H I V / A I D S
M E D I A
G U I D E
HIV
Media Guide
AIDS
The development and printing of this guide were supported by the United States Agency for
International Development (USAID) through the POLICY Project.
The POLICY Project is funded by USAID under contract No.: HRN-C-00-00-00006-00, beginning July 7,
2000. The project is implemented by the Futures Group International in collaboration with the Center
for Development and Population Activities (CEDPA) and Research Triangle Institute (RTI).
The printing of this guide was also supported by the United Nations Educational, Scientific and Cultural
Organization (UNESCO) and the Independent Journalism Foundation (IJF).
The author’s views expressed in this publication do not necessarily reflect the views of USAID, the
United States Government, UNESCO or IJF.
HIV
Media Guide
AIDS
The designations employed and the presentation of the material in this publication do not imply the
impression of any opinion whatsoever on the part of USAID, the United States Government, UNESCO
or IJF concerning the legal status of any country, territory, city or area or of its authorities, or
concerning the delimitation of its frontiers or boundaries.
The mention of specific companies or of certain manufacturers’ products does not imply that they are
endorsed or recommended by USAID, the United States Government, UNESCO or IJF in preference to
others of a similar nature that are not mentioned.
USAID, the United States Government, UNESCO or IJF do not warrant that the information contained
in this publication is complete and correct and shall not be liable for any damages incurred as a result of
its use.
1st Edition
February 2006
ACKNOWLEDGMENTS
T
he National AIDS Authority wishes to express special thanks to the United States
Agency for International Development for its financial and technical assistance through
the POLICY Project, Cambodia, as well as to the United Nations Educational, Scientific
and Cultural Organization and the Independant Journalism Foundation for its financial support.
This media guide on HIV/AIDS was developed by the Special Media Guide Working Group in
cooperation with the POLICY Project, Cambodia.
We are grateful to the following organizations for providing input into the development of
this guide: the Department of Media and Communication at the Royal University of Phnom
Penh, the Cambodian Club of Journalists (CCJ), the Cambodian People Living with HIV/AIDS
Network (CPN+), the HIV/AIDS Coordination Committee (HACC), the National Center for
HIV/AIDS, Dermatology and Sexually-Transmitted Diseases (NCHADS), National Television
of Kampuchea (TVK), UNAIDS, UNICEF and UNESCO as well as to all the participants who
generously gave their time to attend the consultative workshops to review the media guide.
The National AIDS Authority wishes to thank all members of the Special Media Guide Working
Group for their efforts and contributions to this media guide on HIV/AIDS:
HE Dr.Tia Phalla
Fabrice Laurentin
Reach Sambath
Puy Kea
Leu Pannasith
Phan Sopheap
Dy Many
Keo Chhen
Lan Van Seng
Dr. Sim Kim San
Kim Dara
Tin Vora
We would also like to thank Peter Starr and Ung Sophea from the POLICY Project who
reviewed the literature and wrote this guide. Sincere gratitude is also given to Dr.Ty Chettra,
Candice Sainsbury and Chris Ward who reviewed the guide and provided substantial feedback
and guidance.
The pictures in this media guide were provided with permission from the photographer, web
site and the people in the photographs, and in no way imply that these people are living with
HIV/AIDS. Graphics were reproduced courtesy of Boehringer Ingleheim. For technical input
and information, we would like to thank Dr. Mark White, Dr. Sok Bunna, Dr. Jack Spencer,
Julie David, University Research Company (URC), Jenne Roberts and Chum Somonn.
For translation, editing and design, thanks goes to Graphic Roots Co., Ltd, Cambodia Health
Education Media Service (CHEMS), Dr.Tia Savora, Pen Samitthy, Nadia Cavalho, Felicity Young,
Suneeta Sharma, Nancy McGirr, Adrian Patch and Lay Sokketh.
ACKNOWLEDGMENTS
1
FOREWORD
FOREWORD
I
t is now 12 years since HIV was first
diagnosed in Cambodia. Since then, tens
of thousands of Cambodians have died
of AIDS, and many more have lost family
members.
In terms of actual numbers, Cambodia has
fewer HIV cases than some of its neighbors.
But Cambodia's relatively small population
has long had the highest rate of infection
among all Asian countries, posing a huge
challenge to the government and agencies
that work with HIV/AIDS.
Cambodia has been quick to recognize
the importance of educating people about
prevention, and its response is often cited
abroad as one of the rare "success stories"
in curbing the epidemic. In 1997, for
example, three out of every one hundred
Cambodians between the ages of 15 and
49 had HIV.Today, that number is less than
two.
But much work remains to be done.While
the number of new infections among men
has plunged, the number of newly-infected
women has barely changed. Women are
now almost four times more likely than men
to be among the newly infected. What's
more, more than 120,000 people living with
HIV/AIDS need care and treatment,
particularly access to high quality but
affordable drugs and medical services.
2
HIV/AIDS also remains a highly stigmatized
disease associated primarily with sex,
prostitution and infidelity. Stigma and
discrimination is widespread against those
infected and affected by HIV, with poor
and inaccurate media coverage often
contributing to negative attitudes towards
those living with HIV/AIDS.This also results
in stereotyping and victimization.
On behalf of the National AIDS Authority,
I thank everyone who participated in
developing this valuable guide, and hope
that its use will contribute to promoting
respect for human rights and human
dignity in the face of this epidemic.
Misleading information about and negative
perceptions of those infected by HIV must
be addressed.The media has a crucial role
to play in any HIV/AIDS program and is a
central actor in disseminating accurate
information as well as shaping community
attitudes towards those most affected.
Mainstream media in Cambodia have
helped to raise public awareness about
HIV prevention, but much care needs to be
taken to prevent sensationalism.We need
to promote balanced media coverage that
helps rather than hinders our response to
the epidemic.A valuable partnership needs
to be formed to further support the
government ministries and agencies
working with HIV/AIDS in Cambodia.
HE Dr. Hong Sun Huot
Senior Minister and Chairman,
National AIDS Authority
With this comprehensive media guide,
Cambodia now joins a small but growing
group of countries that seeks to help
journalists navigate their way through the
complexities of writing about HIV/AIDS.
FOREWORD
3
CONTENTS AND EXECUTIVE SUMMARY
EXECUTIVE
SUMMARY
CONTENTS
EXECUTIVE SUMMARY.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 1. TIMELINE, FIGURES AND BASIC QUESTIONS.
SECTION 2. HIV/AIDS AND THE MEDIA
25-30
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31-34
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35-40
SECTION 5. STIGMA AND DISCRIMINATION.
SECTION 6. DATA.
. . . . . . . . . . . . . . . . . . . . . . . . . .
41-44
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
45-52
SECTION 7. WOMEN.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 8. CHILDREN AND YOUNG PEOPLE.
SECTION 9. MEN AND OLDER PEOPLE.
57-60
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
61-64
. . . . . . . . . . . . . . . . . . . . . . . . . .
65-68
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
69-72
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
73-76
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
77-78
SECTION 11. TESTING AND COUNSELING.
SECTION 12. TREATMENT AND CARE.
SECTION 13. THE NEXT 10 YEARS.
SECTION 14. GOVERNMENT INSTITUTIONS.
SECTION 15. MULTILATERAL AGENCIES.
. . . . . . . . . . . . . . . . . . . . . . . . . .
79-84
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
85-90
SECTION 16. SELECTED BILATERAL DONORS.
. . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 17. NON-GOVERNMENT ORGANIZATIONS.
SECTION 18. WEBSITES.
53-56
. . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 10. VACCINES AND MICROBICIDES.
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 19. GLOSSARY OF TERMS (A-Z).
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 20. ABBREVIATIONS AND ACRONYMS
SECTION 21. SELECTED REFERENCES
4
9-24
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SECTION 3. LANGUAGE.
SECTION 4. FACTS.
. . . . . . . . . . . . . . . .
5
91-94
95-124
125-132
133-172
. . . . . . . . . . . . . . . . . . . . . .
173-182
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
183-186
T
he global HIV/AIDS epidemic is a
crisis that threatens the health,
security, and economic well-being
of Cambodians. HIV was first detected in
Cambodia in 1991. Awareness of HIV
prevention is now relatively high, and the
media is recognized as having a vital role
in educating people about the epidemic
and reducing stigma and discrimination
against those affected. However, a study of
the print media in Cambodia in 2003 found
that HIV/AIDS reporting was often sensationalist or voyeuristic, displaying little
respect for the dignity of people living
with HIV/AIDS who were usually depicted
as victims or objects of sympathy. This
resource has been developed as a result
of recognition that there was no media
guide to meet the growing demands of
reporters covering the increasingly complex
HIV/AIDS issues.
Sections 1 - 4 look at facts, HIV/AIDS and
the media, and language. Correct reporting
on HIV/AIDS issues involves highly technical terminology. HIV stands for human
immunodeficiency virus, the virus that
causes AIDS by destroying cells integral to
the body's immune system. To distinguish
between the human immunodeficiency
virus and the acquired immune deficiency
syndrome, the terms used are merok eith
("AIDS virus") for HIV and chumngeou eith
("AIDS-disease") for AIDS.
Language has a strong influence on attitudes
toward HIV/AIDS and people affected
by HIV/AIDS. Stigma, prejudices, fear and
misconceptions surrounding HIV/AIDS
are only too abundant. One cannot overemphasize, therefore, the ethical importance
of the media using appropriate language
when covering HIV/AIDS. Appropriate
language is constructive, does not fuel
stereotypes, and does not cause prejudice.
Section 5 studies stigma and discrimination,
both of which strengthen social inequalities
and prejudices, especially those related to
gender, sexual orientation, economic
status and race. Stigma associated with
HIV/AIDS continues to profoundly affect
prevention efforts, leading people to deny
risk, avoid testing, delay treatment and suffer
needlessly. It is also a major barrier to HIV
programs -- people who want to know
their HIV status may be afraid to be tested
out of embarrassment. It has even been
reported that some people are afraid to
buy condoms out of fear of being labeled
as HIV carriers.
People with HIV/AIDS are often blamed
for getting infected. Many people with HIV/
AIDS are shunned by their families, ejected
from homes and villages or abandoned at
health facilities, where they are sometimes
left to die. Many people running small
businesses also suffer declines in customers
and eroding income -- sometimes forcing
parents to withdraw their children from
school. Stigma and discrimination can
similarly affect families of people with HIV/
AIDS.
Section 6 looks at HIV/AIDS data. The
Ministry of Health has been overseeing
a national surveillance system for HIV
EXECUTIVE SUMMARY
5
EXECUTIVE SUMMARY
infection since 1994 and for high-risk
behavior since 1997. Based on the data
collected, national estimates of HIV
prevalence are made, along with estimates
for the actual number of people with HIV
and the number of deaths from AIDS.
The groups included in surveys are
known as sentinel groups, which means
they are susceptible to an infection that is
being monitored. Eleven different sentinel
groups have been included.
Section 7 introduces women and HIV. It is
estimated that women account for almost
half of the HIV cases in Cambodia and
more than a third of the AIDS deaths.
With husband-to-wife transmission emerging
as a main source of new HIV infection in
Cambodia, the National Center for HIV/
AIDS Dermatology and Sexually Transmitted
Diseases (NCHADS) estimated the number
of new infections in women at 6,350 in
2003, almost four times higher than the
1,694 new infections in men and virtually
unchanged from 6,393 in 2002.
Women are more physically susceptible
to HIV infection than men, and younger
women are more susceptible than older
women. In Cambodia, men determine
many decisions relating to reproductive
practices as well as sexual and "healthseeking" behavior. This limits women's
ability to control their own bodies,
increasing their vulnerability to HIV, sexuallytransmitted diseases and unwanted
pregnancies.
Domestic violence makes women more
vulnerable to HIV infection, along with
Cambodian customs that make it inappropriate for women to be knowledgeable
about sex or to suggest condom use. HIV
transmission in Cambodia is fueled by
"large numbers of both married and
6
single men who continue to buy large
amounts of commercial sex."
HIV-positive mothers can pass the virus
to infants during pregnancy or at birth,
as well as during breast feeding. Section 8
examines the impact of HIV/AIDS on
children and young people. Without antiretroviral drug treatment, children are
especially vulnerable to HIV as their
immune systems break down much faster
than adults with the virus. In addition to
the tens of thousands of children
orphaned by AIDS, many other children
are living with family members with
HIV/AIDS. For orphans, who account for
about nine percent of all children in
Cambodia, safety nets are poorly
developed and such children can be
particularly vulnerable to sexual exploitation
and drugs. With young people under the
age of 24 accounting for half of the new
HIV infections in Cambodia, the focus
of HIV prevention is moving towards
adolescents and youth.
Section 9 explores the role of men and
older people in the epidemic. Traditional
expectations of male behavior play a role
in men's vulnerability to HIV infection.
Cambodian men, for example, are usually
expected to drink large quantities of
alcohol when socializing. Alcohol consumption among Cambodian police relates
to "rituals of masculinity" as well as
peer pressure. Men employed in predominantly mobile occupations such as truck
driving, seafaring and the military, are at
risk due to an elevated likelihood of
engaging in commercial or extra-marital
sex.
HIV/AIDS is changing family and community
structures. In a reversal of roles, older
people are looking after their sick adult
children as well as orphans. Despite their
growing responsibilities, older people are
reported as being typically excluded from
most HIV/AIDS programs.
Section 10 introduces the scientific aspects
of HIV. Infectious organisms have proteins
called antigens that cause the immune
system to produce antibodies. With
vaccines, antigens are used to stimulate an
immune response - but not the disease
itself - and protect against infection by the
organism. Developing a preventive vaccine
against HIV is difficult as the virus in
corporates its genetic material into the
very immune system that is designed to
fight viruses. The main challenge for
medical researchers is to find a way to
eliminate or neutralize the virus without
destroying the immune system itself.
Microbicides are chemical or antibiotic
foams or gels that can be applied to the
lining of the vagina or anus to protect
against infections from micro-organisms.
Most of the product developers are small
biotechnology companies, non-profit
companies and academic institutions.
In Section 11, we discuss HIV testing and
counselling. The most common test for
HIV involves taking a blood sample and
testing it for the presence of antibodies
to the virus. However, polymerase chain
reaction (PCR) tests for the virus itself
and can detect HIV within two weeks of
infection. The guidelines for testing in
Cambodia are spelt out in Chapter IV of
the Law on the Prevention and Control of
HIV/AIDS adopted in 2002 and provisions
for confidentiality are contained in
Chapter VII. All testing is supposed to be
voluntary with the informed consent of the
individual. Counseling must take place
both before and after every HIV test.
Treatment and care are covered in Section
12. Anti-retroviral drugs are drugs that
kill or prevent the replication of retroviruses like HIV. By 2004, three classes of
anti-retroviral drugs had been developed.
Doctors refer to using a combination of
drugs from these three classes as highly
active anti-retroviral therapy. Home-based
care is designed to provide symptomatic
relief to comfort and support patients with
life threatening illnesses, such as the
advanced stages of AIDS. The home-based
care system is being expanded nationwide,
with team members being trained in
collaboration with non-government organizations, nursing schools and NCHADS.
The outline for the next ten years in
Cambodia is explained in Section 13. The
seven HIV/AIDS targets for 2015 include
reducing HIV prevalence to 1.8 percent
for adults, and 1.5 percent for young
pregnant women attending ante-natal
clinics.With the NCHADS survey of 2003
showing declines in both rates to 1.9
percent, the targets for 2005 and 2010
have already been met ahead of schedule.
Condom use is meanwhile targeted to
rise to 98 percent for sex workers, 95
percent for young people between the
ages of 15 and 24, and 10 percent for
married women who identify themselves
at risk. Another target for 2015 is for 50
percent of all pregnant women with HIV
to be receiving a complete course of antiretroviral drugs to reduce the risk of
transmitting the virus to the child. The
seventh target is for 50 percent of people
with advanced HIV infection to be receiving
advanced anti-retroviral combination
therapy by 2015.
EXECUTIVE SUMMARY
7
TIMELINE, FIGURES
SECTION 1
1.
TIMELINE, FIGURES
AND BASIC QUESTIONS
The Human Immunodeficiency Virus (HIV),
the causative agent of AIDS, is a retrovirus.
It enters living cells and uses the host cell’s
replication machinery.
Picture and text: Boehringer Ingleheim
8
TIMELINE
SECTION 1
TIMELINE
1959
1984
1991
A Haitian-born sailor in New York dies
of a form of pneumonia called PCP
(pneumocystis carinii pneumonia). A
blood sample is taken from an African port
(present-day Kinshasa in the Democratic
Republic of Congo). Twenty-seven years
later, the blood tests positive for HIV.
Dr Robert Gallo, of the National Cancer
Institute in the United States, announces
the discovery of the virus that causes
AIDS after isolating it from the blood of
healthy sex workers in West Africa. The
virus is named Human T-cell Leukemia
Virus (HTLV) III. After a dispute, Montagnier
and Gallo agree to be named codiscoverers of the virus which is renamed
as the Human Immunodeficiency Virus (HIV).
Cambodia detects HIV for the first time
during screening of donated blood.
1979
Doctors in New York and San Francisco
observe increasing numbers of cases of
people sick with PCP, Kaposi's Sacoma,
cytomegalovirus and candidiasis.
1981
The Centers for Disease Control and
Prevention in Atlanta publishes a report
on the growing incidence of PCP. By the
end of 1981, the number of cases in the
United States reaches 270.
1982
Three studies published in the New
England Journal of Medicine link PCP and
Kaposi's Sacoma to immune deficiency.
The Centers for Disease Control and
Prevention adopts the term Acquired
Immune Deficiency Syndrome (AIDS).
1983
The journal Science publishes a paper by
Dr Luc Montagnier of the Institut Pasteur
in Paris, reporting the isolation of a virus
from West Africa that caused AIDS. The
virus is named Lymphadenopathy Associated
Virus (LAV).
10
1986
The World Health Organization estimates
50,000 people with AIDS in eight countries
in central Africa. Scientists in the United
States announce that zidovudine (AZT), a
drug developed for cancer, seems to benefit
people with AIDS.
1988
The World Health Organization adopts a
resolution calling for the regulation of
discrimination against people infected and
affected by HIV/AIDS.
1989
The United Nations Center for Human
Rights and the World Health Organization
hold the First International Consultation
on HIV/AIDS and Human Rights.
Cambodia passes the Law on Marriage
and the Family, setting the age of consent
for marriage at 20 years for men and 18
years for women unless the parents give
their consent and the woman is pregnant.
1993
Doctors diagnose the first cases of HIV in
Cambodia.
The National AIDS Program is established.
1994
The National Assembly passes the Press
Law which identifies respect for the truth
and the right to individual privacy among
basic principles for journalists. The law
says journalists should avoid publishing
information that incites discrimination and
provides for fines of up to five million riel
for false advertising.
The National Authority for Combating
Drugs is set up.
The Ministry of Health establishes the
HIV Sentinel Surveillance system.
Cambodia is rocked by rumors that people
can be infected with HIV by eating morning
glory grown in Boeng Tumpun.
Social marketing of condoms is launched.
1996
A summit of 42 countries in Paris agrees
to "strengthen the capacity and coordination
of networks of people living with HIV/
AIDS and community-based organizations."
The principle becomes known as Greater
Involvement of People with HIV/AIDS
(GIPA).
1995
Cambodia establishes its first HIV voluntary
testing and counseling center at the
Institut Pasteur in Phnom Penh. Five more
are set up over the following year with
another two centers in Phnom Penh and
one each in Battambang, Kampong Cham
and Siem Reap.
Authorities launch an outreach program
for sexually-transmitted infections in urban
centers in all provinces.
The Joint United Nations Program on
HIV/AIDS (UNAIDS) is set up in Geneva.
The Ministry of Health expands the HIV
Sentinel Surveillance system.
The international AIDS conference in
Vancouver hears promising evidence of
a new range of drugs called protease
inhibitors which prove to be effective when
used in combination with other drugs.
The National AIDS Committee endorses
the National Policies on HIV/AIDS/STD
Prevention and Control.
The office of the United Nations High
Commissioner for Human Rights and
UNAIDS organizes the Second International
Consultation on HIV/AIDS. The meeting
identifies 12 international guidelines for
state action.
T I M E L I N E 11
TIMELINE
Cambodia passes the Law on the Suppression of Kidnapping, Trafficking and
Exploitation of Human Beings and the Law
on the Management of Pharmaceuticals.
SECTION 1
The International AIDS Vaccine Initiative is
set up to accelerate the search for an
effective vaccine against HIV.
1997
Cambodia's HIV prevalence rises to a high
of 3.7 percent of the adult population.
Cambodia passes the Law on the Control
of Drugs.
Rasmei Kampuchea starts a special series
of Sunday articles on HIV/AIDS.
1998
The Minister of Health approves the
National Policy on HIV/AIDS/STD Prevention
and Control.
The National Center for HIV/AIDS,
Dermatology and STDs (NCHADS) is
established.
The National Strategic Plan for STD/HIV/
AIDS Prevention and Care in Cambodia
(1998-2000) identifies priority provinces
and groups of people with high-risk
behavior.These include men who visit sex
workers and highly mobile people like
soldiers and policemen, the wives and
partners of these men and sex workers
themselves.
A pilot scheme called the One Hundred
Percent Condom Use Program is launched
with brothel-based sex workers in
Sihanoukville.
1999
The National AIDS Authority is established
to broaden the government's response
12
to the epidemic. One of its first moves is
to publish the National Policy and Priority
Strategies for HIV/AIDS and STD Prevention
and Control for 1999 to 2004, setting out
a broad response within a human rights
framework.
"significant burden" of increased sickness
and death is inevitable.
A seventh voluntary testing and counseling
center is set up in Sihanoukville.
Cambodia joins other countries in adopting
a declaration at the United Nations General
Assembly Special Session on HIV/AIDS.
The annual NCHADS survey indicates
that HIV prevalence in Cambodia has
dropped to 3.1 percent of the adult
population.
2000
The Ministry of Health develops a Strategic
Plan for HIV/AIDS and STI Prevention and
Care for 2001 to 2005.
Leaders of the United States, Japan,
Germany, France, Britain, Italy, Canada and
Russia agree on the need for more
HIV/AIDS resources during the Group of
Eight summit in Japan.
UNAIDS, WHO and others announce
a joint initiative with five major drug
manufacturers to negotiate lower prices
for HIV anti-retroviral drugs in developing
countries.
HIV prevalence continues to fall in
Cambodia with NCHADS estimating the
adult rate at 2.8 percent.
2001
The Minister of Health approves the
Policy for HIV/AIDS and STI Prevention
and Care in the Health Sector in
Cambodia as an update to the strategic plan
developed in 2000. The policy recognizes
that many married and single men "continue
to buy large amounts of commercial sex"
in Cambodia, that HIV is already spreading
to their wives and girlfriends, and that a
The Ministry of Health develops a National
Policy on Preventing Mother to Child
Transmission of HIV.
