Changes In Drug Treatment, Commercial Sex Work Could Contribute To Spread Of HIV In Cambodia

A report showing a change in the use of drug abuse treatment and rehabilitation services throughout Cambodia has raised concerns about drug-related HIV transmission in the country's rural communities,
the Phnom Penh Post reports. The report, released Monday by the National Authority for Combating Drugs, shows a decrease in the number of drug users accessing treatment and rehabilitation services at 10 state health centers, from 1,719 people in 2007 to 1,005 people in 2008. Additionally, Lour Ramin, NACD general secretary, said that there has been an increase in injection drug use in Cambodia despite a decrease in overall drug use in 2008. Officials "worry" about the impact that the trends will have on the country's HIV/AIDS prevalence, particularly in rural areas, he said, adding that in 2007, 35.1% of injection drug users in Phnom Penh were HIV-positive. Teruo Jinnai, the Cambodian representative for UNESCO, said the report highlights a need to engage high-risk populations, like IDUs, in HIV/AIDS education efforts. He said that IDUs have a "very high risk" of contracting the virus "because their level of understanding and consideration are still low" (Leakhana, Phnom Penh Post, 1/8).

In related news, Cambodian officials say brothel-based sex work has shifted to relationship-based sex work, which is contributing to the spread of HIV in the country, the Post reports. The Post reports that "sporadic but often violent crackdowns" on brothels have led many customers to begin meeting with regular partners at beer gardens and karaoke bars. Tia Phalla, deputy director of the National AIDS Authority of Cambodia, said government data show that condom use also has dropped in correlation with the closing of brothels. He said the findings "also show that 53.7% of entertainment workers have never suggested condom use with their sweetheart, ... although around 70% of them do not know their sweethearts' HIV/AIDS status." Teng Kunthy, secretary-general of the National Authority on HIV/AIDS, said that about half of the men who regularly visit the same commercial sex worker or "sweetheart" do not use condoms, "so it is much more dangerous" than visiting a brothel (Titthara/ Leakhana, Phnom Penh Post, 1/8).

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