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Communities make the difference in ending AIDS

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People living with HIV and their supporters march at a World AIDS Day gathering on Phnom Penh’s Koh Pich in 2016. Post pix

Communities make the difference in ending AIDS

The theme of this year’s World AIDS Day on Sunday was “Communities Make The Difference”.

Cambodia is a shining example of making a difference in Asia, where the Cambodian government and donors work hand in hand with communities of people living with or affected by HIV to implement evidence-based HIV services.

Unleashing the potential of this partnership is the key for Cambodia to sustain epidemic control and end AIDS by 2025.

Cambodia has been offering an evidence-based combination of prevention, care, and treatment services for several years.

Healthcare providers have created supportive environments at healthcare facilities and community venues.

This approach ensures that communities are fully engaged in designing and delivering HIV services that respond to the needs of the affected people.

Nevertheless, there remains an urgent need for a more appealing and effective range of HIV prevention options, especially for younger key populations.

One of the most exciting new options is oral pre-exposure prophylaxis (PrEP), which prevents the acquisition of HIV.

If used properly, and in combination with condoms, PrEP can virtually eliminate the risk of acquiring HIV.

Just a few months the ago, the Chhouk Sar Clinic in Phnom Penh – under the leadership of the Ministry of Health, in partnership with community-based organisations and with support from the US President’s Emergency Plan for AIDS Relief (Pepfar),Global Fund to Fight AIDS, Tuberculosis and Malaria, and JointUnitedNationsProgramme on HIV/AIDS (UNAIDS) – started to offer PrEP.

The name “Chhouk Sar” refers to the white lotus that thrives even in muddy environments.

This is a strong metaphor for the many community organisations that persevere in difficult environments.

Phanith, a young man in his early twenties who had sex with men, is one of the first clients who is taking PrEP.

He likes the fact that he could ask for a HIV test and for PrEP in a community-based clinic, with service providers that didn’t judge his life choices.

A Chhouk Sar Clinic counsellor believes that PrEP has been a game changer because it’s the final piece in the HIV prevention jigsaw puzzle.

“We have already stepped up regular testing, and been encouraging increased condom use and starting people on treatment as soon as possible. PrEP completes that combination prevention picture.”

Two decades ago, Cambodia had a fast-growing HIV epidemic.

Immense achievements

By 2017, it became one of the seven countries globally to achieve the 90-90-90 targets (90 per cent of people know their HIV status; 90 per cent of people who know their status receive treatment with antiretroviral drugs; and 90 per cent of people on treatment are virally suppressed).

Cambodia has also announced its ambitious goal to eliminate virtually all new HIV infections by reaching 95-95-95 by 2025 and achieve an AIDS-free generation.

Between 2010 and 2018, new infections declined by 62 per cent and AIDS-related deaths by 48 per cent. Cambodia has turned its epidemic around by focusing policies and programmes on people.

Today there are an estimated 73,000 people living with HIV in Cambodia, 81 per cent of them are on lifesaving treatment and 78 per cent are virally suppressed.

People living with HIV cannot transmit the virus to others if they stay on treatment and the HIV virus is undetectable.

Despite these immense achievements, the AIDS epidemic in Cambodia is not over.

HIV continues to affect certain groups of people, known as key populations, more than others.

These key populations include female entertainment workers, men who have sex with men, people who inject drugs and transgender women.

In 2018, 25 per cent of new HIV infections were among men who have sex with men, a more than three-fold increase from seven per cent in 2010.

One in every three new HIV infections are in the capital city of Phnom Penh.

Five provinces (Battambang, Siem Reap, Kampong Cham, Banteay Meanchey, and Takeo) and Phnom Penh account for 70 per cent of all new HIV infections in Cambodia.

Strong political leadership, partnering with the communities of people living with HIV and key populations, is the only way to end AIDS globally.

Our communities are a source of strength and represent tremendous untapped potential.

Through their dedication, commitment and extensive networks, they have the potential to help find the remaining people infected with HIV and link them to treatment.

Vladanka Andreeva is UNAIDS Country Director in Cambodia and W Patrick Murphy is the US Ambassador.

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