The Minister of Health approves the
strategy and guidelines for implementing
the Targeted Outreach Program for
Sex Entertainment Services. The new
phase of the program, which started in
1995, recognizes the need to target all sex
workers and all players in the industry.
ASEAN Heath Ministers endorse the
Second ASEAN Work Program on
HIV/AIDS for 2002 to 2005.
Prime Minister Hun Sen and other
Southeast Asian leaders adopt the ASEAN
Summit Declaration on HIV/AIDS in Brunei.
The declaration promotes the "creation
of a positive environment in confronting
stigma, silence and denial" and the
"elimination of discrimination" against
people with HIV/AIDS.
The National AIDS Authority adopts
the National Strategic Plan for a Comprehensive and Multisector Response to HIV/
AIDS for 2001 to 2005.
Cambodian condom sales reach 16 million
with distribution in all 24 provinces and
municipalities.
2002
The National Assembly passes the Law on
the Prevention and Control of HIV/AIDS.
Under its general provisions, Cambodia is
committed to promoting public awareness
of HIV/AIDS, prohibiting discrimination
HIV/AIDS IN NUMBERS
SECTION 1
Network (CPN+). At the time, CPN+
estimates that only 250 people are
enrolled in such programs.
2003
NCHADS estimates that 2.75 percent of
Cambodians with advanced HIV are
receiving anti-retroviral drugs.
The Ministry of Women's and Veteran's
Affairs adopts a revised Policy on Women,
the Girl Child and STI/HIV/AIDS which
promotes the rights of women and girls
living with HIV/AIDS.
2004
United Nations Secretary General Kofi
Annan meets with senior executives of 22
global media companies, giving birth to
the Global Media AIDS Initiative. The
industry leaders resolve to expand public
knowledge and understanding of HIV/AIDS
through their companies.
A progress report on Cambodia's Millennium Development Goals shows that
reducing the spread of HIV/AIDS is one of
only three out of 25 overall targets that
will "probably" be met and one of only
five with "strong" support.
The International Federation of Journalists
(IFJ) offers to work in partnership with
UNAIDS to expand the Global Media
AIDS Initiative to include print media. It
expresses "profound concern" that understanding of HIV/AIDS and ways to avoid
infection are "still woefully low" and calls
for an education strategy for journalists with
training and a media guide.
14
To develop a more effective response to
the epidemic, more than 100 artists and
journalists travel to Sihanoukville for
the Arts and Media Forum for Life in
partnership with the National AIDS
Authority,TVK and UNDP.
Prime Minister Hun Sen intervenes to halt
a controversial trial of the anti-retroviral
drug tenofovir following objections from
sex workers.
The Ministry of Education's National Youth
Risk Behavior Survey of young people from
11 to 18 finds that a third of the country's
sexually-active youths never use condoms
while another third only use condoms
sometimes.
The World Bank launches an AIDS Media
Center with breaking and embargoed
news as well as tools and resources for
journalists.
The NCHADS survey for 2003 shows that
HIV prevalence has dropped to 1.9 percent.
Estimates for previous years are revised
downwards following quality controls
showing false results. The previous 2002
estimate of 2.6 percent is adjusted to 2.1.
2005
The National AIDS Authority develops
the National Strategic Plan for a Comprehensive and Multisector Response to HIV/
AIDS for 2006 to 2010.
HIV/AIDS in numbers
40,300,000
25,800,000
25,000,000
17,500,000
15,000,000
8,300,000
5,300,000
5,100,000
3,100,000
2,300,000
840,000
570,000
330,000
220,000
123,000
66,000
57,000
55,000
20,000
19,800
17,900
6,400
7,300
1,700
49
22
People worldwide with HIV
Africans with HIV
Global AIDS deaths since 1981
Women with HIV
Orphans due to AIDS
Asians with HIV
South Africans with HIV
Indians with HIV
Global AIDS deaths
Children worldwide with HIV
Chinese with HIV
Thais with HIV
Burmese with HIV
Vietnamese with HIV
Cambodians with HIV
Cambodian men with HIV
Cambodian women with HIV
Cambodian orphans due to AIDS (1)
Cambodian men buying sex each day (2)
Cambodians with AIDS (3)
Cambodian AIDS deaths in 2003
Newly-infected Cambodian women in 2003
Cambodian children with HIV (4)
Newly-infected Cambodian men in 2003
Cambodians dying from AIDS every day
Cambodian adults infected by HIV every day
Sources: Cambodia figures are NCHADS estimates for 2003 and other figures are UNAIDS for the end of 2003 except (1) 2001 estimate by Centers
for Disease Control Global AIDS Program in 2001 (2) estimate by National AIDS Authority (3) NCHADS projection for 2004 and (4) UNAIDS estimate
for 2005. All estimates are rounded.
HIV/AIDS IN NUMBERS
Number of people with HIV
SECTION 1
Adults and children
Africa
Asia-Pacific (1)
India
China
Thailand
Myanmar
Vietnam
Cambodia (2)
Indonesia
Pakistan
Nepal
Malaysia
Iran
Papua New Guinea
Australia
Japan
Philippines
South Korea
Singapore
Sri Lanka
Hong Kong
Laos
New Zealand
Fiji
Mongolia
Brunei
Latin America
Eastern Europe + Central Asia
North America
Western Europe
North Africa + Middle East
Caribbean
Global estimates
Adults
Children
Rate of adult HIV infection (%)
End 2003 estimate
25,800,000
8,300,000
5,100,000
840,000
570,000
330,000
220,000
170,000
110,000
74,000
61,000
52,000
31,000
16,000
14,000
12,000
9,000
8,300
4,100
3,500
2,600
1,700
1,400
600
<500
<200
1,600,000
1,300,000
1,000,000
580,000
480,000
430,000
1,400,000
890,000
950,000
540,000
340,000
400,000
37,800,000
35,700,000
2,100,000
34,900,000
32,900,000
2,000,000
Source: UNAIDS, July 2005
(1)
(2)
16
End 2001 estimate
23,800,000
6,604,000
3,970,000
660,000
630,000
280,000
150,000
170,000
110,000
63,000
45,000
42,000
18,000
10,000
12,000
12,000
4,400
5,600
3,400
2,200
2,700
800
1,200
<500
<200
<200
South and Southeast Asia, Northeast Asia and Oceania
Figures don't necessarily correspond with NCHADS estimates for 15 to 49 year olds in 2003
15 to 49 year olds
Africa
Caribbean
Southeast Asia, South Asia
Cambodia
Thailand
Myanmar
India
Nepal
Malaysia
Vietnam
Singapore
Rest of Asia-Pacific
Latin America
Eastern Europe + Central Asia
North America
Western Europe
North Africa + Middle East, Oceania
Northeast Asia (3)
(2)
Global estimates
(1)
(2)
(3)
except Papua New Guinea which was 0.6 percent (0.4 percent in 2001)
Oceania comprises Australia, Fiji, New Zealand and Papua New Guinea
Northeast Asia comprises China, Hong Kong, Japan, North Korea, South Korea, Mongolia
Source: UNAIDS, July 2004, except Cambodia which is from NCHADS, December 2004
BASIC QUESTIONS
SECTION 1
Number of people who have died from AIDS-related illnesses
(1)
(2)
Adults and children
Africa
Asia-Pacific (1)
Thailand
China
Myanmar
Cambodia (2)
Vietnam
Pakistan
Nepal
Indonesia
Malaysia
India
Bangladesh
Rest of Asia-Pacific
2003 estimate
2,200,000
505,000
58,000
44,000
20,000
15,000
9,000
4,900
3,100
2,400
2,000
. . .
. . .
<1,000
Latin America
Eastern Europe + Central Asia
Caribbean
North Africa + Middle East
North America
Western Europe
Global estimates
84,000
49,000
35,000
24,000
16,000
6,000
2,900,000
South and Southeast Asia, Northeast Asia and Oceania
Figures don't necessarily correspond with NCHADS estimates for 15 to 49 year-olds in 2003
Source: UNAIDS, July 2004
2001 estimate
1,900,000
421,000
58,000
30,000
14,000
13,000
5,000
3,900
2,000
600
1,500
. . .
. . .
63,000
31,000
32,000
17,000
16,000
6,000
2,500,000
a year.
WHAT?
What is HIV?
Human Immunodeficiency Virus.The virus
that causes AIDS by destroying cells that
are an integral part of the body's immune
system.
What is AIDS?
Acquired Immune Deficiency Syndrome.
A collection of symptoms and illnesses
known as opportunistic infections that
eventually develop in people with the
virus who are not treated.
What are opportunistic
infections?
Bacterial, viral and fungal infections which
HIV-positive people can get, including
tuberculosis, pneumonia, meningitis,
herpes, thrush and chronic diarrhea.
What are anti-retroviral
drugs?
Drugs that prevent retroviruses like HIV
from replicating. Combinations of at least
three types of anti-retroviral drugs can
reduce the amount of the virus in the
bloodstream. Side effects can be serious
but can also be reduced.
What transmits HIV?
Blood, semen, pre-ejaculate, vaginal fluids
18
BASIC QUESTIONS
WHO?
A 19-year-old man before surgery in France.
Using a condom properly during sex.
Who gets HIV?
Who is in charge of dealing
with HIV/AIDS in
Cambodia?
WHERE?
Anyone. HIV can be transmitted through
the blood, semen, pre-ejaculate, vaginal fluid
or breast milk of an HIV-positive person.
SECTION 1
Who gets AIDS?
HIV-positive people whose immune
systems have been so damaged over the
years that they become susceptible to a
wide range of infections.
Who discovered HIV?
French doctor Luc Montagnier, who isolated the virus that causes AIDS in 1983,
and American doctor Robert Gallo, who
did so in 1984.
Who adopted the
term AIDS?
The Centers for Disease Control in Atlanta
in 1982 following an increase in cases of
people with various infections linked to
immune deficiency.
Who was the first recorded
person to die from AIDS?
A Haitian-born sailor who died of pneumonia in New York in 1959 (blood samples
related to this case were only tested for
HIV in 1986).
Who was the first
Cambodian diagnosed with
HIV?
The National AIDS Authority, an apex
body comprising 26 ministries, leads the
"multi-sectored" response to HIV/AIDS.
The Ministry of Health's National Center
for HIV/AIDS, Dermatology and SexuallyTransmitted Diseases (NCHADS) is
responsible for government surveillance,
prevention, treatment and care.
Where does HIV enter the
body during sex?
Through the mucous linings of the vagina,
vulva, penis and anus. If there are open
sores, HIV can also enter the body
through the mouth but this is much less
likely.
Where does HIV attack?
Who is protected from
discrimination under
Cambodian law?
HIV targets cells known as CD4+ cells, an
integral part of the body's immune
system. The virus replicates inside these
cells, destroying them in the process.
All people known or suspected of being
infected with HIV/AIDS and their families.
Where are the highest rates
of HIV prevalence in Asia?
Who can get anti-retroviral
drugs in Cambodia?
The two government requirements are a
CD4 cell count of less than 200 cells per
microliter and compliance with supervised
medical treatment.
Who is bearing the brunt of
new HIV infections
in Cambodia today?
Wives of infected husbands and children
of infected mothers.The NCHADS survey
in 2003 showed an estimated 6,400
women becoming infected with HIV every
year, primarily from their husbands. New
infections among men were about 1,700
Cambodia (1.9 percent, or about 123,000
people between 15 and 49 in 2003)
followed by Thailand (1.5 percent in 2003)
and Myanmar (1.2 percent in 2003).
Where do Cambodians
buy condoms?
At pharmacies, service stations, supermarkets and brothels.
Where are the most people
with HIV in Asia?
India (an estimated 5.1 million adults and
children in 2003) followed by China
(840,000 adults and children) and Thailand
(570,000 adults and children).
Where are the highest
rates of HIV infection in
the world?
20
BASIC QUESTIONS
and clinics with programs supported by
non-government organizations.
WHEN?
SECTION 1
When did the global
HIV/AIDS epidemic start?
In 1979, when doctors began seeing the
first unexplained cases of bacterial, viral
and fungal infections in New York and San
Francisco. By the end of 1981, America
had an estimated 270 cases of the
mysterious illness.
When were anti-retroviral
drugs developed to treat
people with HIV?
In 1986, when American doctors announced that a drug initially developed for
cancer seemed to benefit people with HIV.
More effective drugs emerged in 1996,
leading to the combinations of drugs that
are widely used today.
When was HIV first
detected in Cambodia?
In 1991, during screening of donated blood.
The first recorded people infected were
diagnosed in 1993, the same year the
National AIDS Program was set up.
When was the National
Center for HIV/AIDS,
Dermatology and SexuallyTransmitted Diseases
(NCHADS) set up?
In 1998, when the Ministry of Health
merged the National Sexually-Transmitted
22
Diseases Center with the National AIDS
Program launched five years earlier.
When was the National
AIDS Authority
established?
In 1999, when it was decided to broaden
the government's response from the
Ministry of Health to a "multi-sectored"
approach involving all ministries.
When did Cambodia set
targets for reducing HIV
prevalence?
In 2001, when it joined other countries in
adopting a declaration at the United
Nations General Assembly Special Session
on HIV/AIDS. Commitments include
reducing HIV prevalence among young
people and infants as well as implementing
strategies to support children affected by
AIDS by 2005.
When did ASEAN leaders
address problems of people
with HIV/AIDS?
In 2001, when they adopted a declaration
promoting the creation of a positive environment to confront stigma, silence and
denial surrounding HIV/AIDS. Leaders also
agreed to promote the elimination of discrimination.
When was discrimination
against people with
HIV/AIDS outlawed in
Cambodia?
In 2002, when the Law on the Prevention
and Control of HIV/AIDS was passed,
prohibiting all discrimination with penalties
of up to six months in jail and fines of up
to one million riel.
WHY?
Why are women more
biologically susceptible to
HIV than men?
Women have a greater area of mucous
membrane exposed than men. In addition,
sexually-transmitted diseases, which
enhance the ability of HIV to penetrate
the body, are more likely to go undiagnosed
in women than in men. Even without such
infections, UNAIDS says HIV transmission
during sex is believed to be about twice
as likely for women than men.
Why are younger women
more susceptible to HIV
than older women?
The genital tracts of women under 20 are
less developed and more prone to infection,
increasing the likelihood of HIV transmission
during sex.
Why don't anti-retroviral
drugs cure HIV/AIDS?
Three classes of drugs inhibit HIV from
replicating. But the virus still remains inside
the body even if it falls to very low levels
and can rise again to dangerous levels
if treatment is stopped or becomes
ineffective due to mutations of the virus.
Why is it so difficult to
develop a vaccine to
prevent HIV infection?
HIV incorporates its own genetic material
into the immune system itself. The virus
also mutates rapidly and has about 10
BASIC QUESTIONS
Through unprotected sex, from mother
to child including breast feeding, and through
unsafe medical and other procedures involving infected blood ranging from blood
transfusions to sharing needles.
Under the Millennium Development
Goals, the proportion of those getting
anti-retroviral combination therapy is
targeted to reach 25 percent of people
with advanced HIV infection by 2005, up
from three percent in 2002. Further
targets are 60 percent by 2010 and 75
percent by 2015. Additional targets from
UNAIDS indicate that 25 percent of AIDS
patients will be receiving anti-retroviral
treatment in 2006, rising to 44 percent in
2007 and 53 percent in 2008.
How is HIV most
commonly transmitted in
Cambodia?
How many orphans due to
AIDS is Cambodia projected
to have in 2010?
From infected husbands to their wives.
142,000, according to a joint report by
UNAIDS, UNICEF and USAID in 2002.
print media allows fraudulent advertisers
to claim they had traditional medicines to
cure HIV/AIDS.
HOW?
SECTION 1
How is HIV transmitted?
How much do anti-retroviral
drugs cost in Cambodia?
Usually between 10 dollars and 70 dollars
a month but sometimes free, depending
on the source.
How many Cambodians
with HIV are receiving antiretroviral drugs?
More than 8,500 people as of mid 2005,
according to the National AIDS Authority,
up from 1,700 in 2003 and an estimated
250 in 2002.
How many Cambodians
are
ing expected to be receivanti-retroviral drugs by
2015?
24
2.
HIV/AIDS AND
THE MEDIA
How much grant aid has
been
for
HIV/AIDS approved
in Cambodia under the
Global Fund to Fight AIDS,
Tuberculosis and Malaria,
since it was set up in 2002?
More than 25 million dollars as of August
2004 (11.2 million dollars in the first
round, 5.4 million dollars in the second
round, nothing in the third round and 8.8
million dollars in the fourth round).
Helper T-cells express the CD4 antigen. HIV enters
cells by binding to CD4. Helper T-cells are known
colloquially as CD4 cells. A healthy individual
normally has between 500 and 1,500 helper T-cells
per cubic millimeter of plasma.
Picture and text: Boehringer Ingleheim
HIV/AIDS AND THE MEDIA
HIV/AIDS AND
THE MEDIA
I
SECTION 2
n South Africa, which had more than
five million people with HIV in 2003,
local editors see the media as a
"powerful tool" in the fight against AIDS.
For the London-based Science and Development Network of journalists and
scientists, media have a "vital role" in
educating people about the epidemic and
reducing stigmatization and discrimination
against those affected. In Senegal, the
African Women's Media Center sees
journalists as an "essential part" of the
solution to the problems caused by the
epidemic in Africa, which had an estimated
25 million people with HIV at the end of
2003. In these and other countries,
journalists have in recent years developed
media guides to meet the growing
demands of reporters covering a very big
and increasingly complex story.
Until this guide was developed, no such
tool was available in Cambodia, which has
had the highest rate of HIV prevalence in
Asia for many years. In its absence,
Cambodian reporting on HIV/AIDS has
been guided by 11 "primary principles" of
ethical standards outlined in the Press
Law of 1995.These include respect for the
truth and individual privacy as well as
refraining from publishing information
which incites discrimination against anyone
based on their social status, although there
is no specific reference to people with
HIV/AIDS.
26
Full and active participation
In 2001, however, Prime Minister Hun Sen
and nine other ASEAN leaders specifically
mentioned the media in their first ever
summit on HIV/AIDS. Meeting in Brunei,
the ASEAN leaders called for the "full and
active participation" of the media and
other groups in responding to the epidemic.
They also called for the "elimination of
discrimination" against people with HIV/
AIDS and the "creation of a positive
environment in confronting stigma, silence
and denial." Cambodian lawmakers went
even further. The Law on the Prevention
and Control of HIV/AIDS passed in 2002
prohibits "all kinds of discrimination
against those persons suspected or known
to be infected or affected by HIV/AIDS",
including family members, and includes
penalties for violators.The law also mentions
the media's role in raising public awareness
of the epidemic.
That role is now recognized by the global
media industry itself. In early 2004,
top executives of 22 broadcasters met
with United Nations Secretary General
Kofi Annan in New York. The meeting -sponsored by the Joint United Nations
Programme on HIV/AIDS (UNAIDS), the
United Nations Department of Public
Information and the Kaiser Family Foundation, with additional support from the
Bill and Melinda Gates Foundation -- gave
birth to what is now known as the Global
Media AIDS Initiative.
Speaking openly
Unique position
"We are the new generation and we are
allowed to speak openly about HIV/AIDS
and our sexual needs. Things are changing"
The global HIV/AIDS epidemic is a major
international crisis that threatens the
health, security and economic wellbeing of all nations. We further recognize
that the world's media are in a unique
position to help fight the AIDS epidemic.
Through its extensive reach, the media
can be used as a powerful force for
educating and informing the public
about the HIV/AIDS epidemic. We therefore resolve through our companies to
expand public knowledge and understanding about HIV/AIDS.
CTN film director and former Rasmei
Kampuchea reporter Poan Phoung
Bopha
The sponsors found that the media were
an "often overlooked and under-utilized
resource" in the fight against HIV/AIDS.
They also estimated that greater access
to prevention and education could stem
as much as two thirds of the 45 million
new HIV infections projected to occur in
the next decade.The broadcasters agreed
that the world's media were in a "unique
position" to help fight the epidemic and
could be used as a "powerful force" for
education and information. Broadcasters
that took part in the media summit
included TVK affiliates such as Japan
Broadcasting Corp. (NHK) and China
Central Television (CCTV), as well as
Gazprom-Media which operates Russia's
popular NTV network, another TVK affiliate.
Other media companies included Hong
Kong's Phoenix Satellite Television, the BBC
and TV5 from France.
The International Federation of Journalists
(IFJ) welcomed the initiative at its annual
congress in Athens in May 2004, offering to
work in partnership with UNAIDS to
expand the initiative to include print
media.The congress expressed "profound
statement by senior executives of
22 media global organizations
meeting with UN Secretary General
Kofi Annan in New York on January
15, 2004
concern" that levels of understanding of
HIV/AIDS and ways to avoid infection
were "still woefully low" and called for an
education strategy for journalists with
training and a media guide. The Brusselsbased federation, which had two
Cambodian journalist associations as
members in 2004, also called for the
introduction of a prize for excellence in
HIV/AIDS reporting and the development
of a forum of media experts.
As part of the UN media initiative, the
World Bank launched in late 2004 an
AIDS Media Center (www.aidsmedia.org)
in partnership with the Kaiser Foundation
HIV/AIDS AND THE MEDIA 27
HIV/AIDS AND THE MEDIA
SECTION 2
and others including Panos, a non-profit
media organization with nine offices, mostly
in Africa and Asia. The website portal
includes breaking and embargoed news as
well as tools and resources for journalists.
To ensure exclusive access by credentialed
media, some parts of the site are password
protected.Among other initiatives, CCTV
and MTV have formed a partnership in
China with MTV planning a Chineselanguage version of its Staying Alive website
(www.staying-alive.org), a global youth
education campaign.
During the International AIDS Conference
in Bangkok in 2004, UNAIDS executive
director Peter Piot said the media companies that attended the January summit
made four commitments including devoting
more space to reporting HIV/AIDS. Piot
said they were also committed to offering
both space and time for public announcements, including HIV/AIDS in popular
programs and helping small media outlets
which don't have the means to produce
material themselves. "I frankly don't know
of any single country that has been
successful in the fight against AIDS without
a very big awareness campaign and with a
constant engagement of media and other
information channels," Piot said.
Good news, bad news
In Cambodia, awareness of HIV prevention
is relatively high. As part of the Global
Media AIDS Initiative, UNAIDS published
a table in early 2004 ranking 29 countries
according to young women's knowledge
of ways to prevent infection.The good news
was that Cambodia ranked third, well ahead
of many more developed countries. The
bad news was that half the Cambodian
respondents did not know how to avoid
the virus.
