Current trends in the spread of AIDS in Third World and developing nations could
be bad news for Cambodia unless the population at large is made aware of this dreaded
disease's existence and the methods by which it is contracted.
The World Health Organization (WHO) estimates that 2 million Asians may die of Acquired
Immune Deficiency Syndrome (AIDS) by the year 2000, where authorities believe the
disease is spreading faster than anywhere else in the world.
Worldwide, WHO estimates that 10 million to 12 million men, women and children are
infected with the HIV virus, the virus that causes AIDS. Two million of those infected
have developed full-blown AIDS and have perished.
AIDS is the late stage of infection by the Human Immunodeficiency Virus (HIV), for
which there is no known cure.
In November 1992, a total of 65 Cambodians had tested positive for the HIV virus.
And a recent survey by the National Centre for Blood Transfusions identified another
35 persons testing HIV positive.
Most of the HIV-positive cases involved commercial sex workers, prostitutes, and
people who had contracted other sexually-transmitted diseases, such as syphilis.
"To educate the people about preventing infection with AIDS is not easy,"
said Tea Phala, a member of the recently-formed National Committee to Fight AIDS,
a coalition of health workers and government ministers. "They do not understand,
and most of them have no indication that certain activities could be harmful or cause
them to contract HIV or AIDS," he said.
Display posters distributed last month as a follow-up to a World AIDS Day seminar
in Phnom Penh on Dec. 1, were roundly rejected by proprietors of restaurants, shops
and brothels. Also television announcements have been shelved because of the implied
reference to sexual congress involved in explaining what the HIV virus is and how
it is contracted.
"It is not against Cambodian traditions to discuss AIDS," said Tea, dismissing
the reluctance Khmers traditionally have in discussing matters sexual. "We want
the people to be able to save their lives themselves by protecting themselves and
being aware of AIDS."
The proliferation of prostitution is a flash point for AIDS education and awareness.
The Ministry of Health conducted a survey of prostitutes in Dong Kor district in
November and found that 35 percent of the prostitutes did not use condoms regularly.
Latex condoms are one of the best defenses against the spread of sexually-transmitted
diseases.
The survey also found that 20 percent of the population at large did not know what
AIDS was and 72 percent had no experience with condoms.
The use of condoms by some prostitutes depends entirely on the wishes of the customer.
"I don't care whether to use the condom or not. It depends on my customer, whether
they prefer to use it," said Miss Srey, wearing heavy makeup as she sat in a
brothel waiting for customers to arrive with her colleagues-both Vietnamese and Cambodian
prostitutes.
Yet there are reports from health officials in Phnom Penh that some prostitutes won't
allow customers to use condoms, or they use petroleum-based lubricants which cause
latex condoms to disintegrate, rendering them useless for protection against infection
with HIV or other sexually-transmitted diseases.
Officials say there were about 6,000 prostitutes in Phnom Penh in 1991, a number
that increased to about 20,000 during 1992. There are a growing number of brothels
opening in provincial towns where in 1991 there were none at all.
Some estimates of the number of prostitutes infected with sexually-transmitted diseases-of
which AIDS is one-run as high as 70 percent to 80 percent.
"At the time being we are trying to make clear communication with the brothel
owners and the prostitutes so we can explain what a dangerous problem AIDS is,"
said Kien Serey Phal, vice-president of the Women's Association. "Some of them
are suspicious of what we advise, and they tear down the posters as though the pictures
are a defamation of their reputation in public areas."
"Cambodians must be aware and must protect themselves from AIDS," said
Alain Rouvillois, chief of the National Centre for Blood Transfusions. "Ninety
percent of AIDS cases are contracted from sexual intercourse, so Cambodians must
use condoms if they want to avoid AIDS."
Rouvillois says there is the possibility that some people could contract the HIV
virus from blood transfusions of contaminated blood or by sharing/using contaminated
needles, "but we can take measures to be sure the blood is safe. That knowledge
is very important for the patient."
The HIV virus cannot survive outside the body, and the disease is not spread by casual
contact at work or at school. You cannot contract AIDS by shaking hands, touching
or hugging. You cannot contract AIDS by sharing a cup or glass, nor can you get it
by swimming in public pools. There is no danger from contact with toilets or other
plumbing fixtures such as sinks or bidets. AIDS is not spread by mosquitos or other
insects.
Almost all AIDS cases are the result of sexual intercourse. Officials advise a latex
condom be employed in all sexual encounters.
