Cambodia's decline in HIV/AIDS mortalities has made it a regional anomaly, according to a new study published today by a global health research centre at the University of Washington.
While HIV/AIDS remains a leading cause of disease burden in Malaysia, Myanmar, Thailand and Vietnam, and mortality rates have been increasing in Laos, the Philippines and Vietnam, deaths have dropped in Cambodia to record lows.
“The news is mainly good for Cambodia, where HIV/AIDS mortality has decreased by 86% since peak mortality rate in 2003. Although the disease is responsible for 1.5 percent of deaths and 1.6 percent of disease burden, HIV/AIDS currently ranks as the 16th leading cause of disease burden in Cambodia,” the report, published by the Institute for Health Metrics and Evaluation, says.
In order to capture the disease burden attributable to HIV/AIDS, the study, titled The Burden of HIV: Insights from the GBD 2010, used a metric that captures years of life lost to premature death and years lived with disability.
“The HIV/AIDS epidemic in Cambodia is concentrated, meaning it primarily affects intravenous drug users (IDU), men who have sex with men, and sex workers,” researcher and lead study author Katrina Ortblad told the Post.
While the report’s news is good, HIV has disproportional effects on certain age groups, cautioned Ortlblad. For example, mother-to-child transmission rates may have significantly declined, but HIV/AIDS remains the fourth-leading cause of health loss for the 25-29 and 30-35 age groups.
However, targeting high-risk populations like “entertainment workers” becomes politically complicated when individuals are working illegally, said Mey Sovannara, communications and advocacy coordinator at the Khmer HIV/AIDS NGO alliance (KHANA).
“The law is not exactly forgiving on this point,” he said.
Similarly, high rates of HIV/AIDS remain prevalent among intravenous drug users, UNAIDS country coordinator Marie-Odile Emond said, adding that one in four drug users who inject has HIV/AIDS.
“We’re still reaching a low number of drug users and entertainment workers, as well as access to the gay male population, who remain quite hidden because of public stigmatisation,” she said, noting the difficulties of disseminating preventative supplies like clean syringes or contraceptives.
Sin Somuny, executive director of health NGO Medicam, pointed to the involvement of local NGOs in implementing government policy as a key reason for Cambodia’s success.
“In the fight against HIV/AIDS, interventions have been undertaken beyond the health system,” Sin Somuny said.
Despite Cambodia’s relative success compared to others in the region, it needs to maintain momentum in tackling the disease burden of HIV/AIDS, Ortblad said.
“Prevention and other effective interventions must be vigilantly maintained; complacency is not an option.”
The declining prevalence of HIV/AIDS is expected to continue, said Mean Chhi Vun, the director of the National Centre for HIV/AIDS, Dermatology and STDs.
Already, he pointed out, “newly infected HIV patients went from 100 [per day] in 1998 to three per day [now]”.