28
With the highest rate of HIV infection in
Asia, media in Cambodia have played an
important role in HIV prevention as initial
sensationalist reports of a frightening
new virus gave way to more informative
reporting. In 1997, for example, Rasmei
Kampuchea spearheaded a Sunday series
of articles on HIV with a special questionand-answer section for readers.
Number one
AIDS is the number one issue on the
world today ... It's the worst health crisis
in at least six, seven centuries. And it isn't
only a health crisis. The media are finally
paying attention to this.
Richard Holbrooke, president of
the Global Business Coalition on
HIV/AIDS
But for the Cambodian media as a whole,
there is clearly scope for more balanced
and accurate reporting. A three-month
study of print media published in 2004, for
example, found that HIV/AIDS reporting
focused on prevention and care. Little
space was devoted to stories on infected
women or discrimination. The study also
found that reporting was often sensationalist
or voyeuristic, with little respect for the
dignity of people living with HIV/AIDS
who were usually depicted as victims or
objects of sympathy.
The study, commissioned by the POLICY
Project, concluded that the print media
exaggerated the vulnerability of Cambodians
with HIV/AIDS and stereotyped them as
depressed and despairing people. "By overdramatizing the situation, the print media
make HIV/AIDS become a banal issue,
thus provoking indifference from the
community," the study said. The authors
urged journalists to show greater respect
for the dignity of people with HIV/AIDS
and to explain and analyze the key concepts
of gender bias, stigmatization and ethics.
But the study also recognized that "those
concepts are not grasped by the majority
of Cambodians.".
Ethics and other aspects of
the Cambodian press law
The ethical framework for journalists in
Cambodia is set out in Article 7 of the
Sources for new stories
An excellent source of new stories and
reports is HIV/AIDS research, a vast and
important enterprise that strives to
improve understanding of HIV/AIDS
and to create new tools and strategies
for HIV/AIDS prevention, treatment and
care ... Yet many journalists and other
communicators shy away from reporting
about HIV/AIDS research because they
fear they will not understand its jargon,
concepts and processes, or because they
are hampered by a lack of accessible information and resources. As with any form
of science reporting, the most important
qualities to have for effective HIV/AIDS
communication are enthusiasm and
curiosity rather than a detailed knowledge
of the subject.
HIV/Journalism and Communication
Skills developed by the Londonbased Science Development Network
with TV Padma of Panos India
Press Law. Among the basic ethical principles
that journalists are supposed to follow are
"respect for truth ... good faith ... a sense of
justice ... (and) fair methods to obtain
news, photographs and documents." The
media are also supposed to "retract any
published information that is imprecise
and leads to a misunderstanding."Another
principle is to "avoid publishing information
which incites discrimination on the basis
of race, color, sex, language, belief, religion,
political opinion or tendency, national or
social origin, wealth or other social status".
Journalists are also suposed to "strictly
respect Khmer grammar" and refrain
from publishing "obscene" or "graphicallyviolent" material.
Forms of "grave professional abuse" include
"acceptance of a bribe in any form" and
writing that creates an "unjust suspicion
among readers about any individual or
party." In addition to defamatory statements,
Article 10 stipulates that a person has the
right to sue a publisher for "humiliation
which harms his or her honor or dignity",
Good science writers
A detailed knowledge of science is not
necessarily the most important requirement.
Most editors agree that the formula for a
good science writer is 80 per cent good
journalism plus 20 percent aptitude to
learn and communicate science.
How to Become a Science
Journalist, Science and
Development Network
with penalties of up to five million riel.
Similar penalties apply to false advertising
and publishing material that either incites
HIV/AIDS AND THE MEDIA 29
HIV/AIDS AND THE MEDIA
people to violence or "affects the good
customs of society" (see next Section).
SECTION 2
But good press laws don't necessarily make
good journalists. Laurie Garrett, a Pulitzer
Prize-winning medical and science writer
for Newsday in the United States, told the
International AIDS Conference in Durban
in 2000 that journalists should "grow up''
in their reporting of HIV/AIDS. "It's high
time for all of us, North and South, to
stop simply saying, 'It's sad. It's pathetic.
The numbers are huge. It's getting worse.
Oh my gosh.' We must take our jobs far
more seriously than that," she said. "We
have to demand accountability.We have to
demand the truth ... The facts must be
heard ... The questions must be asked.
Most important -- what is the strategy?
How can we slow this plague in the absence
of a vaccine or cure? I know of no more
important question for journalists to be
asking at this moment. After all, there is
no other force on Earth -- no wars, no
famines, no genocides -- that is killing as
many millions of people today as is this
damnable microbe."
Allowances
Journalists should not expect, request, or
accept payment for attending meetings,
workshops, or conferences; the expectation of an allowance should not be the
factor that motivates a journalist to
attend such forums.
Reporting on HIVAIDS in Africa,
African Women's Media Center
3.
LANGUAGE
Glycoprotein 120 on the surface of HIV enables
the virus to bind to a target cell. CD4 and other
molecules on the cell surface form a complex
with GP 120 to intiate the fusion of the virus
with the target cell.
Picture and text: Boehringer Ingleheim
30
LANGUAGE
LANGUAGE
I
SECTION 3
f the global struggle against HIV/AIDS
is a "battle," journalists are on the "front
line" in shaping public opinion worldwide.With one of the highest rates of HIV
prevalence in Asia, Cambodia is very much
on the front line.These military terms are
used intentionally to highlight some of the
sensitive language issues surrounding HIV/
AIDS.
According to the HIV-related language
policy of the United Nations Development
Program (UNDP), "the appropriate use of
language respects the dignity and rights of
all concerned." It also "avoids contributing
to the stigmatization and rejection of
the affected and assists in creating the
social changes required to overcome the
epidemic." Such policies are in keeping with
the Press Law of 1995, which specifically
mentions upholding people's dignity (sekdeytlaythnou), and the Law on the Prevention
and Control of HIV/AIDS of 2002 which
devotes an entire chapter to discrimination.
Some experts say that military terms like
"battle", "fight", "war", "combat", "campaign",
"control" and "surveillance" should not be
used as they are divisive and prejudicial.
The UNDP policy also says that it's "better"
if the language used is "drawn from the
vocabulary of peace and human development
rather than from the vocabulary of war."
But this is not consistently applied, even
among international organizations. Moreover, it may not be practical for working
32
journalists, especially when expressions
like "battle against AIDS" can be found in
dictionaries. Moreover, the word "surveillance" is used by NCHADS when monitoring
the Cambodian groups it considers most
at risk of HIV infection.
At the same time, some terms have become
almost universally unacceptable such as
"innocent victims", suggesting that some
people are "guilty" for contracting HIV.
Apart from possibly being defamatory, the
discriminatory notion of innocence and
guilt suggests that some people deserve to
be infected with HIV and that others don't.
Such language lacks objectivity, putting
journalists in the position of expressing an
opinion by judging who is innocent and who
is guilty rather than reporting the facts.
Still,some argue that using the term innocent
victim is acceptable in certain circumstances.
Cambodian terminology
While these are some of the language
issues that journalists writing about HIV/
AIDS have had to deal with internationally
over the past 20 years, the Cambodian
print media faces an additional challenge.
Under the law of 1995, the press is prohibited
from publishing anything that "affects the
good customs of society" including words
that are rude (assourous) or explicitly
describe sexual acts. Although violations
carry penalties of up to five million riel,
some newspapers have openly flouted the
legal prohibition on rude language with at
least one minority group stigmatized for
many years.
"Innocent victims"
"I remember talking to a positive person
in one Pacific Island country many years
ago who was adamant that he was a
victim. He explained that neither his
family, the Ministry of Health, schools
etc provided him with the necessary
information to be able to protect himself.
We can't talk about sex, they said. We
can't talk about many things ... so how
do they expect us to learn? ‘The negligence of society and the powers that be
by preventing me (and many others)
from getting accurate non judgmental
information makes me a victim’ , he told
me. It made me recall that 'Nothing is
more immoral than allowing our youth
to die of ignorance'…. With so many of
the positive people in the world being
denied access to drugs, treatment, love,
a caring and supportive environment,
some of them (like my Pacific Island
friend) have every right to feel that they
are victims."
unidentified Fijian on the Australian
Federation of AIDS Organizations
website
The authors of this media guide have no
intention of trying to determine what words
are rude under the law. That's the job
of Cambodian courts. This media guide
will also avoid some of the cumbersome
language that has been creeping into
English lexicon in recent years. The UN
had official French, Spanish and Russian
translations for these unwieldy terms as
of 2004. But the Khmer language is already
littered with too many words borrowed
from English that people don't understand.
This media guide will therefore use
contemporary terms that are widely used
by Cambodian journalists or published in
Cambodian laws. The term "female sex
worker" (srey roksiplauphet), for example,
has replaced "prostitute" (srey pessya) in
recent years. This is the same term used
by NCHADS, which has been surveying
certain groups of Cambodians and their
sexual behavior since 1994. While "sex
worker" is also the preferred term in
some English-speaking countries, media
acceptance is by no means universal and
many journalists use the two words
interchangeably. Even some sex workers
call themselves prostitutes (notably the
Cambodian Prostitutes Union). But the
term "prostitution" (pessyakam) is usually
used in the pejorative sense, especially in
reference to human trafficking. This is
in keeping with the spirit of Article 46
of the Cambodian constitution which
prohibits "running a business in the field
of prostitution" (thveu ajivakam pnai
pesseyakam) without mentioning either
prostitutes or sex workers.
To distinguish between the Human
Immunodeficiency Virus and the Acquired
Immune Deficiency Syndrome, the terms
used are merok eith ("AIDS virus") for HIV
LANGUAGE 33
LANGUAGE
SECTION 3
and chumngeou eith ("AIDS disease")
for AIDS. These are the same terms
used in the HIV/AIDS law of 2002, which
also refers to "people with HIV/AIDS"
(neah min merok eith/neah min chumngeou
eith). These are preferred to the highlyambiguous "catch AIDS" (geut eith) which
should be avoided as it fails to distinguish
between people who have merely been
infected by the virus and those who get sick
with a related disease such as tuberculosis.
To avoid confusion, abbreviations and
acronyms will be used sparingly in this
guide and mainly confined to medical or
pharmaceutical terms where necessary.
The responsibility to tell journalists what
language to use rests with individual
editors. This guide will, however, signal
preferred terms and misleading terms to
be avoided if possible. It will also highlight
any terms that may cause offense as well
as other terms that are simply inaccurate.
Shaping attitudes
Stigma, prejudices, fear, and misconceptions surrounding HIV/AIDS are only too
abundant. The language we use to
conceptualize and talk about HIV/AIDS
reflects our personal biases and particular
understanding (or lack of understanding).
At the same time, this language also
helps shape our own and others' attitudes
about HIV/AIDS. One cannot overemphasize, therefore, the ethical importance
of the media using appropriate language
when covering HIV/AIDS.
34
Appropriate language is constructive,
does not fuel stereotypes, and does not
cause prejudice. There are three main
points to consider about language:
1. It is essential to use language appropriate to the journalist's audience.
The use of language is not just the
question of whether to use a local
dialect, but how to phrase concepts,
and what type of vocabulary to use.
To find the appropriate language, a
journalist needs to build her/his
understanding of their audience,
and to become "fluent" in HIV/AIDS
terminology.
4.
FACTS
2. Language has strong influence on
attitudes toward HIV/AIDS and people
affected by HIV/AIDS. It can be
damaging or it can be non- judgmental,
positive, and constructive. Good
media coverage of HIV/AIDS uses
neutral, gender-sensitive language.
3. HIV/AIDS involves highly technical
terminology. It is imperative for
journalists to "translate" this terminology into ideas and terms that their
audiences can readily understand. It
is also crucial to ensure that the
language used in stories is accurate.
Good journalism requires journalists
to understand the facts about HIV/
AIDS, and to get these across to their
audiences in ways the audiences
can understand.
Reporting on HIVAIDS in Africa,
African Women's Media Center
In the presence of inadequate therapy, such as monotherapy or
partially suppressive therapy, resistant viral strains (green, purple)
develop. The rapid replication of HIV and its high mutation rate
mean that mutant strains with different attributes, e.g. drug
resistance, emerge very quickly. Drug resistance may develop
within a few weeks or several months. If a drug resistant viral
strain develops in the presence of inadequate therapy, it will
have a growth advantage over the other strains and quickly
become one of the dominant strains in the population. Rapid
‘outgrowth’ of the resistant strain leads to drug failure.
Picture and text: Boehringer Ingleheim
FACTS
FACTS
HIV stands for Human Immunodeficiency
Virus, the virus that causes AIDS by
destroying cells integral to the body's
immune system. Infection occurs through
intimate contact when blood, semen,
pre-ejaculate, vaginal fluids or breast milk
carrying HIV enters the bloodstream of
an uninfected person.Various types of HIV
tests can confirm infection. The most
common test looks for the presence of
antibodies that usually develop within three
months.
The virus was isolated by French doctors
in 1983 and American doctors in 1984
using blood samples from western Africa.
HIV is a type of virus known as a retrovirus
which means it stores genetic information
differently from common viruses that
cause colds, chicken pox or measles. It is
also a lentivirus which means that it is
slow-acting -- like a similar virus that affects
monkeys (Simian Immunodeficiency Virus).
For this reason, many people with HIV
can remain healthy for more than 10 years
without treatment. In Cambodia, people
with HIV usually remain healthy for shorter
periods of between four to six years due
to various factors such as poor nutrition.
Different HIV strains are associated with
different geographical areas and people. If
a person is infected with more than one
strain, different parts can recombine into
a new form which can then be passed to
others. New combinations of strains have
recently been reported in China,Thailand
36
and Vietnam (see HIV strains in glossary of
terms).
HIV was first detected in the blood
supply in Cambodia in 1991, and doctors
diagnosed the first HIV cases in 1993. For
many years, Cambodia has had the highest
rate of infection in Asia. But with reduced
risk behavior and increased numbers of
deaths in recent years, NCHADS figures
show that HIV prevalence has fallen from
an estimated 3.0 percent of all adults in
1997 to 1.9 percent in 2003.The estimated
number of adults infected dropped from
more than 158,000 to 123,000 in the
same period, with the number of new
infections running at an estimated 8,000 a
year in 2003. In terms of the number of
infections in Asia, UNAIDS figures for the
end of 2003 showed Cambodia ranking
sixth behind India, China, Myanmar,Thailand
and Vietnam.
Transmission
The ability of HIV to survive outside of
the human body is very limited.As a result,
the virus can only be spread through
unprotected sex, from mother to child
including breastfeeding and unsafe
procedures involving infected blood.
Viruses that spread through such intimate
contact are called infectious viruses. In
other words, they are much harder to
catch than contagious viruses like colds
which are airborne.
Blood-borne transmission can occur during
transfusions or through contaminated
Cambodians with HIV
Estimated number of people aged 15-49 living
with HIV/AIDS, 1990-2003, Cambodia
180,000
158,300 158,900 155,900
160,000
147,300
120,000
100,000
142,100
123,100
120,600
95,700
85,600
80,000
101,900 102,500 99,100
92,700
84,600
81,100
75,200
65,600
60,800
60,000
45,700
40,000
1,150
51,600
33,700
18,700
20,000
149,900
132,900
Total
Men
Women
140,000
Number
SECTION 4
HIV
56,400
56,400
56,800
57,200
57,500
57,700
57,500
1997
1998
1999
2000
2001
2002
2003
39,500
4,300
24,800
12,000
0
1990
1991
1992
1993
1994
1995
1996
Year
Source: NCHADS 2004
Gender distribution
Gender distribution of people currently living with HIV/AIDS,
1997-2003, Cambodia
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Men
Women
1997
1998
1999
2000
2001
2002
2003
Source: NCHADS 2004
FACTS 37
FACTS
Transmission routes
Myths
Route of HIV Transmission over time in Cambodia
SECTION 4
100%
80%
Extramarital
Mother to child
Sex worker
Female from husband
Male from wife
60%
40%
razor blades or nail clippers is considered
extremely unlikely, although sharing such
items is not a good idea due to the possible
transmission of other viruses such as
Hepatitis C.
HIV is primarily a blood-borne virus and
is not contagious like air-borne viruses
such as influenza or SARS. HIV cannot be
transmitted by saliva, sweat, tears or urine.
So it cannot be spread by shaking hands,
coughing, sneezing or regular kissing. Nor
can it be transmitted by mosquitoes or
Seeds from the slaeng plant (a vine
related to strychnine) cannot "cure" AIDS.
Cambodians with AIDS
Male from sex worker
Estimated number of AIDS cases, 1990-2004, Cambodia
20%
25000
0%
22575
1990
Year
1995
2000
22444
21855
Source: NCHADS 2004
Women
20000
21497
20087
Men
19814
17298
Total
15000
14473
14147
14103
13377
needles and syringes that often contain a
small amount of blood after injections.
Needles used for tattoos or acupuncture
can transmit HIV if not sterilized. The
virus can also be spread through infected
blood products, tissue and organs.
In Cambodia, however, sexual transmission
has been the main cause of HIV infection.
During unprotected sex with an infected
partner, HIV can enter the body through
linings of the vagina, vulva, penis and anus.
The presence of sexually-transmitted
diseases increases the risk of transmission,
especially for women.
Because of husbands infecting their wives,
mother-to-child transmission is a growing
source of HIV infection in Cambodia. An
infected mother can pass the virus to her
child during pregnancy or birth.The other
route is through breast feeding -- even if
the child is born without the virus.
38
AIDS
AIDS stands for Acquired Immune
Deficiency Syndrome, a collection of
symptoms and illnesses that eventually
develop in HIV-positive people who do
not receive treatment. People who develop
AIDS often have infections of the lung,
brain, eyes and other organs, and frequently
suffer debilitating weight loss. People with
HIV do not necessarily have AIDS. But all
people with AIDS have HIV.
NCHADS has estimated that the number
of AIDS cases in Cambodia has fallen from
a peak of almost 23,000 in 2001 to less
than 21,500 cases in 2003, projecting a
further decline to 19,800 in 2004. But the
AIDS death toll has continued to climb,
reaching a record of almost 17,900 deaths
in 2003 comprising more than 11,300
men and more than 6,500 women. Separate
estimates for 2001 indicated 55,000
children orphaned by AIDS.
12974
13121
11456
10000
9023
2267
1990
7708
8103
8342
8522
8344
5841
4281
3627
2732
1457
0
0
6966
6290
5085
5000
11470
9096
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
Source: NCHADS 2004
sharing cups, glasses, forks, spoons,
chopsticks, toilets or swimming pools.
Transmission through passionate kissing is
extremely rare -- the one noted case in
the United States involved two people
with severe dental disease which allowed
infected blood to pass from one person
to the other.
As HIV has a limited ability to survive
outside the human body. Transmission
through household items like toothbrushes,
Nor can lemon juice, although there has
been some inconclusive evidence that a
substance found in lemons can help to
prevent transmission of HIV. Grilled
pineapple skins, sex with virgins and green
bean porridge cannot cure AIDS either.
In Cambodia, false advertising of such
"cures" carries a penalty of up to one year
in jail under the HIV/AIDS law. Under
the Press Law of 1995, false advertising
carries a penalty of up to one million riel.
FACTS
39
FACTS
Sex and HIV
SECTION 4
Abstaining from sexual activity is the
safest way to protect against HIV from
sexual transmission, and this includes
delaying sexual initiation among youth.
The safest sex is between two people
who have both tested HIV negative twice
in three months and who are otherwise
not exposed to other modes of transmission. If the two partners remain faithful,
there is zero risk of exposure to HIV. But
if the HIV status of one of the partners is
unknown, sex can only be safe if there is
no exchange of semen, pre-ejaculate, vaginal
fluids or blood.
Condoms are the only way to prevent
transmission during sex with an HIVpositive partner. But condoms are only
safe if used properly. Common problems
include failing to use new condoms after
each ejaculation, failing to unroll them
completely and failing to put condoms on
before genital contact. For maximum safety,
additional lubricant is sometimes used to
prevent breakages of unlubricated condoms.
Lubricants must be water-based. Oilbased lubricants weaken the latex and can
also cause condoms to break.
5.
STIGMA AND
DISCRIMINATION
HIV is able to infect the central nervous system (CNS), including
the brain.The CNS has been shown to be a major reservoir of the
virus. Not all of the available anti-retroviral drugs are able to cross
the blood: brain barrier and enter the CNS, however. Many HIV
specialists believe that combinations of anti-retroviral drugs should
include at least one drug which is able to penetrate the CNS. Drugs
such as nevirapine and zidovudine have been shown to enter the
cerebrospinal fluid.
Picture and text: Boehringer Ingleheim
40
STIGMA AND DISCRIMINATION
STIGMA AND
DISCRIMINATION
S
SECTION 5
tigma and discrimination strengthen
social inequalities and prejudices,
especially those related to gender,
sexual orientation, economic status and
race. Stigma associated with HIV/AIDS
continues to profoundly affect prevention
efforts, leading people to deny risk, avoid
testing, delay treatment and suffer needlessly.
Guilt by association
UNAIDS defines stigma as a "multi-layered
process of devaluation that tends to reinforce negative connotations by associating
HIV and AIDS with already-marginalized
groups." The agency also notes that stigma
"lies at the root of discriminatory actions
that exclude people who need AIDS-related
services."
In Cambodia, sex workers and men who
have sex with men are among the marginalized groups most affected by HIV/AIDS.
Injection drug users are another group on
the margins of Cambodian society, although
their numbers are believed to be small
and their role in the epidemic has so far
not been significant compared with other
countries such as Vietnam and Malaysia.
The case of the moving
corpse
One of the most striking cases recounted
by the Cambodian Human Rights and
HIV/AIDS Network involved a Phnom
Penh hospital that falsely claimed a
42
patient had died when it realized the
patient's family had no more money.
The patient, a father of five who tested
HIV positive in early 2002, was admitted
to the unidentified hospital when he
became seriously ill in 2003.
Within four days, by which time the
family had exhausted its entire savings
of 300 dollars, the hospital said the man
had died and had to be removed.
After arranging to have the body
cremated, the family transported the
body to a pagoda. But when the undertaker removed the shroud, it was found
that the man was not dead and could
still move his hands and open his eyes.
The family took the man to another
hospital where he received free treatment
before dying four days later.
The stigma associated with HIV/AIDS is
one of the greatest obstacles to
Cambodians living with the virus. It is
also a major barrier to HIV programs -people who want to know their HIV
status may be afraid to be tested out
of embarrassment. It has even been
reported that some people are afraid to
buy condoms out of fear of being
labeled as HIV carriers.
The POLICY Project, HIV/AIDS and
Human Rights in Cambodia, 2005
Violating human rights
Discrimination is defined by UNAIDS as
an infringement of human rights that often
leads to people being subjected to various
forms of abuse. In Cambodia, any discrimination in the workplace based on a person's
actual, perceived or suspected HIV/AIDS
status is prohibited under Article 36 of the
Law on the Prevention and Control of HIV/
AIDS. Termination of employment on the
same basis is unlawful.
