The government, in close collaboration with the Global Fund to Fight HIV/AIDS, Tuberculosis (TB) and Malaria, is set to allocate over $10 million annually for HIV/AIDS treatment.
The National AIDS Authority (NAA) also aims to reduce the daily HIV infection rate to below one person by 2025. An estimated 12,000 individuals living with undiagnosed HIV/AIDS have not yet received treatment.
This goal has kindled optimism in a woman who has lived with HIV for over a decade, envisioning a future where no one unknowingly lives with HIV, as she once did.
The interviewee, a 39-year-old who spoke on condition of anonymity, reflects on the year 2014 when, battling a severe fever, she sought medical assistance. Turning to a village medic in Roka commune of Battambang province’s Sangke district, she received a syringe injection during that visit. The unlicensed medic has since been prosecuted for “misconduct leading to the spread of HIV”.
“After a few days of receiving the injection, my fever subsided. Astonishingly, less than two weeks later, people throughout the village found they had unwittingly contracted HIV from injections received at the medic’s residence. I chose to undergo a blood test which confirmed my infection with HIV,” she recounts.
She says she was pregnant at the time, and her baby also contracted HIV. Nevertheless, both she and her child diligently follow regular antiretroviral drug treatment, ensuring they never miss a dose.
Her husband remains uninfected. Furthermore, she has another son, slightly over a year old, who did not contract HIV. Upon his birth, doctors prescribed medication for him to take for a month and a half, and he has not required further treatment since.
“My husband remains free of HIV. Despite regular blood tests conducted by doctors, no signs of infection have been detected, and he doesn’t require medication like I do. Initially, I worried about my son contracting HIV from me, but blood tests have shown no signs of infection. I’ve been on medication for an extended period, and I’ve observed that my skin has become brighter than before,” she says.
She mentions that despite consistently taking prescribed medication, her condition limits her ability to seek employment outside her hometown. Presently, she relies on her husband, employed as a construction worker, but their livelihood faces challenges due to his job’s instability. Emphasising the importance of a supportive partner, she advises everyone to seek professional medical care to avoid the regrets she has faced.
Soy Chandary, a representative of the Cambodian Women for Peace and Development, a local NGO, said the association collaborates with individuals living with HIV, receiving support from the Global Fund through the government. They currently provide various free support services, including HIV blood tests, prevention of mother-to-child HIV transmission services and counselling support.
She adds that the NGO actively engages with women in entertainment establishments, such as karaoke venues, massage parlours and beer gardens. Regular visits to these locations aim to enhance understanding of HIV prevention methods. If individuals are willing to undergo a blood test, the association provides this service free of charge.
Chandary underscores that those engaging in high-risk behaviours, such as having multiple sexual partners and unprotected sex, are most at risk for HIV transmission. Certain populations, including sex workers, women in karaoke establishments, and men who have sex with men (MSM), face the highest risk.
Elimination goal: Undetectable HIV presence
Additionally, besides in-person education, the association utilises social media platforms and widely popular messaging apps like Facebook and Telegram to disseminate public health information. Currently, the association operates in Phnom Penh and the provinces of Kandal, Preah Sihanouk and Prey Veng, identified as higher-risk areas.
“The highest HIV infection rate is observed among MSM, whereas women who have sex with men do not have a particularly high infection rate. We receive inquiries from individuals expressing their desire for HIV testing, as well as tests for other sexually transmitted diseases [STDs],” Chandary says.
Chhim Khin Dareth, a spokesperson for the NAA, tells The Post that the goal of eliminating HIV/AIDS by 2025 does not necessarily imply the complete eradication of the virus. Instead, the objective is to maintain an undetectable level of HIV presence in the blood, aiming to reduce the detectable virus by at least 95 per cent by 2025.
“We expect to have a three-pillar response mechanism. Firstly, the government, with the Ministry of Health as its administration. Secondly, development partners, including both local and international organisations, along with civil society groups and the participation of people living with HIV. Thirdly, we have investment based on past experiences,” he says.
Khin Dareth notes that Cambodia has grappled with the HIV epidemic since the early1990s, spanning more than 30 years. Despite this prolonged struggle, there is still no cure or preventive vaccine for HIV/AIDS leading to complete eradication. However, the current goal of achieving a rate of less than one new infection per day in 2025 is deemed both realistic and sustainable.
He adds that the NAA, collaborating with the government-led National Centre for HIV/AIDS Dermatology and STDs, and other relevant organisations, estimated approximately 76,000 people living with HIV in 2022. Out of this figure, around 64,000 individuals sought and received services. Consequently, an estimated 11,000 to 12,000 individuals had yet to undergo diagnostic blood tests.
Enhancing overall wellbeing
“We’re uncertain about the end of AIDS. It remains unclear when a cure or vaccine will be found. Right now, we focus on providing treatment to those living with HIV to ensure their overall well-being and allow them to lead as close to normal lives as possible. Consistent medication adherence is essential to improving their health,” he explains.
He says that by the third quarter of 2023, over 67,000 individuals had sought services, with approximately 1,100 deaths reported annually. The increasing number of people seeking services indicates improved awareness and information dissemination through media channels. As a result, more people proactively undergo HIV blood tests, enhancing their understanding of the disease progression.
Khin Dareth says the nation presently has an ample supply of treatment medicine for individuals living with HIV. This ensures that anyone testing positive for HIV can receive immediate treatment. Consequently, the rate of HIV treatment has reached 99 per cent, and the effectiveness of the treatment stands at a high 98 per cent.
“We must persist in encouraging individuals to step forward and undergo HIV testing, ensuring all community members have access to these services. With 73 testing and treatment centres established nationwide, accessible by dialling the toll-free number 115, people can conveniently access testing and treatment services throughout the country,” he says.
He also points to studies conducted by the NAA that reveal approximately 1,400 new HIV infections occurring annually. MSM are identified as the highest-risk group for transmission, with an estimated population exceeding 90,000. Vulnerable populations also include transgender individuals, entertainment workers and drug users. The NAA’s findings also indicate that approximately 43 per cent of vulnerable populations fall within the age group of 15 to 24 years old.