cambodia is now one of the first developing countries to have over 90 per cent of adults with advanced HIV infection already on antiretroviral therapy, up from 38 per cent in 2005.
Despite the nation’s success in controlling the HIV epidemic, more must be done to maintain the momentum in combating the spread of the virus. The maturing nature of the HIV epidemic left Cambodia with an estimated 75,131 adults living with HIV in 2010. Further, today, HIV has tightened its grip on the nation’s most vulnerable and marginalized populations, which include more women, children and young people. Women now represent more than half of the people living with HIV – 40,553 women compared to 34,578 men in 2010. Not only are women generally infected at a younger age than men, government estimates reveal that nearly half of all new infections are among married women. This has obvious consequences for children, not only due to the increased risk of infection through mother-to-child transmission, but also through the impact on children’s lives because of the loss or chronic illness of their mothers. While it is loosely estimated that there are approximately 6,000 children living with HIV in Cambodia, 5,836 children (aged under 15) were reported to be receiving HIV-related care and treatment at public health facilities by the end of 2010.
These trends reflect the underlying gender and cultural dynamics that drive the epidemic in Cambodia, where extra-marital sex is relatively acceptable for men, and
women struggle to suggest condom use with their husbands. At the same time, a potential ‘second wave’ of new infections among most-at-risk groups, including commercial sex workers and their clients, men who have sex with men, and injecting drug users threatens to undermine the nation’s progress in controlling HIV and AIDS. Young people under the age of 24 within these sub-populations are among those most at risk.
Compounding this situation further, the level of HIV and AIDS resources that Cambodia has enjoyed so far has begun to decline as a result of the worsening economic climate. The need for high impact, low cost HIV programmes in Cambodia is becoming more evident in the face of increasing financial resource constraints. Without harmonized and intensive efforts, the epidemic in Cambodia is showing strong potential for resurgence.
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