Other articles guarantee freedom of abode,
lodging and travel and the right to seek
public office for people with HIV/AIDS
and prohibit discrimination by educational,
financial and health institutions.While the
law does not spell out penalties for discrimination in the workplace, first-time
violators of the other provisions face a
fine of up to one million riel and up to six
months in jail.
Despite these provisions under Cambodian
law, stigma and discrimination persist.
People with HIV/AIDS are often blamed
for getting infected. Many people with HIV/
AIDS are shunned by their families, ejected
from homes and villages or abandoned at
health facilities where they are sometimes
left to die. Many people running small
businesses also suffer declines in customers,
eroding income and sometimes forcing
parents to withdraw their children from
school. Stigma and discrimination can
similarly affect families of people with
HIV/AIDS.
Tarred by the same brush
"Stigma devalues and discredits people,
generating shame and insecurity. In the
context of AIDS, it can fuel the urge to
scapegoat, blame or punish certain people
(or groups) in order to detract from the
fact that everyone is at risk. Stigma taps
into existing prejudices and patterns of
exclusion and further marginalizes people
who might already be more vulnerable
to HIV/AIDS. It stems from the association
of HIV/AIDS with sex, disease and death,
and with behaviors that may be illegal,
forbidden or taboo such as pre and
extra-marital sex, sex work, sex between
men and injecting drug use."
"Stigma ... prompts people to act in ways
that directly harm others and deny them
services or entitlements -- actions that
take the form of HIV-related discrimination.
Such unjust treatment can be tantamount
to a violation of human rights."
UNAIDS Epidemic Update, 2003
Rejection, hardship,
bankruptcy and corruption
A report sent to the United Nations
Office of the High Commissioner of Human
Rights in 2004 included details of some of
the 80 cases of HIV/AIDS-related violations
of human rights recorded in Cambodia
since 2003.The Cambodian Human Rights
STIGMA AND DISCRIMINATION 43
STIGMA AND DISCRIMINATION
SECTION 5
and HIV/AIDS Network (CHRHAN)
collected the information from seven
provinces and municipalities. In 13 cases,
people reported being ostracized or
rejected by their families or communities,
sometimes leading to extreme hardship.
In 20 cases, people said they were shunned
when they began to show signs of illness
or when there was a known or suspected
AIDS-related death in the family. A laundry
and a manicure shop were among small
businesses that collapsed as a result of
association with HIV/AIDS.
CHRHAN also reported violations of
human rights in the health care sector. In
some cases, health facilities were refusing
to provide services for people with HIV/
AIDS. In others, health facilities charged
fees that limited access to services -- even
though the HIV/AIDS law of 2002 states
that people with the virus are entitled to
free primary care in all public health facilities.
Moral judgments
Making moral judgments based on how
a person contracted HIV perpetuates
stigma and promotes discrimination
against (people living with HIV/AIDS)
and people who are vulnerable to infection,
and thereby undermines HIV prevention,
treatment, care, and support work.
Talking about those infected 'while having
sexual encounters during a drinking
spree' and ascribing them guilt for this
doesn't help us understand how to
prevent HIV infections, nor does it help
us care for and about people who are
infected.
... We should avoid easy conclusions. The
phrase 'no human beings in their right
thinking mind would want to contribute
to their own infection' makes the very
complex reasons why we have sex or use
drugs seem so simple. But we know this
is not the case. People smoke, and get
lung cancer. Men and women have sex,
and have unwanted pregnancies.
Sometimes we think about the implications of our actions, and other times not.
Andy Quan, Australian Federation
of AIDS Organizations
6.
DATA
This picture shows the struture of the Human
Immunodeficiency Virus (HIV). The outer shell of the
virus is known as the viral enevlope.
Picture and text: Boehringer Ingleheim
44
DATA
DATA
NCHADS and its predecessor have been
surveying specific groups of people for
HIV across Cambodia since 1994. These
groups are known as sentinel groups, which
means they are susceptible to an infection
that is being monitored. Between 1994
and 2003, nine separate HIV Sentinel Surveillance (HSS) surveys covered 11 different
groups. There was no survey in 2001 and
results of the ninth survey in late 2003
were released at the end of 2004, showing
that Cambodia's rate of HIV prevalence
was lower than previously estimated. The
survey system is among the most developed
in the world and is now in a phase known
as "second-generation surveillance" which
could provide a wealth of information on
the dynamics of the epidemic.
Two groups -- direct female sex workers
and policemen -- have been included in
every survey. Pregnant women attending
ante-natal clinics have been covered in
all but one of the surveys. Other groups
covered have been tuberculosis patients,
indirect female sex workers (beer-
46
The number of provinces and municipalities
surveyed rose from five in 1994 (Phnom
Penh, Banteay Meanchey, Battambang,
Sihanoukville and Siem Reap) to 22 in 1997.
Since then, the number has fluctuated
between 19 and 22.
In 2003, the HSS covered all provinces
and municipalities except Kep and
Mondolkiri. HIV prevalence rates were
estimated at 20.8 percent for direct sex
workers, 11.7 percent for indirect sex
workers, 2.5 percent for policemen and
2.2 percent for pregnant women attending
ante-natal clinics. National prevalence was
estimated at 1.9 percent.The 2003 survey
performed quality controls on samples
going back to 1999. Researchers identified
false results, both positive and negative,
in each group and adjusted the figures
accordingly. For 2002, for example,
Cambodia's national HIV prevalence was
adjusted downwards from the previous
estimate of 2.6 percent to a revised 2.1
percent.
The number of blood samples taken in
the 2003 survey was 20,707 with pregnant
women comprising the biggest sentinel
group (10,867) followed by policemen
(5,796), direct female sex workers (2,411)
and indirect female sex workers (1,633).
HIV trend in direct sex workers
Adjusted HIV prevalence* among direct female sex workers, by age
group, 1998-2003, Cambodia
50
43.5
40
40.4
34.2
41.3
30
29.9
32.2
24.8
24.1
20
19.7
10
20 years and older
<20 years
7.8
0
1998
1999
2000
2001
2002
2003
Year
*Adjusted for results of quality assurance testing
Source: NCHADS 2004
HIV trend in indirect sex workers
Adjusted HIV prevalence* among
indirect female sex workers, 1996-2003, Cambodia
50
40
42.8
39.1 40.0
38.0
32.1
Percent
HIV Sentinel Surveillance
promotion girls and karaoke hostesses
who sell sex), male military personnel,
married women of reproductive age, freelance sex workers (including massage girls
and bar girls), hospital inpatients and
household males and females.
Percent
SECTION 6
T
he Ministry of Health has been
overseeing a national surveillance
system for HIV infection since
1994 and for high-risk behavior since 1997.
Based on the data collected, national estimates of HIV prevalence are made, along
with estimates for the actual number of
people with HIV and the number of deaths
from AIDS.
28.0
30
20.8
20
10
0
1996
1997
1998
1999
2000
2001
2002
2003
Year
*Adjusted for results of quality assurance testing
Source: NCHADS 2004
DATA
47
DATA
HIV trend in policemen
Adjusted HIV prevalence* among police,
1996-2003, Cambodia
Adjusted, weighted data
SECTION 6
6
5
4.5
Percent
4.3
4.4
Adjusted, weighted data smoothed with EPP
4.2
3.8
4
3.5
3.1
3
2.7
2
1
0
1996
1997
1998
1999
2000
2001
2002
2003
Year
Source: NCHADS 2004
Behavioral Surveillance
Survey
HIV trend in pregnant women
Adjusted HIV prevalence* among ANC
women, 1996-2003, Cambodia
Adjusted, weighted data
Adjusted, weighted data smoothed with EPP
3.0
2.3
Percent
2.5
2.0
2.5
2.5
2.5
2.4
2.3
1.9
2.1
1.5
1.0
0.5
0.0
1996
1997
1998
1999
2000
Year
48
For future surveys, NCHADS highlighted
the need for data on HIV prevalence among
drug users, men who have sex with men
and migrant populations. It also recommended that pilot surveys of these groups
be carried out before the next survey.
NCHADS had previously admitted that
estimating HIV prevalence among men
was limited as police were the only male
group surveyed. Moreover, with recruitment
of new police more or less suspended since
1993, police are an aging population from
which it is difficult to draw conclusions. As a
result, the only way to estimate the rate of
HIV infection among the male population at
large is to make indirect estimates based
on data for pregnant women. NCHADS
has also noted that the only data tracking
changes in the risk of male infection in
Cambodia are the separate surveys of
behavior.
2001
2002
2003
Source: NCHADS 2004
NCHADS started surveying the behavior
of sentinel groups in 1997. With the
exception of 2002, surveys have been
carried out every year. Since 2001, the BSS
has covered five distinct groups -- direct
sex workers, beer and karaoke girls, men
serving in the military, policemen and
motorcycle taxi drivers. In the sixth survey
in 2003, military and police were merged
into one group with equal numbers,
leaving four sentinel groups. Other groups
surveyed over the years have included
vocational students, women who work
and household males.
Between 1997 and 2001, the survey was
limited to five provinces and municipalities
-- Battambang, Kampong Cham, Phnom Penh,
Siem Reap and Sihanoukville. In 2003,
however, it covered five additional provinces
-- Kampot, Koh Kong, Kratie, Pursat and
Takeo. The number of people surveyed in
2003 was 4,858 (1,351 military and police,
1,308 direct sex workers, 1,252 indirect sex
workers and 947 motorcycle taxi drivers).
The results of the survey, released in early
2004, showed that consistent condom use
with clients was 95.1 percent for direct
female sex workers, 81.7 percent for beer
girls and 81 percent for karaoke girls. But
among those with boyfriends, only 55.6
percent of the sex workers, 65.8 percent
of beer girls and 41.7 percent of karaoke
girls used condoms with their boyfriends
all the time.
Among the men surveyed, consistent
condom use with sex workers was 95.5
percent for policemen, 90.8 percent for
military personnel and 88.9 percent for
motorcycle taxi drivers. But among those
with girlfriends, only 37.6 percent of the
military, 30.7 percent of the motorcycle
taxi drivers and 26.4 percent of the
policemen used condoms with their
girlfriends all the time.
In addition to calling for young men to be
included in future surveys, NCHADS said
efforts were needed to sustain the high
use of condoms in commercial sex and
for "innovative approaches" to address
the sexual risks with boyfriends and
girlfriends.
Demographic Health
Survey
The Cambodia Demographic and Health
Survey, conducted by the Ministry of
Planning and the Ministry of Health in
2000, covered 15,351 women between
the ages of 15 and 49. The survey, the
most comprehensive of its type, found
that knowledge of HIV/AIDS was "very
DATA 49
DATA
high" among Cambodian women. Ninetyfive percent had heard about HIV/AIDS.
But awareness was "significantly lower" in
remote provinces such as Mondolkiri,
Ratanakiri, Preah Vihear, Steung Treng,
Kratie and Banteay Meanchey.
SECTION 6
About 70 percent of all women knew that
condoms could prevent HIV transmission
and that HIV could be spread during
pregnancy and breast feeding. More than
60 percent knew that a healthy-looking
person could have HIV and that the virus
could be transmitted while giving birth.
Almost half knew someone with HIV or
someone who had died of AIDS. But 24
percent either did not know about HIV/
AIDS or if it could be avoided.
At least 90 percent said it was acceptable
for media to report about HIV/AIDS. A
similar proportion said it was acceptable
for secondary schools to discuss the issue,
with 80 percent approving such discussion
in primary schools. More than half said
they were willing to care for a relative sick
with AIDS but only a third said people
with HIV should be allowed to keep working.
Only three percent of women had been
tested for HIV. Among those who had not
been tested, 84 percent did not know
where to get a test, and 25 percent of all
respondents said they wanted an HIV test
but had not yet been tested. Such "unmet
demand" for HIV testing was particularly
high in Kampong Chhnang, Kampong
Speu and Pursat.Awareness of other sexually-transmitted infections was low -- less
than 40 percent of Cambodian women
had heard about such infections.
Sex workers using condoms with clients
Clients using condoms with sex workers
Consistent condom use with sex
worker in past 3 months, 1997-2003, Cambodia
90%
60%
68.8
65.6
61.8
53.8
30%
20%
10%
0%
1997
1998
90%
80%
Sweethearts
Client
42
60%
55.2
53.4
BEER
10%
20%
14.8
10%
8.2
0%
1998
1999
2001
37.4
49.0
29.7
30%
DSW
14.8
1997
38.2
40%
29.7
30%
55.2
50%
38.2
40%
0%
84.4
80%
70%
60%
20%
2003
Beer girls: consistent condom use
by type of partner*, 1997-2003, Cambodia
90%
70%
50%
2001
Source: NCHADS 2003
100%
84.4
78.1
1999
Beer promotion girls using condoms
96
91.7
69.7
69.8
43.3
Consistent condom use with clients:
female groups, 1997-2003, Cambodia
100%
94.2
86.9
89.4
55.1
50%
40%
88.8
87.0
83.9
80.3
80%
70%
Police
Military
Moto-taxi
100%
1997
26.1
19.3
1998
1999
2001
2003
2003
*Comdom use with client among those with clients; condom use with sweethearts among those with sweethearts
Source: NCHADS 2003
50
Source: NCHADS 2003
DATA 51
DATA
Men using condoms with girlfriends
Consistent condom use with
sweethearts: by male groups, 1997-2003, Cambodia
50%
Moto-taxi
Military
Police
SECTION 6
45%
44.4
40%
41.2
35%
32.4
30%
29.8
27.8
25%
26.5
27.3
25.0
7.
WOMEN
20%
15%
14.5
10%
11.4
5%
0%
0
1997
10.6
12.8
10.3
5.0
1998
1999
2001
2003
Source: NCHADS 2003
Perinatal transmission of HIV from mother to
baby is the major cause of HIV infection in
children worldwide.
Picture and text: Boehringer Ingleheim
52
WOMEN
WOMEN
SECTION 7
N
CHADS estimates that women
account for almost half of the HIV
cases in Cambodia and more than
a third of the AIDS deaths.
Worldwide, women are more biologically
susceptible to HIV than men because of
their physical makeup. In Cambodia and
several other countries, women are also
socially vulnerable to HIV because of the
large numbers of husbands and boyfriends
who infect their wives and girlfriends.
HIV Sentinel Surveillance in 2003 indicated
that about 57,500 women were HIV
positive, amounting to 47 percent of all
adults infected. With husband-to-wife
transmission emerging as the main source
of new HIV infections in Cambodia,
NCHADS estimated the number of new
infections in women at 6,350 in 2003,
almost four times higher than the 1,694
new infections in men and virtually
unchanged from 6,393 in 2002.
The survey estimated 6,544 new AIDS
deaths among women in 2003, amounting
to 37 percent of all adult deaths from
AIDS the same year. But the proportion
of women developing AIDS was higher -- 40
percent of all new cases among adults,
amounting to 8,522 women. Even though
the number was projected to decline to
8,344 in 2004, women's share of the total
was expected to climb even higher to reach
42 percent of all adults developing AIDS.
Women with HIV, new infections and AIDS deaths
Estimated number of women aged 15-49 living with HIV,
newly infected with HIV, and who died from AIDS, 1990-2003
Cambodia
Number
70,000
Living with HIV (Prevalence)
Deaths (Mortality)
New HIV Infections (Incidence)
60,000
50,000
40,000
30,000
20,000
10,000
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year
54
Source: NCHADS 2004
Biological susceptibility
Social vulnerability
Women are more physically susceptible
to HIV infection than men, and younger
women are more susceptible than older
women. Under a policy adopted in 2003, the
Ministry of Women's and Veterans Affairs
recognized that women were up to four
times more vulnerable to HIV infection than
men during unprotected sex. This is because
of the larger surface areas exposed and
retention of infected body fluids.
In Cambodia, many decisions relating to
reproductive practices as well as sexual
and "health-seeking" behavior are determined by men.This limits women's ability
to control their own bodies, increasing
their vulnerability to HIV, sexually-transmitted diseases and unwanted pregnancies.
In its 2003 policy, the Ministry of Women's
and Veterans Affairs recognized that
domestic violence made women more vulnerable
to HIV/AIDS. The policy also recognized that
Cambodian customs made it "inappropriate
for women to be knowledgeable about sexuality
or to negotiate safe sex or condom use."
UNAIDS reckons transmission is about
twice as likely in an uninfected woman
having vaginal sex with an HIV-positive
man than an uninfected man having vaginal
sex with an HIV-positive woman.
The chances of HIV infection are even
higher if an uninfected woman has sores
or cuts in her vaginal wall, which are mostly
caused by sexually-transmitted diseases.
The National AIDS Authority (NAA)
reckons the presence of sexually-transmitted diseases makes transmission up to
10 times more likely. In addition to causing
open sores, such diseases bring immune
cells to the site of the infection, enhancing
the ability of HIV to enter the body. Due
to an absence of symptoms, women are
unaware they have such diseases about
half of the time. As a result, they are frequently left untreated. Teenage girls are
particularly susceptible to HIV exposure
as their genital tracts are not fully developed
and therefore more prone to infection.
The National AIDS Authority has also noted that
the traditional code of conduct says women
are supposed to be "demure and obedient"
and "not too intelligent to argue with their
husbands." This presents obstacles for HIV
prevention efforts.
In its policy for HIV/AIDS and STI prevention
and care adopted in 2001, the Ministry of
Health noted that the risk of HIV transmission in Cambodia was fueled by "large
numbers of both married and single men
who continued to buy large amounts of
commercial sex." The ministry warned
that HIV infection among men throughout
Cambodia was already so high that the
virus was spreading to wives, girlfriends
and children, creating a "significant burden"
in terms of increased sickness and death.
The NAA has estimated that up to 20,000
men buy sex every day in Cambodia.
WOMEN 55
WOMEN
Mother-to-child
transmission
SECTION 7
HIV-positive mothers can pass the virus
to infants during pregnancy or at birth,
known as perinatal infection, as well as
during breast feeding. Such mother to child
transmission, also known as vertical
transmission, can also occur if the mother
is infected while breast feeding. In
low-income countries like Cambodia,
UNAIDS estimates that the likelihood of
an infected mother passing the virus to
her newborn child is at least 30 percent.
In rich countries, however, HIV-positive
mothers rarely transmit the virus to their
children due to alternatives to breast
feeding and the availability of Caesarian
deliveries as well as access to anti-retroviral
drugs.
Under Cambodia's national policy on
preventing mother-to-child transmission
adopted in 2001, the Ministry of Health
projected 1,000 new cases of children with
HIV every year by 2000.
The policy recommends preventive
treatment with the anti-retroviral drug
nevirapine where the full range of support
services is available. For HIV-positive
mothers, a single dose of 200 milligrams is
recommended at the onset of labor or
before a Caesarean. For new-born babies,
a single dose of oral nevirapine (two
milligrams per kilogram) is recommended
within 72 hours of birth. The consent of
the mother is required in both cases.
The policy also requires HIV-positive
women to be informed about breast feeding
and other feeding methods. Women
who are HIV-negative are supposed to be
informed about the importance of avoiding
infection during pregnancy and breast
feeding. The policy also recommends that
infants born to HIV-positive mothers be
tested at 18 months and that immunization
and preventive treatment for opportunistic
infections be provided to the newborn.
In addition, HIV-positive women and
children are supposed to be "protected
from stigmatization and discrimination."
Under the Cambodian Millennium Development Goals, 10 percent of HIV-infected
pregnant women attending ante-natal
clinics are targeted to receive a complete
course of anti-retroviral drugs by 2005, up
from 2.7 percent in 2002.The target is 35
percent for 2010, rising to 50 percent in
2015.
8.
CHILDREN AND
YOUNG PEOPLE
The battle between the viral infection and
the cells of the immune system continues
throughout the course of the infection.
Picture and text: Boehringer Ingleheim
56
CHILDREN AND YOUNG PEOPLE
CHILDREN AND
YOUNG PEOPLE
U
SECTION 8
NAIDS has estimated that
Cambodia had 7,300 children
under the age of 15 with HIV at
the end of 2003, up from 6,400 two years
earlier. And the Ministry of Health has
forecast that about 1,000 children will go
on to develop AIDS every year by 2005.
The number of children who have lost
parents to AIDS was meanwhile estimated
at 55,000 in 2001. Projections by UNAIDS,
UNICEF and USAID show the number of
orphans due to AIDS skyrocketing to
142,000 by 2010 with HIV/AIDS accounting
for one out of every four orphans.
Children with HIV
Newborn infants and children are mainly
infected by HIV during pregnancy, birth
or breast feeding. Without anti-retroviral
drug treatment, children are especially
vulnerable to HIV as their immune systems
break down much faster than adults with
the virus. Figures quoted by UNAIDS in
2004 showed that at least 25 percent of
newborns infected with HIV die before
turning one and that up to 60 percent die
before reaching their second birthday,
with most dead before they turn five.
Such deaths are expected to hamper
efforts to reduce Cambodia's under-five
mortality rate, which at more than one in
every 10 live births is already one of the
highest in Asia.
UNAIDS has noted that few anti-retroviral
drug treatments are formulated for children.
Moreover, indications that a child might
58
benefit from such treatment are different
from those in adults, so different criteria
are needed to determine if children are
eligible for the drugs.The agency has also
noted that treating children may be a low
priority in families where several members
are HIV positive. Moreover, many HIVpositive children have also lost their
mothers to AIDS, making it difficult to
supervise treatment.
Even if they are not born with HIV, children
are still vulnerable to infection, especially
street children who are highly mobile and
often separated from their families.
A study cited by the National AIDS
Authority (NAA) found that due to their
circumstances, street children were more
likely to sell sex and inject drugs than other
children. It also noted that street boys
tended to have both male and female
sexual partners, increasing their risk of
both contracting and transmitting the virus.
Sexually-exploited children, especially girls,
are particularly vulnerable to HIV if they
are forced into sex work.
Orphans and other
children affected by AIDS
In addition to the tens of thousands of
children orphaned by AIDS, many other
children are living with family members
with HIV/AIDS. For orphans, which account
for about nine percent of all children in
Cambodia, the NAA has noted that safety
nets are poorly developed in Cambodia
and that such children can be particularly
vulnerable to sexual exploitation and drugs.
Orphans can also be a burden on grandparents and other family members. In
other cases, orphans can end up being
street children or heading households to
avoid being separated from their siblings.
The UN defines orphans as children who
have lost either one or both parents, the
same definition used by the Chuon Nath
dictionary. The UN definition covers
children below the age of 18.
The NAA says discrimination against
children affected by AIDS is a "prime
factor" that hinders their access to schools,
playgrounds and medical services resulting
in trauma exacerbated by the loss of parents.
