The Health Ministry is planning no further HIV tests in Kandal province’s Peam village, where a disproportionate cluster of infections has been discovered, despite two-thirds of the village still remaining untested.
Ly Penh Sun, director of the ministry’s National Centre for HIV/AIDS, Dermatology and STD Control (NCHADS), yesterday said there was no need.
“Listen to me, those who volunteer to test, they are having something to expose them to HIV. Those that don’t get exposed don’t need to test,” Penh Sun said. “Not everyone needs to get tested. Have you ever been tested? I’ve never been tested, because I know I haven’t been exposed to HIV.”
Penh Sun said on Monday that the initial decision to offer testing in Peam had been taken because the health centre is more than 10 kilometres from the village.
Alarm bells began to ring when NGO Khemara earlier this month tested 47 people in Peam, a village of 1,039, and found five to be HIV positive, with nine more receiving positive diagnoses soon after from a local hospital. Further tests this week of 279 villagers brought the total to 16.
The cluster of diagnoses had raised fears of a repeat of the Roka outbreak in Battambang that eventually saw 282 people in an isolated area diagnosed as HIV positive.
However, WHO Cambodia’s team leader for HIV, Dr Laurent Ferradini, said he was “totally comfortable” with NCHADS’s decision not to roll out further blood tests in Peam, pointing out that tests were now available at the local health centre.
Ferradini downplayed Penh Sun’s assertion that “not everyone needs to get tested”.
“I think what he wanted to say was, if you . . . think you might have been infected, please get tested,” he said. “At the moment, we don’t have the resources to test everyone, so we have to target the populations most at risk.”
“It’s not my job to judge the director of a national program,” he added.
But Ferradini’s viewpoint was not shared by Dr Ayesha Kharsany, an epidemiologist at the Centre for the AIDS Programme of Research in South Africa, which has one of the highest HIV rates in the world.
“That’s not true,” Kharsany said of Penh Sun’s remarks. “It’s worldwide accepted knowledge that you have to go in for testing . . . It’s not like you know when you’ve been exposed. That’s what worries us, that way you get people never coming in for testing.”
She also questioned the wisdom of stopping testing.
“Recently we had UNAIDS telling us we need to look at specific locations,” said Kharsany. “Here, we have a specific location with numbers. An increase in numbers in a specific geographic location is something that needs looking into.”
Ke Sovannaroth, a CNRP lawmaker and head of the National Assembly’s health care commission, described halting the blood tests as “a mistake”, and said she would ask the ministry to “take action to ask them to test all together”.
Cambodia has an HIV prevalence of 0.6 per cent, putting Peam – even with only partial testing – at nearly three times the national average. However, WHO’s Ferradini said this was not cause for particular alarm.
“These are the number of cases that we expect. Many cases still remain to be identified among the community,” he said, later adding, “0.3 or 0.6 per cent [prevalence] is the general population, it varies from site to site.”