Other problems include loss of identity,
psychological stress, malnutrition, increased
demand for labor, loss of inheritance, forced
migration, homelessness, starvation and
crime. Children affected by HIV/AIDS also
risk being infected by the virus.The NAA
says the government is unable to help
children without extended families but
notes that some orphanages are receiving
support from non-government organizations
to accept them.
One study found that about one in five
Cambodian children in AIDS-affected
families had to start working in the previous
six months. The study, by the Khmer
HIV/AIDS NGO Alliance (KHANA) and
Family Health International, found that
one in three had to provide care and take
on major housework. Many had to leave
school, go without food and clothing or
be sent away from home. All of the children
surveyed had been exposed to high levels
of stigma and psycho-social stress, with
girls being more vulnerable than boys.
Young people
With young people under the age of 24
accounting for half of the new HIV
infections in Cambodia, the focus of HIV
prevention is moving towards adolescents
and youth. To reduce the rate of new
infections among young Cambodians, the
Ministry of Education, Youth and Sport
developed a strategic plan for 2001 to 2005.
But while HIV/AIDS is addressed to some
extent between Grades 5 and 12, the
NAA has noted that there is "no link"
between lessons and that the capacity of
teachers is limited. It says the lack of any
policy on sexual education is an "important
determinant" of young people's vulnerability. The NAA has also noted that
teenagers who start having sex at an early
age are more likely to have sex with highrisk or multiple partners and less likely to
use condoms.
At the same time, the use of amphetamines
appears to be growing among young people
in Cambodia.The NAA has noted that the
use of such drugs as well as alcohol have
been linked to risky behaviour. It has also
noted that the movement of young people
from rural to urban areas to find jobs or
study can lead to risky sexual behavior,
and that single young migrant workers are
more likely to have casual sex and less
likely to use condoms.
CHILDREN AND YOUNG PEOPLE 59
CHILDREN AND YOUNG PEOPLE
SECTION 8
Under the Cambodian Millennium Development Goals, 85 percent of 15 to 24year-olds are targeted to be reporting the
use of condoms during sex with a nonregular partner in 2005, up from 82
percent in 2002.
Youth risk behavior
The Ministry of Education's National
Youth Risk Behavior Survey completed in
2004 found that less than two percent of
11 to 18 year olds admitted to having sex
although one in three personally knew
young men who had been involved in bauk
(See definition on page 142).
Among those who admitted to having sex,
only 34 percent always used condoms.The
survey, covering 9,388 young people in
school and out of school in all 24 provinces
and municipalities, also found that 52
percent of sexually-active girls and two
percent of sexually-active boys had been
forced to have sex. Eight percent of the
sexually active boys and two percent of
the girls said they had been involved in
forcing someone else to have sex.
Twenty-four percent of young Cambodians
were not aware of sexually-transmitted
infections. Although 98 percent were
aware of HIV/AIDS, only 67 percent had
heard of syphilis and only 38 percent had
heard of chancroid. Less than five percent
of all respondents had heard about genital
warts, gonorrhea or herpes.
9.
MEN AND
OLDER PEOPLE
Only 57 percent had been educated about
AIDS by their parents or other guardians.
Asked about how to avoid HIV infection,
84 percent suggested always using a
condom when having sex and 36 percent
mentioned not sharing needles. Thirteen
percent of Cambodian young people said
they believed HIV infection could be
avoided by not having sex at all. Almost
two percent suggested touching or being
near people with AIDS could result in HIV
infection.
During HIV infection, millions of viral
particles are present in the blood stream.
They continuously infect cells of the immune
system.
Picture and text: Boehringer Ingleheim
60
MEN AND OLDER PEOPLE
MEN AND
OLDER PEOPLE
SECTION 9
Men
oping AIDS was lower at 60 percent of all
new cases among adults, amounting to
12,974 men. With a sharp decline to
11,470 projected for 2004, men's share of
the total was expected to fall even further
to 58 percent of all adults developing
AIDS.
NCHADS estimates that men account for
slightly more than half of the HIV cases in
Cambodia and almost two thirds of the
AIDS deaths. NCHADS nevertheless estimated in 2003 that the number of new
infections in men had plunged to 1,694,
down from a peak of 27,464 in 1994 and
only a quarter of the rate of new infections
in women.
NCHADS has admitted that one of the
limitations of the surveys is that policemen
have been the only male group included in
every survey (see page 49).As a result, the
only way to estimate the rate of HIV
infection among the male population at
large is to make indirect estimates based
on data for pregnant women. In the 2003
The HSS estimated 11,335 new AIDS deaths
among men in 2003, amounting to 63
percent of all adult deaths from AIDS the
same year. But the proportion of men devel-
Men with HIV, new infections and AIDS deaths
Estimated number of men aged 15-49 living with HIV,
newly infected with HIV, and who died from AIDS, 1990-2003, Cambodia
Living with HIV (Prevalence)
120,000
Deaths (Mortality)
New HIV Infections (Incidence)
Number
100,000
80,000
60,000
40,000
20,000
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year
62
Source: NCHADS 2004
survey, NCHADS highlighted the need for
data on HIV prevalence among men who
have sex with men as well as injection
drug users and migrant populations, calling
for pilot surveys of these groups before
the next survey is carried out. NCHADS
had previously acknowledged that men
who have sex with men had been identified
as a "highly vulnerable population" through
ad hoc studies in Phnom Penh and that
"more information is needed on the size
of this population."
In the 2003 survey, NCHADS estimated
that 2.7 percent of Cambodian policemen
were HIV positive nationwide. A separate
Behavioral Surveillance Survey earlier found
that 25 percent of men between 20 and
25 years of age had visited a sex worker
over the previous year. Within this group,
20 percent did not use a condom. The
survey, covering male members of households in five provinces, also found that 40
percent of men in their early thirties did
not use condoms with sex workers.
The National Aids Authority (NAA),
which estimates that up to 20,000 men
buy sex every day in Cambodia, has noted
that traditional expectations of male
behavior play a role in men's vulnerability
to HIV infection. Cambodian men, for
example, are usually expected to drink
large quantities of alcohol when socializing.
Peer pressure is a major factor. But the
NAA has also noted that alcohol
consumption among Cambodian police
relates to "rituals of masculinity" as well
as peer pressure. Predominantly mobile
occupations in the transport, fisheries and
military sectors meanwhile increase the
likelihood of commercial sex.The authority
has also noted that while the police and
military have been monitored by
NCHADS surveys, programs have not
been extended to the navy, airforce and
some groups of police which may be even
more vulnerable. As for men who have
sex with men, the NAA says this group
is "difficult to address" and that more
qualitative research is required to explore
their sexual behavior, culture and identities.
Men who have sex
with men
In the world of HIV/AIDS, the term used
internationally and by NCHADS is "men
who have sex with men" (proh delrourm
phet jimoi proh dôchknir). This term recognizes that many biological men who have
sex with other men also have sex with
women and that they may not "identify"
with being homosexual (nea rourm rea
phet dôchknir). A study of more than 200
such men in Phnom Penh by Family Health
International in 2000, for example, found
that only 23 percent reported their "sexual identity" as being homosexual. More
than 30 percent considered themselves
men, 27 percent reported a bisexual
identity and 19 percent identified themselves as being a woman.
MEN AND OLDER PEOPLE 63
MEN AND OLDER PEOPLE
Older people
SECTION 9
In the absence of reliable information
about the impact of HIV/AIDS on older
people in Cambodia, Help Age International
carried out an indicative study in 15 rural
villages in Battambang in 2003. The study
found that HIV/AIDS was changing family
and community structures. In a reversal of
roles, older people were looking after their
sick adult children as well as orphans.
The study found that the epidemic had
led to "significant changes in the responsibilities and needs of older people,"
especially in terms of increased workload
for those taking care of sick relatives or
orphans. "Older people in HIV/AIDSaffected households are vulnerable to
extreme poverty and, at times, destitution,"
the study found. "Many older people in
HIV-affected households also suffer from
poor physical and mental health, and are
commonly subjected to discrimination
from other community members." The
study noted that grandparents who look
after grandchildren orphaned by AIDS
have a deep sense of responsibility to
keep families together. "At a time when
physical and mental ability is often waning,
the need to start again as would a young
mother or father is the ultimate sacrifice."
Despite their growing responsibilities,
older people are typically excluded from
most HIV/AIDS programs. "Prevention and
awareness activities are almost exclusively
targeted at young people, and rarely reach
out to older age groups," the study said.
"As a result, older people seldom have
access to information about HIV/AIDS,
which compromises their ability to
protect themselves and those in their care."
10.
VACCINES AND
MICROBICIDES
HIV infects the vulnerable CD4 cells and replicates at a high
rate within these cells. As the number of infected cells increases,
the destruction of the immune system progresses. Controlling
HIV disease is only possible by potent combination therapy. In
the absence of such therapy, the ‘fittest’ strain of HIV (red),
known as the wild type, dominates the viral population.
Picture and text: Boehringer Ingleheim
64
VACCINES AND MICROBICIDES
VACCINES AND
MICROBICIDES
SECTION 10
Vaccines
Infectious organisms have proteins called
antigens that cause the immune system
to produce antibodies. With vaccines,
antigens are used to stimulate an immune
response -- but not the disease itself -- and
protect against infection by the organism.
Preventive vaccines are not a cure. But
they can prevent people getting sick from
viruses such as measles or mumps.Therapeutic vaccines, also known as treatment
vaccines, are being used in people with
HIV to maintain, stimulate or repair the
immune system. For HIV, the most extensive trials have involved Interleukin-2, a
natural protein produced by the body that
can dramatically raise the number of CD4
cells.
Developing a preventive vaccine against
HIV is difficult as the virus incorporates
its genetic material into the very immune
system that is designed to fight viruses.
The main challenge for medical researchers
is to find a way to eliminate or neutralize
the virus without destroying the immune
system itself. Another challenge is the
rapid mutation of the virus and the growing
number of HIV strains (see page 154). Just
like different vaccines are developed for
various strains of influenza, developing a
66
way to prevent HIV infection may require
different vaccines for the different strains.
But even if a potential preventive HIV
vaccine began clinical trials today and
proved to be safe and effective, it has been
estimated that it would not be available to
the public for at least five years. One
complication is that most international
vaccine research has targeted the strain
most common in developed countries.
Another focuses on the ethical issues
surrounding clinical research trials in
developing countries including Cambodia.
Microbicides
Microbicides are chemical or antibiotic
foams or gels that can be applied to the
lining of the vagina or anus to protect against
infections from micro-organisms. Most of
the product developers are small biotechnology companies, non-profit companies
and academic institutions.
Members of the International Partnership
for Microbicides committed almost 79
million dollars to research in 2003, with
more than half of the commitments
coming from the United States. The rest
came from philanthropic organizations,
other bilateral donors and multilateral
agencies. Of the 40 potential microbicides
being developed in 2004, only one was
sponsored by a major pharmaceutical manufacturer.
The International AIDS Vaccine Initiative
(see page 158) spent about 570 million
dollars on research and development in
2002, about 100 million dollars more than
2001. The private sector accounted for
less than 25 percent of the spending, with
about 14 percent coming from pharmaceutical manufacturers and about seven
percent coming from biotechnology
companies. In 2004, the principal
government institutions funding clinical
research were the National Institutes for
Health in the United States, the Medical
Research Council in Britain, the Agence
Nationale de Recherches sur le Sida in
France and the European and Developing
Countries Clinical Trials Partnership.
VACCINES AND MICROBICIDES 67
VACCINES AND MICROBICIDES
SECTION 10
11.
TESTING AND
COUNSELING
During the later stages of HIV disease, the
follicular dendritic cell network begins to break
apart. This releases increasing amounts of the
virus into the bloodstream.
Picture and text: Boehringer Ingleheim
68
TESTING AND COUNSELING
TESTING AND
COUNSELING
SECTION 11
I
n 1995, the Institut Pasteur established
the first HIV testing and counseling
center in Cambodia. Over the next four
years, another five were set up -- two at
the National STI Clinic and the Preah
Bat Norodom Sihanouk Hospital in
Phnom Penh and one each in Battambang,
Kampong Cham and Siem Reap. A seventh
was established in Sihanoukville in 1999.
By 2005, the Ministry of Health was aiming
to have testing and counseling centers in
all 24 provinces and municipalities. Together with all national hospitals and some
referral hospitals, some non-government
organization (NGO) centers offer testing
and counseling services in Phnom Penh as
well as the provinces. By mid 2004, the
number of government and NGO centers
amounted to 58 and by 2005 this had
increased to around 90.A large number of
unregulated private testing centers also
operate in most major towns. These are
linked to private hospitals and clinics and
operate independently.
Another test known as polymerase chain
reaction (PCR) tests for the virus itself
and can detect HIV within two weeks of
infection. A special blood test involving a
process called nucleic acid amplification
can detect HIV infection during the
"window period" of up to three months.
Testing
Anonymity and confidentiality for all HIV
testing is guaranteed by the Ministry of
Health under Article 22. Under Article 31,
the government's program for monitoring
HIV/AIDS has to use a coding system that
promotes anonymity. Under Articles 33
and 34, the confidentiality of all people
with HIV/AIDS has to be maintained
except in cases involving government
monitoring, health workers and court
orders. First-time violators face a fine of
up to 200,000 riel and up to six months in
jail.
The most common test for HIV involves
taking a blood sample and testing it for
the presence of antibodies to the virus.
But seroconversion, the development of a
detectable level of antibodies following
exposure to a virus, can take up to three
months with HIV. So the results of such
tests, known as the enzyme-linked
immunosorbent assay (ELISA), can be
negative even if the person is infected by
HIV within the previous three months.
70
The guidelines for testing in Cambodia
are spelt out in Chapter IV of the Law on
the Prevention and Control of HIV/AIDS
adopted in 2002 and provisions for confidentiality are contained in Chapter VII.
All testing is supposed to be voluntary
with the informed consent of the individual,
and there are provisions for testing minors
who cannot get the written consent of
their legal guardians. Under guidelines for
implementing the law, a minor is defined
as anyone less than 18 years of age. Compulsory testing is allowed only if requested
by a court. Any testing for employment,
education, housing, travel, medical and
other services is "strictly prohibited"
under Article 20 of the law.
It is not clear why government monitoring
of the epidemic needs to be exempted
from confidentiality as Article 22 states
that "all" testing should be anonymous.
Moreover, Article 32 states that information gathered through "health intelligence
activities" should remain confidential and
classified.
NCHADS reviewed the policy and
strategy for testing and counseling in
2001. The new policy, strategy and
guidelines adopted by the Ministry of
Health state that compulsory testing with
no option to refuse is prohibited under all
circumstances in Cambodia. Anonymous
testing for research and surveys must be
approved by the Ministry of Health and
its ethics committee, and also must
conform with the ministry's ethical guidelines for HIV/AIDS-related research. All
public and private institutions doing HIV
tests have to be licensed and super
vised by the ministry, strictly follow
ministry guidelines and be run by staff
trained under approved courses. In
addition, all have to report regularly to
NCHADS using standardized formats.
Test results in both public and private
health-care facilities must be "confined to
staff directly responsible for the patient's
medical care" and no relatives should be
notified unless the patient has given
explicit permission.
Counseling
Under the Ministry of Health policy,
strategy and guidelines adopted in 2002,
counseling is supposed to take place both
before and after every HIV test. Before
the test, counselors have to discuss why
the test is being sought and assess the
client's understanding of HIV/AIDS and
his or her risk of getting infected. Pre-test
counseling is also supposed to cover the
client's plans to reduce high-risk activities
and the meaning of positive and negative
results including the "window period" of
up to three months. Counseling after the
test is supposed to take place when the
client returns to get the results. Informing
clients of the results by telephone or letter
is strictly prohibited.
In the case of HIV-positive results,
counselors have to explain the result and
reassure clients that they can learn to
cope with the situation. In addition to
offering emotional and psychological
support, counselors have to discuss the
implications of the result, any worries,
fears or immediate problems and how to
live with HIV and stay healthy. Counselors
must also inform the client about medical,
counseling, support and other services for
people with HIV.
With negative results, counselors have to
explain the result and discuss the client's
plan to reduce his or her high-risk behavior.
Counselors also have to offer psychological
support and plan for further tests if
appropriate.
TESTING AND COUNSELING 71
TESTING AND COUNSELING
SECTION 11
12.
TREATMENT
AND CARE
HIV binds to cells via a molecule known
as the CD4 antigen. Macrophages and a
subset of lymphocytes (T-cells), known as
helper T-cells, express CD4 and so are
vulnerable to HIV infection.
Picture and text: Boehringer Ingleheim
72
TREATMENT AND CARE
TREATMENT
AND CARE
SECTION 12
Anti-retroviral drugs
Anti-retroviral drugs kill or prevent the
replication of retroviruses like HIV. By
2004, three classes of anti-retroviral drugs
had been developed. Using a combination
of drugs from these three classes is
referred to by doctors as Highly-Active
Anti-Retroviral Therapy. Such treatment is
also known as combination or cocktail
therapy. Although such treatment reduces
the amount of HIV in the bloodstream,
the virus is still present and can rise again
to dangerous levels. The drugs can have
serious and even potentially life-threatening side effects including diarrhea, liver
problems, rashes, nerve damage and
neurological problems.
More than 8,500 people in Cambodia
were receiving such drugs as of mid 2005,
up from 1,700 in 2003, according to the
National AIDS Authority.Treatment ranges
from 10 dollars to 70 dollars a month but is
sometimes free, depending on the source
of the drugs. In terms of the proportion of
people with access to the drugs, only three
percent of people with advanced HIV
infection were receiving anti-retroviral
combination therapy in 2002. But under
the Cambodian Millennium Development
Goals, the proportion is targeted to reach
25 percent by 2005, 60 percent by 2010
and 75 percent by 2015.
74
Treatment with anti-retroviral drugs goes
back to 1986 when American doctors
announced that a drug originally developed
to treat cancer seemed to help people
with HIV. These drugs, which target a
protein known as reverse transcriptase,
were only moderately effective. Since
1996, however, a new class of drugs called
protease inhibitors has been developed
and proven effective when combined with
other drugs. These drugs target the
protease enzyme, which the virus needs
to replicate. A third class of drugs also
targets the reverse transcriptase protein.
People who receive anti-retroviral
treatment must strictly adhere to their
doctor's instructions and have to be
monitored regularly with tests to determine
whether the combination is effective.
Adhering to the therapy is important to
avoid resistance.This is difficult due to the
side affects and, until recently, the large
number of tablets that have to be taken
and the frequency of doses. People taking
these drugs still have HIV, even if the
presence of the virus falls to levels that
cannot be detected using standard testing
procedures.
Fixed-dose combinations
As of mid-2004, the World Health Organization had approved three fixed-dose
combinations that made treatment a lot
simpler. Two are produced by Indian
manufacturers of generic drugs, Cipla and
Rambaxy, and a third is being made by
British pharmaceutical company GlaxoSmithKline. Patients taking the most widely
available fixed-dose combinations of d4t,
3tc and nevirapine -- marketed as GPOvir
in Thailand where it also being produced -can take one pill twice a day instead of six
pills a day if the three drugs are taken separately. Medecins sans Frontieres strongly
advocates such combinations, saying it
pays only 270 dollars a year for each
patient for such treatment compared with
562 dollars if the drugs are bought separately from the originators.
Opportunistic infections
and caring for people with
AIDS
Under the Ministry of Health's strategic
plan for HIV/AIDS prevention and care
for 2001 to 2005, drugs for opportunistic
infections are supposed to be on the
essential drugs list. These drugs are
supposed to be available at all national
hospitals and 12 referral hospitals in the
provinces.
The National AIDS Authority has stated
that home-based and community care
needs to be expanded in Cambodia as
institutions are unable to cope with the
rapid increase in the number of AIDS
patients. But it has also noted that many
Cambodians have yet to accept the idea
of caring for people as many believed that
HIV/AIDS is a "well-deserved punishment
for those who have had socially-unacceptable sex." As a result, the authority said
"all efforts to encourage people to take
good care of AIDS patients should be
actively encouraged."
The Ministry of Health has identified care
and support as one of 12 strategic areas
under its strategic plan for 2001 to 2005.
Under the plan, the home-based care
system is being expanded nationwide,
with team members being trained in
collaboration with non-government
organizations, nursing schools and the
National Center for HIV/AIDS Dermatology
and Sexually-Transmitted Diseases. One
of the goals of the plan is to ensure that
programs receive drug kits and other
supplies.
Home-based care is designed to provide
symptomatic relief to comfort and
support patients with life threatening
illnesses such as the advanced stages of
AIDS.The World Health Organization has
recently produced guidelines indicating
that drugs derived from opium, including
morphine take orally, are necessary for
such "palliative" care. In Cambodia,
morphine is illegal unless prescribed by
a doctor.
TREATMENT AND CARE 75
TREATMENT AND CARE
SECTION 12
13.
THE NEXT
TEN YEARS
Reverse transcriptase is involved in the
production of a RNA-DNA double helix.
A DNA copy of HIV RNA is synthesized
using the viral RNA as a template.
Picture and text: Boehringer Ingleheim
76
THE NEXT TEN YEARS
THE NEXT
TEN YEARS
U
SECTION 13
nder the Millennium Declaration
signed by all 189 members of the
United Nations General Assembly
in 2000 including Cambodia, decreasing
the spread of HIV/AIDS. is one of 25
targets to be met by 2015. Following talks
between ministries, donors and nongovernment organizations, the Council of
Ministers approved specific indicators and
targets for Cambodia including seven in
the area of HIV/AIDS. A progress report
released in 2004 showed that meeting the
overall target of reducing the spread of
HIV/AIDS was one of only three out of
the 25 overall targets that would "probably" be met and one of only five that had
"strong" support.
The seven HIV/AIDS targets for 2015
include reducing in HIV prevalence to 1.8
percent for adults and 1.5 percent for
young pregnant women attending antenatal
clinics.With the NCHADS survey of 2003
showing declines in both rates to 1.9
percent, the targets for 2005 and 2010
have already been met ahead of schedule.
Condom use is meanwhile targeted to
rise to 98 percent for sex workers, 95
percent for young people between the ages
of 15 and 24 and 10 percent for married
women who identify themselves at risk.
Another target for 2015 is for 50 percent
of all pregnant women with HIV to be
receiving a complete course of anti-retroviral drugs to reduce the risk of transmitting
the virus to the child. The seventh target
is for 75 percent of people with advanced
HIV infection to be receiving advanced
anti-retroviral combination therapy by
2015.
14.
GOVERNMENT
INSTITUTIONS
Targets for reducing HIV (%)
HIV among adults
HIV among pregnant women
Sex workers using condoms
Young people using condoms
Married women using condoms
Benchmark
3.3
2.8
91
82
1
2005
2.3
2.4
98
85
2
2010
2.0
2.0
98
90
5
2015
1.8
1.5
98
95
10
2005
10
25
2010
35
60
2015
50
75
Targets for getting ARV treatment (%)
Pregnant women with HIV
People with advanced HIV infection
Benchmark
2.7
3.0
Notes: "Adults" means 15 to 49 years, "pregnant women" means those attending ante-natal clinics, "young people" means 15 to 24 year-olds
having sex with non-regular partners, "married women" means those who identify themselves as being at risk of infection. Benchmark years are 2002
except for HIV among adults (1997), HIV among pregnant women (1998), and married women using condoms (2000).
Source: Ministry of Planning, Cambodian Millennium Development Goals Report 2003
78
Antibodies directed against antigens on
pathogens, such as HIV, are released from
plasma cells. Each plasma cell synthesizes
antibodies which recognize a specific
antigen on the pathogen, e.g. the HIV GP 120
protein.
Picture and text: Boehringer Ingleheim
GOVERNMENT INSTITUTIONS
GOVERNMENT
INSTITUTIONS
SECTION 14
Under the Council of
Ministers:
National AIDS Authority (NAA)
80
centered with a focus on empowering
individuals, communities and society."
Based on this framework, seven strategies
were designed.
Chief of Information:
Dr. Sim Kim San (012-940-854)
Email: [email protected]
Website: www.naa.org.kh
Tel: 023-885-129
The authority was set up in 1999 to
broaden the government's response to
HIV/AIDS which had until then been
almost entirely confined to the Ministry
of Health. As the apex body in charge of
developing a multisectoral approach to
HIV/AIDS, the authority has a policy
board comprising secretaries of state
from 26 ministries and third deputy
governors from all 24 provinces and
municipalities. The authority is chaired by
the prime minister or someone assigned
by the prime minister. In addition to four
vice chairmen, the NAA has a secretary
general responsible for its day-to-day
operation.
The National Strategic Plan for 2006 to
2010 was being reviewed by the Policy
Board of the NAA as this guide went to
press.
As well as coordinating the multisectoral
approach to HIV/AIDS, the NAA is responsible for policy development, strengthening
relations with all stakeholders and mobilizing resources from national and international institutions and agencies. It also
advocates for legislative support and
research on the socio-economic impact
of HIV/AIDS, coordinates the research
agenda and approves information, education
and communication programs in all sectors.
National Center for HIV/AIDS,
Dermatology and Sexually
Transmitted Diseases (NCHADS)
Under its National Strategic Plan for a
Comprehensive and Multi-Sectoral Response
to HIV/AIDS for 2001 to 2005, the NAA
outlined two approaches to reduce
vulnerability to HIV/AIDS. The first concentrated on influencing individuals that
safer behavior was a more attractive
option, while the second focused on
supporting individuals to protect themselves
from infection and cope with the
consequences of HIV/AIDS. The plan also
called for a shift from a segmented and
health-centered top-down approach, to a
"more holistic development approach,
that is gender sensitive and people
The authority aims to reduce the vulnerability of women and girls to HIV/AIDS by
seeking to offset discriminatory attitudes,
especially among men. Under the National
Poverty Reduction Strategy, the NAA is
also responsible for the HIV/AIDS prevention and elimination strategy. The
strategy includes promoting public information and education about HIV/AIDS,
creating specific programs for different
sub-populations, and strengthening and
expanding preventive programs.
NCHADS and the Ministry of Health have
also developed the Strategic Plan for
HIV/AIDS and STI Prevention and Care
for the period 2001 to 2005.The goals of
the plan are to reduce new infections of
HIV, to provide care and support for people
living with and affected by HIV/AIDS, and
to alleviate the socio-economic impact
on individuals, families, communities and
society. NCHADS also plays a role in
providing care across a "continuum" ranging
from homes and communities to health
centers and hospitals.
Deputy Secretary General:
Dr.Teng Kunthy (023-885-129)
Under the Ministry of
Health:
The Ministry of Health established the
center in 1998 as part of an upgrading of
its national AIDS program launched in
1993. The center is responsible for
surveying sentinel groups and implementing
programs for those infected and affected
by HIV/AIDS.
The system of HIV Sentinel Surveillance
began in 1994. With the exception of
2001, surveys of different sentinel groups
were carried out every year between
1994 and 2003. During this period, the
number of provinces surveyed rose from
five to 20. In the 2002 survey, NCHADS
was responsible for coordination, training
and supervision as well as data management
and analysis. Provincial AIDS committees
provided management and administrative
support while provincial health departments
and provincial AIDS offices collected and
transported the data. The United States
Agency for International Development,
through Family Health International,
provided technical assistance along with
the University of California in Los
Angeles, the University of New South
Wales in Sydney, the World Health
Organization and the East West Center
in Honolulu. The Centers for Disease
Control - Global AIDS program in
Cambodia supported the ninth round of
HIV surveillance at the end of 2003. This
included several important changes to
confidentiality safeguards, decentralization
of testing, a switch to rapid testing and
a quality assurance protocol.The changes
were expected to ensure better and more
reliable results than previous surveys.
Director:
HE Dr. Mean Chhi Vun
Deputy Directors:
Dr. Ly Penh Sun
Surveillance Chief:
Dr. Heng Sopheab
Information Chief:
Dr. Lan Van Seng
Email: [email protected],
[email protected]
Website: www.moh.gov.kh
Tel: 023-216-515
GOVERNMENT INSTITUTIONS 81
GOVERNMENT INSTITUTIONS
Ethics Committee
Approves anonymous HIV testing for
research and surveys.
SECTION 14
Director:
Professor Eng Hout
Other contacts:
Dr. Ung Sam An, Dr. Saphorn Vothorn
Tel: 012-836-781, 012-890-889
National Blood Transfusion
Center (NBTC)
Ministry of Health center promoting
voluntary blood donations from people
with a low risk of HIV infection. Also
screens blood for HIV and offers counseling
before and after donations.
Director:
Dr. Nhem Tourk (023-215-949)
Other contacts:
Dr. Hok Kim Chaeng (016-849-966),
Dr. Chhorn Samnang (016-865-565)
Email: [email protected]
National Center for Tuberculosis
and Leprosy Control (CENAT)
Ministry of Health center working with
NCHADS to develop strategies addressing
tuberculosis. Runs afternoon tuberculosis
screening for people at risk of infection.
Services include referrals for voluntary
counseling and testing.
Director:
Dr. Mao Tan Eang (023-219-274,
012-916-503)
HIV/AIDS contact:
Dr. Chay Solun (012-925-571)
Email: [email protected],
[email protected]
82
National Institute for Public
Health (NIPH)
Ministry of Health research and training
institute. Also runs a laboratory.
Director:
Dr. Sam An Ung (023-880-345,
023-881-345, 023-882-941)
Other contact:
Dr. Sophorn Vuthanak (012-866-608)
Email: [email protected]
National Maternal and Child
Health Center (NMCHC)
Ministry of Health center responsible
for research, policies, guidelines and
training for the prevention of mother to
child transmission of HIV. Also operates
Cambodia's leading maternity teaching
hospital which includes screening for
HIV, treatment with nevirapine and
counseling on infant feeding.
Director:
Prof Koum Kanal
(023-724-257, 012-943-785)
Other contacts:
Prof Sann Chan Soeung
(012-933-344),
Dr.Tan Vuoch Chheng
(011-951-002)
Reproductive health contact:
Dr.Tung Rathavy
(016-834-700, 023-427-300)
Nutrition contact:
Dr. Ou Ke Vanna (012-855-319)
JICA contact:
Dr. Kazuhiro Kakimoto
(012-983-091)
Email: [email protected],
[email protected]
Other Ministries:
Ministry of Cults and Religion
Involved in HIV/AIDS prevention and care
with support from UNICEF, the POLICY
Project and monks.
Contacts:
Hoy Chan Vireak (012-830-399),
Dr. Ken Phun (023-212-707)
Email: [email protected]
Website: www.interior.gov.kh
Ministry of Justice
HIV/AIDS contact:
Uong Sophearin
(023-725-699, 012-850-192)
Email: [email protected],
[email protected]
Develops laws and policies to reduce the
spread of HIV/AIDS and ensure the rights
of people infected and affected by the
virus.
Ministry of Education,Youth and
Sport
HIV/AIDS contact:
Dr. Neangsina Vatanak
(023-360-327, 012-683-329,
023-212-693, 011-893-417)
Supports development of HIV/AIDS policies
and education for young people in and
out of school. Under a five-year plan,
HIV/AIDS activities are being strengthened
at provincial and district levels. Carried
out a youth risk behavior survey with
support from UNICEF and UNESCO
in 2003 and 2004. Implements a program
funded by DFID, focusing on student values
and behavior.
Shoool and Health Department Director:
Pen Saroeun
Youth Department Director:
Chhim Samanh
Tel: 023-217-253, 428-084, 219-284-5
Email: [email protected]
Website: www.moeys.gov.kh
Ministry of Interior
The Ministry's health department has a
prevention and care plan for police officers
and those infected or affected by HIV/
AIDS. Strategies include integrating HIV/
AIDS education into training. Partners
include the Cambodian Red Cross,
NCHADS and the NAA as well as Family
Health International, USAID, UNDP and
UNAIDS.
Ministry of National Defense
Runs an education program for the military
in 21 provinces. Also has a five-year
strategic plan for HIV/AIDS running until
2006. The ministry has received support
from Family Health International since
1999.
Health Department Director:
General Dr.Thou Tharith
(012-819-610)
HIV/AIDS Unit:
Lietenant-Colonel Tan Sokhey
(011-810-610)
Email: [email protected],
[email protected],
[email protected]
Website: www.mond.gov.kh
Ministry of Planning
Works with other ministries and agencies
on socio-economic sectors such as the
Millennium Development Goals which
include specific targets for reducing
HIV/AIDS and increasing anti-retroviral
treatment.Also involved in the population
GOVERNMENT INSTITUTIONS 83
GOVERNMENT INSTITUTIONS
census and other national surveys relevant
to HIV/AIDS such as the demographic
health survey with the Ministry of Health
and a youth risk behaviour survey with
the Ministry of Education, Youth and
Sports.
SECTION 14
Census Survey Department
Deputy Director:
Long Chindtha
(023-720-901-4, 212-049,
212-055, 210-549, 012-810-810)
National Institute of Statistics
Deputy Director General:
Hang Lina (023- 210-719, 213 650,
012-723-107, 016-832-762)
Email: [email protected],
[email protected]
Website:www.mop.gov.kh
Ministry of Rural Development
The Department of Rural Health works
with local communities to combat the
spread of HIV/AIDS under a strategic plan
from 2000 to 2005. Works with UNICEF
and youth volunteers in Kampong Chhnang,
Kampong Speu, Svay Rieng, Koh Kong,
Oddar Meanchey and Stueng Treng.
Rural Health Care Department Director:
Dr. Chea Samnang (023-366-627,
012-873-671)
HIV/AIDS contact:
Dr. Ouk Rim (012-973-738)
Email: [email protected],
[email protected]
Ministry of Social Affairs,Veterans
and Youth Rehabilitation
Trains officials at the national, provincial
and district levels and also educates
migrant workers recruited to work in
countries such as Korea and Malaysia.
With support from the Global Fund,
84
educates workers at six garment factories
around Phnom Penh and also helps vulnerable children and widows affected by
HIV/AIDS in a separate project with
Nyemo.
Social Affairs Director General:
HE Keo Boren
(023-724-091, 365-469,
012-417-399)
HIV/AIDS contact:
Em Sophon (012-886-748)
Researchers:
Sat Sithy (012-271-288),
Phauk Sotheara (012-642-907),
Ban Ravuth (012-823-399)
Email: [email protected]
15.
MULTILATERAL
AGENCIES
Ministry of Women's Affairs
Educates women, young people and their
families about HIV/AIDS, especially in
rural areas. Has projects with UNFPA in
eight provinces (Kandal, Kampot, Prey
Veng, Svay Rieng, Kampong Chhnang,
Kampong Cham, Battambang and Siem
Reap). Also works with UNAIDS and the
POLICY Project. Encourages "genderresponsive" HIV prevention in Battambang,
Banteay Meanchey, Koh Kong, Siem Reap
and Phnom Penh.
Minister:
HE Dr. Ing Kantha Pavi
(023-216-573)
Secretary of State:
HE Chann Serey (012-985-052)
Director General:
HE Chou Bun Eng (012-872-639)
HIV/AIDS contact:
Dr. Kou Sothea (012-707-705)
Email: [email protected],
[email protected]
Website: www.mwva.gov.kh
Nevirapine (green) is a potent inhibitor of viral
replication.
Picture and text: Boehringer Ingleheim
MULTILATERAL AGENCIES
MULTILATERAL
AGENCIES
SECTION 15
Asian Development
Bank (ADB)
A multilateral financial institution
established in Manila in 1966 with
Cambodia as one of the founding
shareholders. Following the civil war, the
ADB resumed operating in Cambodia in
1992 with a resident mission established
in Phnom Penh in 1996. Funding for
HIV/AIDS has included a project to prevent
transmission among vulnerable groups in
Battambang, Koh Kong, Prey Veng and Svay
Rieng. Cambodia has also received technical
assistance from the ADB's Japan Special
Fund for capacity building in the areas of
prevention and control. In 2001, the ADB
and UNAIDS helped finance a study called
Health, Wealth, AIDS and Poverty -- the case
of Cambodia. A separate series of ADB/
UNAIDS studies has compared the impacts
of HIV/AIDS in Cambodia with the impacts
on India,Thailand and Vietnam.
Country Director:
Shyam Bajpai (023-215-805)
Project Officer: (023-214-556)
Email: [email protected]
Website: www.adb.org
Joint United Nations
Programme on HIV/AIDS
(UNAIDS)
Pools experience, efforts and resources of
10 co-sponsoring agencies working in the
field of HIV/AIDS as of 2004 (UNICEF,
UNDP, UNFPA, UNHCR, UNODC, the
ILO, UNESCO, the WHO, the World Bank
86
and the World Food Program). The UN
Theme Group on HIV/AIDS comprises
the heads of all agencies in Cambodia,
chaired in 2005 by UNICEF representative
Rodney Hatfield. A separate group
known as the Technical Working Group
comprises various UN experts working in
the field of HIV/AIDS. The UN Country
Team developed a "common strategy" to
support Cambodia's response to the HIV
epidemic from 2001 to 2005.Top priorities
were advocacy and building capacity to
coordinate aid.
HIV/AIDS team:
Haritiana Rakotomamonjy,
Sedtha Chin, Fabrice Laurentin,
Bunthy Chea, Udom Kong
(023-426-214/5)
Email: [email protected],
[email protected],
[email protected],
[email protected]
[email protected],
[email protected]
Website: www.unicef.org/
infobycountry/cambodia.html
Country Coordinator:
Tony Lisle (023-219-340)
E-mail: [email protected]
http://www.unaids.org/en/
geographical+area/by+country/
cambodia.asp
United Nations
Development Program
(UNDP)
United Nations Children's
Fund (UNICEF)
Prevention and care activities include
raising awareness of HIV/AIDS through
radio, television and hotlines, support for
voluntary counseling and testing, strategies
to prevent mother-to-child transmission
of HIV and pagoda-based support groups.
UNICEF works closely with the Ministry
of Health, the Ministry of Rural
Development, the Ministry of Education,
Youth and Sport, the Ministry of Cults and
Religion, the Ministry of Social Affairs,
Veterans and Youth Rehabilitation as well
as the NAA.
Representative:
Rodney Hatfield (023-426-214/5)
Supports local leaders and communities in
dealing with HIV/AIDS and has developed
booklets and films for speakers and
commune counselors. Working with the
NAA, it launched a media campaign
against HIV/AIDS endorsed by Prime
Minister Hun Sen in 2003.The UNDP also
sponsored the first arts and media forum
on HIV/AIDS with the NAA and TVK
in 2004. The UNDP is also in charge
of helping countries meet targets under
the Millennium Development Goals,
such as reducing the spread of HIV/AIDS
and expanding access to anti-retroviral
treatment.
Resident Representative:
Douglas Gardner (023-216-167)
HIV/AIDS contacts:
Renato Pinto (023-216-167)
Dr. Seng Sutwantha
Email: [email protected],
[email protected].
[email protected]
Website: www.un.org.kh/undp/
United Nations
Educational, Scientific and
Cultural Organization
(UNESCO)
Focuses on preventive education and
culture.Activities have included traditional
Cambodian theatre and graphic arts, and
have involved different partners including
the Ministry of Culture and Fine Arts,
NGOs and students. Supports Ministry of
Education, Youth and Sport in producing
materials, developing curricula, training
teachers and conducting surveys. Also
supports communications initiatives,
television commercials and the Inthanou
hotline. UNESCO wants to expand its
"edutainment" activities to develop selfesteem and confidence among young
people living with HIV/AIDS and reduce
HIV-related discrimination.
Education Section Head:
Dr. Supote Prasetsri
HIV/AIDS focal point:
Julie David
Email: [email protected],
[email protected]
[email protected]
Website: www.unesco.org
MULTILATERAL AGENCIES 87
MULTILATERAL AGENCIES
United Nations High
Commissioner for
Refugees (UNHCR)
SECTION 15
Became a UNAIDS cosponsor in 2004.
Has HIV unit at its headquarters in
Geneva with two technical experts and
four regional coordinators for Africa. A
regional coordinator for Asia is planned
for 2005.
Tel: 023-216-005
Email: [email protected]
Website: www.un.org.kh/unhcr/
United Nations Office on
Drugs and Crime
(UNODC)
Given what seems to be "relatively limited"
use of needles among illicit drug users in
Cambodia, UNODC sees an opportunity
to prevent the scale of drug-related HIV
transmission seen in countries like
Thailand and Vietnam. In 2004, it helped
set up the Drug-related HIV/AIDS
Technical Working Group, jointly chaired
by the NAA and the National Authority
for Combating Drugs (NACD). Comprising
government and non-government agencies
as well as bilateral and multilateral donors,
the group endorses activities to counter
drug-related HIV transmission. But the
legal authority to approve activities rests
with the government's Drug and HIV/AIDS
Committee, which includes various
ministries and agencies such as the NAA,
the NACD and the Ministry of Interior.
With its human rights-based approach,
UNODC reckons Cambodia is in a unique
position to prevent drug-related HIV
transmission "before a significant onset of
injecting drug use becomes clearly evident."
88
HIV/AIDS contact:
Dr.Tea Phauly (023-222-349)
Email: [email protected],
[email protected]
Website: www.unodc.org.kh
Committee and the Condom Use Working
Group of NCHADS.The World Bank has
a five-year health sector support project.
Approved in 2002, this project aims to
integrate HIV/AIDS into all services.
United Nations Population
Fund (UNFPA)
Country Director:
Nisha Agrawal (023-213-639)
HIV/AIDS contact:
Simeth Beng (012-772-226)
Email: [email protected],
[email protected]
Website: www.worldbank.org/kh
Integrates HIV/AIDS into community
activities though a network of more
than 900 volunteers in eight provinces.
Promotes reproductive health through
community networks and trains midwives
at regional centers. HIV prevention is a
priority in an initiative involving the
European Union and UNFPA. In collaboration with UNESCO and the Ministry of
Health, UNFPA has also developed a
manual for training teachers about HIV
transmission and prevention.
Representative:
Bettina Maas (023-215-519)
Deputy Representative:
Alice Levisay (023-215-519)
HIV/AIDS contacts:
May Tum, Dr. Chong Vandara
(023-215-519)
Email: [email protected],
[email protected], [email protected],
[email protected]
Website: www.un.org.kh/unfpa/
World Bank
Supporting anti-retroviral treatment, 100
percent condom use and other activities
in 12 provinces and municipalities (Pailin,
Kampot, Banteay Meanchey, Steung Treng,
Preah Vihear, Battambang, Kampong Speu,
Pursat, Kampong Thom, Kratie, Kep,
Oddar Meanchey). Also supports the
Condom Use Monitoring and Evaluation
World Food Program
(WFP)
Provides food and basic medicine to
households affected by HIV/AIDS in
partnership with the Ministry of Health
and non-government organizations.
Assistance also covers orphans and
vulnerable children and is provided up to
eight months when a parent is unable to
work and up to five months after a parent
has died. Monthly food rations involved
about 4,000 households in 2004.The WFP
has agreements with World Vision,
KHANA and Caritas in 10 provinces
(Kampong Thom, Kampong Speu, Takeo,
Kandal, Banteay Meanchey, Kampong
Cham, Kampot, Prey Veng, Siem Reap and
Svay Rieng).
World Health
Organization (WHO)
Key partner of the Ministry of Health
supporting NCHADS in such areas as
HIV/AIDS Sentinel Surveillance, diagnosis
and treatment of sexually transmitted
infections and home-based care. Also
supports the "continuum of care" framework as well as the National Blood
Transfusion Center, the National Maternal
and Child Health Center, the National
Tuberculosis Control Program and the
National Nutrition Program. In addition,
the WHO also works on HIV prevention
with the Ministry of National Defense.
Representative:
Dr. Michael O’Leary
HIV/AIDS contact:
Dr. Massimo Ghidinelli
Tel: 023-216-005, 023-212-228
Email: [email protected].
who.int,
[email protected].
who.int
Website: www.who.int/countries/
khm/en/
HIV/AIDS contact:
Heng Mory (023-212-137/8)
Email: [email protected],
[email protected]
Website: www.wfp.org/kh
MULTILATERAL AGENCIES 89
MULTILATERAL AGENCIES
SECTION 15
16.
SELECTED
BILATERAL DONORS
After the GP 120 protein has enabled the virus
to bind to CD4 and other host cell surface
molecules, HIV starts to fuse with the target
cell. The infectious cycle of HIV begins.
Picture and text: Boehringer Ingleheim
90
SELECTED BILATERAL DONORS
SELECTED
BILATERAL DONORS
SETION 16
Australian Agency for
International
Development (AusAID)
Australian government agency assisting
the Ministry of Health to develop a research
capacity and information database to
determine the optimal way to use antiretroviral treatment. The results of the
three-year project, carried out by a
University of New South Wales research
center, are expected to have wider
applications given the little research on
anti-retroviral treatment in poor countries.
AusAID also has HIV/AIDS activities in a
regional program.
Country Representative:
Fleur Davies (023-213-470)
Email: [email protected]
Website: www.ausaid.gov.au/
country/country.cfm?CountryId=34
Cooperation Française
Supports efforts to prevent HIV being
transmitted from mother to child and
also supports follow ups for babies born
with the virus. Partners include the
Ministry of Health, NCHADS and referral
hospitals as well as Calmette Hospital, the
National Pediatric Hospital and French
organization Esther which has partnerships with three French hospitals.
Country Director:
Dominique Dordain (023-430-032)
Health Advisor:
Dr. Regine Lefait-Robin
92
Email: dominique.dordain@diplo
matie.fr,
[email protected]
Website: www.cooperation.gouv.fr/
actu/actu.asp?DOS=12544
Department for
International Development
(DFID)
British government agency working with
the Cambodian government, the Asian
Development Bank and the World Bank
on a 77 million dollar health sector support
project which includes HIV/AIDS activities.
Also supports Population Services International, BBC World Trust and the NAA.
Health and Population Advisor:
Elizabeth Smith (023-430-240)
Program Support Officer:
David Quinn (023-430-240)
Email: [email protected]
Website: www.dfid.gov.uk/
countries/asia/cambodia.asp
European Union (EU)
The European Commission Delegation
to Cambodia has funded various bodies
working on HIV/AIDS in Cambodia ranging
from Medecins du Monde and Medecins
Sans Frontieres to Marie Stopes International, the Institute of Tropical Medicine,
Healthnet International and NCHADS.
The European Commission is also funding
the second phase of a reproductive health
initiative with UNFPA from 2004 to 2007.
Senior Project Officer:
Elizabeth Pirnay (012-806-937)
Email: [email protected]
Website: www.delkhm.cec.eu.int
United States Agency
for International
Development (USAID)
Japan International
Cooperation Agency
(JICA)
USAID-administered funding for Cambodia
is expected to exceed 50 million dollars
in 2006. Of the total US funding for
Cambodia in the year to September 2006,
28.7 million dollars is earmarked for
health and 14.3 million dollars is earmarked
for HIV/AIDS. Agencies cooperating with
USAID in the field of HIV/AIDS include the
Centers for Disease Control's Global AIDS
Program, Family Health International,
CARE, the POLICY Project, Population
Services International, Reproductive
Health Association of Cambodia, Khmer
HIV/AIDS NGO Alliance, Reproductive
and Child Health Care Alliance, University
Research Company, Helen Keller International, Partners for Development and
World Vision.
Supports the National Prevention of
Mother To Child Transmission Program
including technical assistance to two pilot
projects in Phnom Penh and Battambang.
Financial support has included workshops,
HIV testing kits, antiretroviral drugs and
education materials. Also supports the
National Tuberculosis Control project
which started referrals between TB and
HIV medical facilities in Phnom Penh in
2003.
Country Representative:
Juro Chikaraishi (023-211-673)
Assistant Country Representative:
Tsuyoshi Yusa (012-909-609)
HIV/AIDS contacts:
Dr. Kosuke Okada (023-211673)
Dr. Kazuhiro Kakimoto
(012-938-091)
Email: [email protected],
[email protected],
[email protected]
Website: www.jica.org.kh
Team Leader for Family Health:
Dr. Chak Chantha,
E-mail: [email protected]
Development Assistance Specialist:
Dr. Sok Bunna,
E-mail: [email protected]
(023-216-438)
Website:www.usaid.gov/locations/
asia_near_east/
countries/cambodia/cambodia.html
SELECTED BILATERAL DONORS 93
SELECTED BILATERAL DONORS
Centers for Disease
Control and Prevention
(CDC) Global AIDS
Program
SETION 16
Established by the Centers for Disease
Control in Atlanta in 2002, the CDC
Global AIDS Program in Cambodia is
strengthening capacity at the National
Institute of Public Health and NCHADS
laboratories. It also provides technical
assistance and has a cooperative agreement
with the Ministry of Health to support
HIV prevention and care in Banteay
Meanchey. In 2004, the CDC program
worked with NCHADS to open two sites
for preventing mother to child transmission
and related activities. It also expanded
AIDS clinical care at three sites and was
involved in the ninth round of HIV
Sentinel Surveillance.
HIV/AIDS contacts:
Dr. Hor Bun Leng, Dr. Joyce Neil
(023-216-436), Michael Calabria
(012-222-994)
Email: [email protected], lhor@gapcd
ckh.org.kh, [email protected], calabriam
@gapcdckh.org.kh
Website: www.cdc.gov/nchstp/od/
gap/countries/cambodia.htm
17.
NON-GOVERNMENT
ORGANIZATIONS
Following the establishment of a stable contact,
the viral membrane fuses with the membrane of
the CD4 cell.
Picture and text: Boehringer Ingleheim
94
NON-GOVERNMENT ORGANIZATIONS
NON-GOVERNMENT
ORGANIZA-
T
SECTION 17
he following section includes
members of the HIV/AIDS Coordination Committee (HACC), those
that appear in University Research
Companys’ (URC) HIV/AIDS agency list,
and a selection of other non-government
organizations and agencies with related
activities in Cambodia.
Action IEC
Phnom Penh
Local organization producing communication
materials to change behavior.
Country Director:
Chheng Kossal (012-212-944)
Email: [email protected]
Website: www.actioniec.org
Adventist Development
and Relief Agency (ADRA)
Phnom Penh
Faith-based organization with projects in
Pursat and Kampong Thom, which aim to
restore dignity and educate young people
about reproductive health. Training
Buddhist leaders and local authorities.
Country Director:
Mark Schwisow
(023-880-693, 012-813-213)
HIV/AIDS contact:
Sieng Bunthoeun (011-957-741)
Email: [email protected],
[email protected]
Website: www.adracambodia.org
96
Aphiwat Srei
Battambang
Provides psychological and social support
through home visits. Supported by
KHANA and Frontiers Prevention Project.
Director:
Thong Thavrin (012-694-390)
Email: [email protected]
Asian Outreach Cambodia
(ASC)
Kandal
Faith-based organization founded in Hong
Kong. Offers home care and support in
Lvea Em district.
Country Director:
Mike Robb (023-217-706,
012-798-136)
HIV/AIDS contact:
Lorraine Hudson (012-415-749)
Email: [email protected].
[email protected], lorraine_hud
[email protected]
Website: www.aocam.org
Association for Farmer
Development (AFD)
Takeo
Supports PLHA, orphans and vulnerable
children in Kirivong operational district
including home visits and food support
in partnership with the World Food
Programme.
Director:
Srey Keo Pisei (012-713-960,
012-954-894)
Other contacts:
Sak Sokim,Van Chamran
(012-439-750)
Association of Medical
Doctors of Asia (AMDA)
Phnom Penh
Japanese organization working with four
heath centers in Kampong Speu, training
health volunteers on HIV/AIDS.
Country Director:
Dr. Sieng Rithy (023-218-820,
012-805-034)
HIV/AIDS contact:
Dr. Peas Muslim (011-875-404)
Email: [email protected],
[email protected]
Website: www.amda.or.jp
with union federations spanning the garment,
footwear, maritime, hospitality, tobacco,
cleaning and rubber industries.
Country Director:
Barbara Fitzgerald
(023-216-034)
HIV/AIDS contacts:
Ly Kim Song, Ms Lim Lok San
(011-918-810)
Email: [email protected]
Website: www.apheda.org.au
Australian Red Cross
(ARC)
Phnom Penh
Provides HIV/AIDS technical support and
funds to the Cambodian Red Cross for
community projects in Kampot and
Battambang and youth education projects
at universities in Phnom Penh and schools
in Siem Reap, Pailin and Kampot.
Australian People for
Health, Education and
Development Abroad
(APHEDA)
BBC World Service Trust
Phnom Penh
Phnom Penh
Also known as Union Aid Abroad,
the overseas aid agency of the Australian
Council of Trade Unions has integrated
STD/HIV/AIDS awareness into all AusAIDassisted vocational education and agricultural
training programs. Working with the ILO,
it has also carried out an HIV/AIDS project
Promotes changes in behavior through
the production of radio and television
commercials including Jackie Chan with
Louk Chouy. Also produces a television
drama called "Taste of Life" on TV5 and
radio phone-in shows.
Email: [email protected]
Tel: 023-990-030
www.redcross.org.au
NON-GOVERNMENT ORGANIZATIONS 97
NON-GOVERNMENT ORGANIZATIONS
Country Director:
David Wood (023-430-555)
Email: [email protected]
Website: www.bbc.co.uk/
worldservice/trust
SECTION 17
Banteay Srei Care and
Support
Phnom Penh
Tel: 023-216-992
Email: [email protected]
BattambangWomen's
AIDS Project (BWAP)
Battambang
Provides home-based care and supports
orphans and vulnerable children in Thmor
Kol operational district including referrals
to key health services and support for
self-help groups.
Operations Manager:
Em Siv Heng (053-952-150,
016-777-199, 016-530-236)
Consultants:
Kim Lon (016-934-241),
Grik Pouv (016-946-174)
Email: [email protected]
Buddhism for Development
(BFD)
Battambang
Trains monks in HIV/AIDS and uses
the Anlongville Wat as a home for
children orphaned by AIDS. Provides
home-based care in Anlongville and O
Dambang 1 and 2 communes. Refers
suspected tuberculosis cases to health
centers for screening and treatment.
Branch Manager:
Pok Socheat (063-370-041,
012-725-191)
98
Other contacts:
Prak Chea (012-736-042),
Mok Chantha (012-571-543),
Khem Bounnath (012-566-253),
Venerable Toeuch Yun (012-996-455),
Kong Sokunthea (012-592-497)
Email: [email protected]
Cambodia Family
Development Services
(CFDS)
Banteay Meanchey
Targets sex workers in Sisophon and
Poipet. Offers education and vocational
training. Funded by USAID through Family
Health International.
Cambodia HIV/AIDS
Education and Care
(CHEC)
Phnom Penh
Works with provincial HIV/AIDS offices
and about 200 volunteers in each district
to provide training, counseling, care and
support.
Program Manager:
Kasem Kolnary (023-884-473)
HIV/AIDS contacts:
Dr. Pen Leakhena (092-294-218),
Kim Ton (012-486-940)
Email: [email protected]
Website: www.chec-cambodia.org
Director:
John Phay (012-847-720)
Project Manager:
Meas Yen (054-710-022)
Email: [email protected],
[email protected]
Cambodian Children
Against Starvation and
Violence Association
(CCASVA)
Cambodia Health
Committee (CHC)
Educates young people and sex workers
and supports PLHA and affected children
in 16 villages in Takor and Kampong Leav
communes in Kampong Leav district.
Phnom Penh
Provides home care in Svay Rieng and
Kampot. Also provides anti-retroviral
treatment in Svay Rieng in cooperation
with NCHADS and the Svay Rieng
Referral Hospital. In Kampot, patients are
referred to Takeo where Medecins Sans
Frontieres Belgium operates a clinic.
Country Director:
Dr. Chiv Bunthy (023-885-169,
012-952-508)
HIV/AIDS contact:
Dr. Sok Thim (012-952-858)
Email: [email protected],
[email protected],
[email protected]
Prey Veng
Country Director:
Bunrouen Phok (023-993-615,
012-888-613)
Email: [email protected]
Cambodian Development
and Relief Center for
the Poor (CDRCP)
Kampot
Provides home care with counseling
and welfare support. Also supports the
enrolment of orphans and vulnerable
children in schools and provides food
in partnership with the World Food
Programme. Also provides education and
referrals in Kampong Trach and Dangtong
districts.
Director:
Leng Sothea (012-651-123)
Email: [email protected]
Cambodian Health and
Human Rights Alliance
(CHHRA)
Phnom Penh
Works on research and action to increase
the human rights of especially vulnerable
people.
Director:
Sim Kim Horn (023-212-941)
Email: [email protected]
Cambodian Health
Education Development
(CHED)
Phnom Penh, Battambang, Pailin
Provides home based care in Pailin. In
collaboration with CHEMS (see below),
broadcasts radio programs on two stations
in Battambang and one in Pailin. Has also
been working in five garment factories in
Phnom Penh.
Executive Director:
Lok Vichet (023-884-842,
053-952-771, 012-820-883)
Pailin Coordinator:
Khy Nearyroth (012-708-301)
Email: [email protected]
NON-GOVERNMENT ORGANIZATIONS 99
NON-GOVERNMENT ORGANIZATIONS
SECTION 17
Cambodian Health
Education Media Service
(CHEMS)
Cambodian Network of
People Living With HIV/
AIDS (CPN+)
Cambodian Organization
for Human Rights and
Development (COHD)
Cambodian Social
Economic Development
Association (CSEDA)
Phnom Penh
Phnom Penh
Pursat
Bantey Meanchey
A project of UK based organization Health
Unlimited, CHEMS produces radio and
television commercials mainly targeting
young people from 12 to 25.It also produces
a twice-weekly 15-minute radio soap opera
called "Lotus on a Muddy Lake" as well as
a live one-hour radio show called "Especially
for You,Young People."
Lobbies for human rights, reducing stigma
and discrimination, and access to antiretroviral treatment. Meets with hospital
doctors and school teachers, and has
strong government links. In 2004 it
covered over 10,000 PLHA in 275 self-help
groups in 12 provinces and municipalities
(Phnom Penh, Battambang, Kampong
Cham, Siem Reap, Prey Veng, Svay Rieng
Kampong Thom, Sihanoukville, Kandal,
Takeo, Pursat and Kampong Speu).
Provides home care for PLHA as well
as orphans and vulnerable children in
Sompov Meas district. Also provides
education and referrals.
Provides home care to PLHA as well as
orphans and vulnerable children in O
Chrov and Thmar Pouk operational districts.
Food is provided through the World Food
Programme.
Director:
Heng Sokrithy
(023-216-399, 012-934-777)
Email: [email protected]
Phnom Penh
Executive Director:
Kim Sokuntheary
Other contacts:
Yvette Height (023-219-305,
023-218-410, 012-214-973)
Nou Sovann (012-848-785),
Sour Leng (016-830-447)
Email: [email protected],
[email protected]
Website: www.healthunlimited.org
Cambodian Human Rights
and HIV/AIDS Network
(CHRHAN)
Phnom Penh
Network of more than 30 local human
rights and HIV/AIDS related nongovernment organizations. Investigates,
documents and monitors human-rights
violations against PLHA and others
affected, and advocates for the elimination
of stigma and discrimination. Funded by
USAID through the POLICY Project.
Director:
Dr. Kang Serei (023-993-295,
012-588-299)
Email: [email protected]
100
Cambodian Organization
of People Living with
HIV/AIDS (COPHA)
Phnom Penh
Provides traditional medicine, counseling,
home care and referrals. Works with
Italian organization Don Bosco in caring
for children with HIV/AIDS.
Country Director:
Bunthy Sok (012-803-040)
HIV/AIDS contact:
Billy Barnaart (016-890-891)
Email: [email protected]
Director:
Mr. Kim San (052-951-752,
012-723-853, 012-652-271)
Email: [email protected]
Cambodian Red Cross
(CRC)
Started with community education in five
provinces in 1995. By 2004, it was working
in 11 provinces and municipalities providing
education for young people and police,
community support for PLHA and their
families and effort to prevent stigma and
discrimination. In addition to Phnom Penh,
HIV/AIDS activities are also located in
Siem Reap, Kampot, Pailin, Kampong Cham,
Banteay Meanchey, Battambang, Koh Kong,
Sihanoukville, Prey Veng and Svay Rieng.
HIV/AIDS Program Manager:
Dr. Sok Long (023-990-030,
012-688-081)
Project Team Leader:
Mom Chanthy (012-928-579)
Email: [email protected],
[email protected]
Director:
Yim Bun Son (054-710-056,
012-835-931)
Deputy Director:
Sok Sarun (012-863-415)
Email: [email protected]
Cambodian Vision for
Development (CVD)
Battambang
HIV prevention for indirect sex workers
and workers clearing landmines.
Country Director:
Mounh Sarath (012-565-699)
Email: [email protected]
Cambodian Women for
Peace and Development
(CWPD)
Phnom Penh
Provides education for sex workers,
migrants, community leaders and indigenous people in Kandal, Kampong Chhnang,
Kampong Thom, Kampong Speu, Battambang, Siem Reap, Pailin, Prey Veng and
Kampong Cham as well as Phnom Penh.
Country Director:
Men Sam An (023-724-274,
012-912-042)
NON-GOVERNMENT ORGANIZATIONS 101
NON-GOVERNMENT ORGANIZATIONS
Other contact:
San Arun (012-807-704)
Email: [email protected]
Catholic Office for
Emergency Relief and
Refugees (COERR)
Cambodian Women's
Development Association
(CWDA)
Phnom Penh
SECTION 17
Phnom Penh
Provides education on human rights in
relation to HIV/AIDS among sex workers,
police, military and teachers including
training in brothels.
Director:
Kien Serey Phal (023-210-449,
023-210-487, 012-999-995)
HIV/AIDS contact:
Keo Sichan (016-904-915)
Email: [email protected]
Website: www.bigpond.com.kh/
users/cwda
Caritas
Siem Reap
Faith-based organization providing homecare services to PLHA including antiretroviral treatment, food and loans to
start businesses. Also builds homes and
provides transport from villages to hospitals
and clinics.
Country Director:
Bernadette Glisse (012-735-477)
Email: [email protected]
Website: www.caritas.org.au
102
Faith based organization from Thailand.
Conducts seminars on HIV/AIDS prevention
and care for monks in Kampong Speu and
helps operate the Wat Opod Health
Center in Takeo province which cares for
PLHA.
Director:
San Vandin (023-364-306)
Email: [email protected]
Catholic Relief Services
(CRS)
Battambang
American faith-based organization
conducting HIV/AIDS awareness and
education activities in five districts.
Country Director:
Richard Balmadier (012-907-806)
HIV/AIDS contact:
Heng Bunsieth (012-907-802)
Email: [email protected],
[email protected]
Website: www.catholicrelief.org
Center for Advanced
Studies (CAS)
Phnom Penh
Independent institution devoted to
research, education and public debate on
issues affecting the development of
Cambodian society. Since 1998, it has
completed surveys and other research
related to HIV/AIDS.
Director:
Dr. Hean Sokhom (016-813-511)
Email: [email protected]
Website: www.cascambodia.org
Tel: 023-214-494
Centre Canadien d'Etude
et de Cooperation
International (CECI)
Takeo
Operating in Kvao and Roneam communes,
CECI seeks to mitigate the spread of
HIV/AIDS among women and vulnerable
people in rural areas.
Country Director:
Monique Larose (023-217-561)
Health Coordinator:
Muriel Mac-Seing (012-449-367)
Email: [email protected],
[email protected]
Website: www.ceciasia.org
Christian Care for
Cambodia (CCFC)
Phnom Penh
Operates a center in Kampong Speu
for desperate families with HIV/AIDS.
Families also come from outside the
province, referred by organizations such
as Maryknoll, Servants to Asia's Urban
Poor and Hagar.
Team Leader:
Barry Higgins (023-880-019)
HIV/AIDS contact:
Tim Razloff (023-883-653)
Email: [email protected],
[email protected]
Church World Service
(CWS)
Phnom Penh
American faith-based organization providing
education on prevention, transmission
and care in Kampong Thom, Battambang,
Banteay Meanchey and Svay Rieng.Targets
include traditional birth attendants and
volunteers.
Country Director:
Josephine Barbour (023-217-786)
Deputy Director:
Olivet Visda (023-213-438)
Email: [email protected],
[email protected]
Website: www.churchworldservice.org
Community of Cambodian
Women for Development
(CCWD)
Kandal
Educates young people and garment
factory workers. Makes referrals and
home visits.
Director:
Sorn Dedynin (011-667-727)
Other contacts:
Mo Rein (011-621-376)
Ing Sengkim (012-833-584)
Community Development
Action (CDA)
Battambang
Has prevention projects in Banan and
Battambang districts. Part of the Frontiers
Prevention Project, it aims to extend
prevention activities and services to more
NON-GOVERNMENT ORGANIZATIONS 103
NON-GOVERNMENT ORGANIZATIONS
than 1,000 men who have sex with men
including Battambang,Thmar Kol and Sangke
operational districts.
Country Director:
Im Luom (012-530-525)
Email: [email protected]
SECTION 17
Community Poverty
Reduction (CPR)
Kampong Chhnang
Provides home support for PLHA as well
as orphans and vulnerable children. Also
provides education on prevention and
referrals for testing.
Director:
Roth Sophea (012-797-930)
Cooperation for a
Sustainable Cambodian
Society (CSCS)
Phnom Penh
Administrator:
Chim Chan Nang (012-668-853,
023-726-181)
Email: [email protected]
Cooperative for Assistance
and Relief Everywhere
(CARE)
Phnom Penh
The Cambodian partner of the Bangkokbased Asian Business Coalition on HIV/
AIDS works with youth, casino workers,
sex workers, mobile populations, married
couples, garment factory workers, soldiers
and police, seafarers, men who have
sex with men, PLHA, orphans and vulnerable children and moto-taxi drivers. In
Cambodia for more than 20 years.
104
Country Director:
Sharon Wilkinson
(023-215-267/8/9,
Fax: 023-426-233)
HIV/AIDS contact:
Dr. Sok Pun (012-914-129)
Emails: [email protected],
[email protected]
Website: www.care-cambodia.com
Koh Kong (012-661-165)
Poipet (012-520-014)
Pursat (012-910-931)
Sisophon (012-725-962)
Oddar Meanchey (012-725-962)
Head of Delegation:
Agnes Lesage (023-212-945,
012-424-019)
Phnom Penh Medical Coordinator:
Beatrice Mea (012-263-617)
Sihanoukville Medical Coordinator:
Rozenn Le Meliner (012-325-925)
Email: crf-cambodge-hod@every
day.com.kh,
[email protected],
[email protected]
Website: www.croix-rouge.fr
DHAMMYIETRA
Coordination of Action
Research on AIDS and
Mobility (CARAM)
Mongkol Borei
Phnom Penh
Team Leader:
Arlys Herem (012-924-248)
Email: [email protected]
Aims to reduce HIV/AIDS among migrant
workers including Cambodians going to
work abroad as well as Vietnamese and
Cambodian sex workers. Provides home
care, support groups, education and
counseling.
Program Director:
Tep Mony (023-218-065,
012-847-976)
Sex Worker Project Coordinator:
Ek Salan (012-782-193)
Email: [email protected]
Croix Rouge Francaise
(CRF)
Phnom Penh
Operates program funded by the Global
Fund on AIDS, Tuberculosis and Malaria
for adults and children with HIV/AIDS in
Phnom Penh and Sihanoukville including
access to anti-retroviral treatment.Works
with the Cambodian Red Cross and the
National Pediatric Hospital.
Cares for people with AIDS who are dying
at home.
Douleurs Sans
Frontieres (DSF)
Phnom Penh
French-based organization working in the
areas of pain management and palliative
care for people with chronic diseases
including HIV/AIDS and cancer. Based at
Calmette Hospital, it works closely with
the Ministry of Health and Ministry of
National Defense. Supported by the
Global Fund on HIV/AIDS, Tuberculosis
and Malaria, it also operates a care center
at Preah Keat Mealea Hospital in Phnom
Penh.
Country Director:
Auk Phany (023-430-334,
012-917-971)
Email: [email protected]
Website: www.douleurs-sansfrontieres.org
Ensemble pour une
Solidarite Therapeutique
Hospitaliere En Reseau
(Esther)
Phnom Penh
Supports anti-retroviral treatment at
Calmette Hospital and Siem Reap Regional
Hospital in partnership with three French
university hospitals (Bicetre, Tours and
Brest). Project had reached almost 1,000
patients as of 2004.
Country Representatives:
Ly Cheng Huy (012-977-933)
HIV/AIDS contact:
Heng Tay Kry (023-426-948,
011-810-790)
Ouk Vara (011-820-035)
Email: [email protected],
[email protected],
[email protected],
[email protected]
Website: www.esther.fr
Family Health
International (FHI)
Phnom Penh
American-based organization which
provides technical support to NCHADS
for the HIV Sentinel Surveillance system
and interpretation of the data. FHI is also
involved in preventing HIV among those
most at risk of sexual transmission,
providing care to PLHA in Battambang
and reducing the impact of AIDS on
orphans and vulnerable children. Future
priorities include expanding prevention
for families of high-risk men and expanding
a pilot care and treatment program to
more areas. Operations in Kampong Cham,
Koh Kong, Kep, Siem Reap, Kampong Thom,
Battambang,Pursat,Pailin,Banteay Meanchey,
NON-GOVERNMENT ORGANIZATIONS 105
NON-GOVERNMENT ORGANIZATIONS
Kandal, Kampong Chhnang and Phnom
Penh as well as at the national policy level.
SECTION 17
FHI Country Director:
Dr. Chawalit Natpratan
(023-211-914, 012-808-980)
HIV/AIDS contact:
Caroline Francis (012-804-292)
Senior Surveillance and Evaluation Officer:
Dr. Guy Morineau (023-211-914)
Email: [email protected],
[email protected],
[email protected]
Website: www.fhi.org
Friends Association
Pioneer
(FAP)
Siem Reap
Provides care and support for PLHA as
well as orphans and vulnerable children in
Sothnikom operational district. Works
closely with Médecins Sans Frontières to
provide anti-retroviral treatment.
Executive Director:
Peng Sakun (012-943-155)
Email: [email protected]
Frontiers Prevention
Project (FPP)
Siem Reap and Battambang
Works with government and non-government agencies to avoid duplication. Also
works with sex workers, men who have
sex with men and PLHA in Battambang
operational district.
Siem Reap Coordinator:
Dr. Kros Sarath (012-695-676)
Battambang Coordinator:
Dr. Ouk Vichea (012-621-351)
Email: [email protected],
[email protected]
106
Hagar
Phnom Penh
Project run by Swiss organization Associazione Bambini Bisognosi d'Asia (ABBA)
with a shelter for women and children in
Phnom Penh. Provides counseling and
support for women with HIV/AIDS and
referral for home care. Some women also
receive vocational training. Hagar also
operates a soymilk factory.
Director:
Keiv Rany (023-217-478, 012-569-299)
Shelter Manager:
Mam Savath (012-910-536)
Email: [email protected],
[email protected]
Website: www.hagarproject.org
Handicap International
France (HIF)
Siem Reap
French-based organization which provides
HIV/AIDS education to people living in
Kralanh district through the Sen Sok, Prey
Chouk, Sleng Spean and Sam Bour health
centers.
Country Manager:
Yvan Thebaud (012-441-982)
Health contact:
Dr. Chuo Vivath (012-812-990)
Email:[email protected],
[email protected]
Healthnet International
Phnom Penh
Netherlands-based organization working
with NCHADS and the Antwerp Institute
of Tropical Medicine to educate young
people about HIV prevention and provide
care to PLHA. Activities in Sampow Meas
operational district in Pursat and Kirivong
and Ang Roka operational districts in
Takeo.
Country Representative:
Marc Vandenberghe
(023-213-561, 012-803-065)
Email: [email protected]
Website: www.healthinternational.org
Health Unlimited
Rattanakiri
British-based organization working to
prevent HIV among the Tampoeun, Kreung,
Brao and Jarai indigenous peoples in 32
villages in Rattanakiri. Working with
Population Services International.
Project Manager:
Caroline McCausland
(075-974-109, 023-215-192)
Email: [email protected],
[email protected]
Website: www.healthunlimited.org
Helen Keller
International (HKI)
Phnom Penh
New York-based organization carrying
out a food production project in Banteay
Meanchey for people affected by HIV/
AIDS.
Health contact:
Hou Kroeun (012-824-061)
Website:www.hki.org
Helpage International
(HAI)
Battambang and
Banteay Meanchey
British-based organization which implements
income generation and home care programs
targeting older care givers, orphans and
vulnerable children and PLHA.
HIV/AIDS contact:
Dim Vy
(053-952-797, 012-949-375)
Email: [email protected],
[email protected]
Website:www.helpage.org
HIV/AIDS Coordinating
Committee (HACC)
Phnom Penh
A network of some 80 local and international non-government organizations
working in the HIV/AIDS sector. Plays a
leading role in coordinating yearly national
awareness campaigns. Also publishes
information on caring for PLHA and a
directory of members. HACC is managed
by a voluntary steering committee of seven
members and is headed by a full-time
coordinator. Major donors in 2003 were
KHANA, USAID, Pact and Pfizer.
Coordinator:
Seng Sopheap (012-774-373)
Email: [email protected]
Hope for Persons with
HIV/AIDS
Organization (HPHAO)
Kampot
Provides free traditional medicine to the
poorest PLHA, allowing them to prolong
their lives as they wait for anti-retroviral
treatment. Also runs free child-care centers
in Kampot and Kampong Chhnang.
Director:
El Sma El (012-934-261)
Hope Worldwide
Phnom Penh
American faith-based organization targeting
destitute PLHA as well as patients at the
Russian, Calmette and Military hospitals
and the Sihanouk Center for Hope in
NON-GOVERNMENT ORGANIZATIONS 107
NON-GOVERNMENT ORGANIZATIONS
Phnom Penh.
SECTION 17
Community Project Coordinator:
Chhavelith Vathdama (011-822-113)
Officer Manager:
Ms Kao Pov (023-211-524,
023-882-614, 011-822-113)
Volunteer Coordinator:
Teav Roth Mith (011-850-473,
023-882-613, 011-932-663)
Team Leader:
Phoung Bunthy (011-841-366)
Email: hopecambodia@
bigpond.com.kh,
[email protected],
Website: www.hopeww.org
Implementing AIDS
Prevention and Care
Project (Impact)
Phnom Penh
USAID's flagship effort for addressing the
global epidemic. Managed by Family Health
International (FHI), the project works
with government and non-government
organizations in Cambodia to reduce HIV
transmission, improve HIV/AIDS care and
support, mainly for sex workers and their
clients. The programs help women to
negotiate safe sex, educate uniformed
personnel about HIV/AIDS, build capacity
for institutional care and support, and
reintegrate orphans and other vulnerable
children into extended or foster families.
FHI Country Director:
Dr. Chawalit Natrapan
(023-211-914, 012-808-980)
HIV/AIDS contact:
Caroline Francis (012-804-292)
Senior Surveillance and Evaluation Officer:
Dr Guy Morineau (023-211-914)
Email: [email protected],
[email protected], [email protected]
Website: www.fhi.org
Indradevi Association
(IDA)
Phnom Penh
Operates a clinic for sexually-transmitted
infections and provides education about
prevention and home care for PLHA in
Phnom Penh and Kien Svay district in
Kandal province. Covers people ranging
from sex workers, factory workers and
young people out of school to police and
military.
Country Director:
Dy Ratha
(023-214-804, 012-897-161)
Program Coordinator:
Uy Soung Chhan Sothy
(012-556-270)
Kandal Team Leader:
Som Sin Sokha (011-923-217)
Email: [email protected]
(042-941-783, 012-300-042)
Email: [email protected],
[email protected]
Institut Pasteur du
Cambodge (IPC)
Phnom Penh
Private foundation dedicated to prevention
and treatment of diseases through biological
research, education and public health
activities. Several projects funded by the
French organization for AIDS research.
Country Director:
Dr. Jean-Louis Sarthon
(023-368-036)
HIV/AIDS contact:
Dr. Phoung Viseth (012-802-979)
Email: [email protected],
[email protected]
Website: www.pasteur-kh.org
Institute of Tropical
Medicine of Antwerp (ITM)
Inner Change
Phnom Penh
Kampong Cham
Provides technical advice to NCHADS
and works with the Sihanouk Hospital
Center for Hope in Phnom Penh. Also
works with British-based organization
Health Unlimited. Operations cover
Sihanoukville, Takeo and Pursat as well as
Phnom Penh
A program for poor people run by
Church Resource Ministries, an American
faith-based group. In Kampong Cham, it
runs a home-care project for PLHA called
Sunrise which provides simple drugs,
food, accommodation and referrals to
Medecins Sans Frontieres for anti-retroviral
treatment.
Program Director:
Diane Moss:
Project Manager:
Dr. Francois Crabbe (012-809-330)
Clinician:
Dr. Paul de Munther (012-678-925)
Email: [email protected],
[email protected]
International Cooperation
Cambodia (ICC)
Phnom Penh
108
Faith-based organization with a childwelfare project in Phnom Penh and
Kandal training orphanages on how to
care for children affected by or living
with HIV/AIDS. Another project targeting
indigenous people in Rattanakiri deals
with HIV/AIDS education.
Project Manager:
Deth Yim Symons
(023-215-200, 023-213-310)
Program Manager:
Sarah Chhin (012-563-144)
Email: [email protected],
[email protected],
Website: www.icc.org.kh
Inthanou
Phnom Penh
Cambodia's first HIV/AIDS hotline. Started
in 2000 with support from UNICEF
and Mobitel. It provides information on
transmission, prevention and care as well
as psychological support for PLHA. The
hotline operates from 11 a.m. to 8 p.m.
and was receiving 160 calls a day in its
fourth year. Partners include the Ministry
of Education, Youth and Sport, UNESCO,
RHAC and HACC.
Country Director:
Dr. Loun Monyl (012-911-664)
Hotline: (012-999-008, 012-999-009)
Email: [email protected]
Jeannine's Children
Association (JCA)
Phnom Penh
Runs an orphanage in Tuol Kork for children
whose parents have died of AIDS. Works
with HIV-positive children with Maryknoll.
Country Director:
Kong Sovanlay
NON-GOVERNMENT ORGANIZATIONS 109
NON-GOVERNMENT ORGANIZATIONS
SECTION 17
(012-803-040, 012-932-285)
Email: [email protected]
Director:
Ing Soeurn (012-816-971)
Program Manager:
Pak Kimsan (012-912-727)
E-mail: [email protected],
[email protected]
Kaksekor Thmey
Khemara
Kampong Cham
Phnom Penh
Implements a program that integrates
HIV/AIDS education within its agricultural
activities.
Educates women in Russey Keo district
about HIV/AIDS. Also runs a shelters for
women victims of domestic violence.
Khmer HIV/AIDS NGO
Alliance (KHANA)
Director:
Men Savann (012-968-605)
Email: [email protected]
Director:
Koy Phallany (023-430-620)
HIV/AIDS contact:
Pol Rithy (012-927-279)
Email: [email protected]
Phnom Penh
Kien Kes Volunteer
Network (KKVN)
Battambang
Provides care and support for orphans
and vulnerable children as well as PLHA in
Thmor Kol district.
Tel: 012-681-450
Key of Social Health
Education
Road
(KOSHER)
Phnom Penh
Supports four home-care teams in Phnom
Penh for more than 400 adults and
children with HIV/AIDS and more than
600 children affected. Teams provide
clinical management, nursing, health
education and referrals as well as
counseling, education to reduce stigma and
discrimination. Also provides food and
clothing and supports schooling and
funerals.Works with the National Center
for Tuberculosis and Leprosy Control,
voluntary counseling and testing centers,
clinics for sexually-transmitted infections
and government hospitals as well as local
authorities and pagodas.
Director:
110
Nguon San (012-928-290)
Email: [email protected]
Khmer Buddhist
Association (KBA)
Banteay Meanchey
Supports PLHA and orphans in Thmar
Pourk operational district. Provides home
support, food through the World Food
Programme and referrals to health facilities
for testing and care. Also conducts HIV
prevention activities.
Project Director:
Ros Monichoth: (012-824-373)
Facilitator:
Yan Somaly: (ICOM 146520,
call sign "kilobase")
Khmer Development of
Freedom Organization
(KDFO)
Phnom Penh
Works with men who have sex with men
in three areas of Phnom Penh (Boung
Tompon, Veal Vong and Chba Ampeou)
and also tries to prevent sexual health
clinics from over-charging for services.
Distributes free condoms.
Provides technical and financial support
to more than 50 local non-government
organizations to carry out a wide range of
HIV/AIDS activities including prevention
for sex workers, garment factory workers
and young people. Partners also take care
of PLHA and their families including
orphans and vulnerable children. Home
care in collaboration with NCHADS
involves staff from government health
centers and volunteers including monks.
Teams provide basic medical care, psychological and social support, counseling,
welfare and referrals. They also negotiate
waivers of schools fees and provide
school clothes and materials as well as
advice to parents with HIV/AIDS. Partners
are also involved in reducing stigma and
discrimination against PLHA, their families
and other marginalized people like sex
workers and men who have sex with men.
Operates in Banteay Meanchey, Seam
Reap, Battambang, Kampong Thom, Kratie,
Kampong Cham, Kampong Chhnang,
Pursat, Kampong Speu, Prey Veng, Svay
Rieng, Kampot, Takeo, Phnom Penh and
Sihanoukville.
Director:
Dr. Oum Sopheap
(023-211-505, 012-349-635)
HIV/AIDS contact:
Dr. Phum Sophiny (012-809-250)
Email: [email protected],
[email protected]
Khmer Rural Development
Association (KRDA)
Battambang
Provides care and support for more than
100 PLHA in Moung Russey district.
Works closely with CPN+ and is increasingly
involved in human rights-related work.
Home care includes treatment, counseling,
food, home repairs, and education about
hygiene. Most staff are teachers from Thai
border camps.
Director:
Pouk Cham Roeun
(012-920-029, 012-420-057)
Email: [email protected]
Website: www.krda.org.kh
Khmer Women's
Cooperation for
Development (KWCD)
Sihanoukville
Provides home care for PLHA and support
for orphans and vulnerable children. Also
works with sex workers and men who
have sex with men in addition to making
referrals for other services including antiretroviral treatment. Operates a gardening
project in partnership with Helen Keller
International.
Director:
Sum Satum (012-866-617)
Other contact Heng Bunhak
(011-884-121)
Email: [email protected],
NON-GOVERNMENT ORGANIZATIONS 111
NON-GOVERNMENT ORGANIZATIONS
[email protected],
[email protected]
Kratie Women's Welfare
Association (KWWA)
Kratie
SECTION 17
Provides home care for PLHA as well as
support for orphans and vulnerable
children in Kratie operational district.Also
educates people about HIV prevention,
especially young people, and makes
referrals to health facilities.
Director:
Yous Thy
(072- 971-586, 012-916-329)
Email: [email protected]
Leadership's Khmer
Women for Development
(LKWD)
Banteay Meanchey
Executive Director:
Buth Hiev (012-633-687)
Email: [email protected]
Lutheran World
Federation (LWF)
Phnom Penh
The Swiss-based federation of Christian
churches in the Lutheran tradition works
closely with the government in Kampong
Speu, Kampong Chhnang and Battambang
in the field of rural development including
HIV/AIDS-related activities. It works with
provincial and district AIDS committees
and offices as well as volunteers, educators,
monks, traditional birth attendants and
PLHA, focusing on awareness, prevention,
care and support. In Battambang, it works
with provincial AIDS officials in targeting
112
sex workers, migrants and casino workers
in the borders areas of Kam Rieng and
Phnom Prek districts.
Country Director:
David Mueller
(023-881-100, 012-791-191)
Program Coordinator:
Albert Weinmann (012-791-193)
Email: [email protected],
[email protected],
Website: www.lwfcam.org.kh,
www.lutheranworld.com
Marie Stopes
International (MSI)
Phnom Penh
British-based reproductive health organization with outreach activities targeting
factory workers and karaoke girls,
community condom distribution and
education programs on HIV/AIDS.
Project Director:
Ros Thoeun
(023-720-125, 023-720-724)
Nurse Lab Technician:
Dr. Nop Sothearanak (012-838-347)
Email: [email protected]
Maryknoll Seedling of
Hope
Phnom Penh
American faith-based organization targeting
poor PLHA and Vietnamese in 15 fishing
villages in and around Phnom Penh including
Takhmao. Provides education and information on how to care for people with AIDS
and works to reduce stigma and discrimination. Provides home or office care to
hundreds of PLHA including medicines,
food, money, emotional support, rent
support and monitoring of children. Also
supports provides group homes from
children infected and affected by HIV/AIDS,
as well as income generating activities for
families affected by HIV/AIDS
Program Director:
Father Jim Noonan (023-425-018)
Email:[email protected],
[email protected]
Media Consulting and
Development (MCD)
Phnom Penh
Provides HIV/AIDS clippings from local
press and developing annual HIV/AIDS press
monitoring report. Also working on film
projects with Action IEC and NCHADS.
Country Director:
Sebastien Drans
(023-224-303, 012-550-110)
HIV-AIDS contact:
Cedric Jancloes (012-803-670)
Email: [email protected]
Médecine de l'Espoir
Cambodge (MEC)
Phnom Penh
Operates clinic for sex workers in
Psa Thmei. Also works with men who
have sex with men. Partnership with
Family Health International.
Director:
Keth Thairth
(023-986-715, 012-844-449)
HIV/AIDS contact:
Dr. Ung Prohot (012-939-250)
Email: [email protected]
Médecins Du Monde (MDM)
Phnom Penh
French organization with an inpatient
department at Calmette Hospital offering
55 beds and an outpatient department
specializing in HIV/AIDS care. Moved all
HIV/AIDS activities to Preak Kossamak
Hospital in 2004.
Country Director:
Dr. Pierre-Regis Martin
(023-882-238)
Email: [email protected]
www.medecinsdumonde.org
Médecins Sans FrontièresBelgium (MSF-B)
Phnom Penh
Belgian organization providing care through
chronic disease clinics in provincial referral
hospitals in Siem Reap and Takeo and the
district referral hospital in Sotnikum in
Seam Reap. Services include treatment
for opportunistic infections like pneumocystis carinii pneumonia and cryptococcal meningitis as well as counseling
and education to promote adherence to
anti-retroviral treatment.The number of
people receiving highly-active anti-retroviral
treatment was estimated to reach 1,500 in
2004.
Country Director:
Richard Veerman
(023-880-334, 012-811-302)
HIV/AIDS contact:
Bart Janssens (012-871-447)
Email: [email protected],
[email protected]
Website: www.msf.be
Médecins Sans FrontièresFrance (MSF-F)
Phnom Penh
French organization providing anti-retroviral
treatment at the infectious diseases department of Preah Bat Norodom Sihanouk
NON-GOVERNMENT ORGANIZATIONS 113
NON-GOVERNMENT ORGANIZATIONS
SECTION 17
Hospital in Phnom Penh and the HIV clinic
at the provincial hospital in Kampong Cham.
Also trains doctors and nurses working
for the Ministry of Health and supports
other organizations such as the Association
of Users of Anti-Retrovirals. By 2004, the
French organization was providing antiretroviral treatment to more than 1,300
people.
Programme and makes referrals to
USAID-supported clinics.
Head of Mission:
Catherine Quillet
(012-211-281, 012-854-395)
Faith-based organization running a hospice
for tuberculosis patients in Chaom Chau.
Also has orphanages in Phnom Penh
and Siem Reap for HIV-positive children
abandoned by their families.
Medical Coordinator:
Dr. Didier Laureillard
(012-815-393)
Email: [email protected],
msffr.sida@online,com.kh
Website: www.msf.org
Men's Health Cambodia
(MHC)
Phnom Penh
Carries out prevention activities with
men who have sex with men and sex
workers in Phnom Penh and Siem Reap.
HIV/AIDS contact:
Mao Kim Run
(016-885-535, 011-783-354)
[email protected]
Director:
Penh Sinal (012-898-258)
Email: [email protected]
Missionaries of Charity
Phnom Penh
Hospice Contact:
Sister Mary Paul (023-363-435)
Orphanage Contact:
Sister Bertina (023-213-491)
Mith Samlanh/Friends
Phnom Penh
Targets street children, vulnerable youth
and their families. Provides information,
condoms and medical supervision including
access to anti-retroviral treatment when
possible, as well as funding for cremation
ceremonies.
Nak Akphivath Sahakum
(NAS)
Kampong Cham
Operates three home-care teams for up
to 130 patients in as many as 10 villages.
The teams are based in local health centers
and include part-time government staff
as well as volunteers. Also educates
local villagers about HIV/AIDS and
recruits monks to help reduce stigma and
discrimination.
Director:
Savan Samol (012-579-048)
Project Coordinator:
Pho Sophorn
(012-897-103, 012-579-048)
Email: [email protected]
National Center in HIV
Epidemiology and Clinical
Research (NCHECR)
Phnom Penh
Minority Organization
Development Economy
(MODE)
Coordinator:
Sebastien Marot (023-220-596)
Program Director:
Ms Ly Sophat (023-426-748)
Email: [email protected]
Website: www.streetfriends.org
Kampong Thom
Mlop Tapang
Runs HIV prevention activities and home
care for PLHA as well as orphans and
vulnerable children in Kampong Thom
operational district. Provides food in
partnership with the World Food
Sihanoukville
Australian research center collaborating
with NCHADS since 2000. Provides
funding and support for anti-retroviral
treatment at the Cambodia Treatment
Access Clinic including full-time technical
advisors and training for health staff
providing HIV/AIDS treatment. Also
supports NCHADS surveillance systems.
Italian organization educating street children
about HIV/AIDS at a day-care center in
Sihanoukville. Works closely with Khmer
Women's Cooperation for Development.
Technical Advisor:
Dr. Sarah Huffam (023 223 146)
Email: [email protected]
Website: www.med.unsw.edu.au/nchecr
Maggie Eno (012-587-407)
114
HIV/AIDS contact:
Touch Setha (012-472-305)
Email: [email protected],
[email protected]
Website: www.mloptapang.org
Association (NAPA)
Kampong Speu
Provides home care for PLHA in Kampong
Speu as well as support for orphans and
vulnerable children. Also educates young
people about prevention.
Director:
Ang Chamroeun (016-838-387)
Nyemo
Phnom Penh
Runs a center for vulnerable women and
children in Phnom Penh. Services include
counseling, health care, psychological
support, day care for children, temporary
shelter. vocational training and job
placement .
Director:
Ky Kanary
(023-216-944, 012-889-956)
Coordinator:
Hoeung Vireak (012-965-253)
Email:kykanary_nyemo@everyday.
com.kh, [email protected]
Website: www.nyemo.com
Operations Enfants
de Battambang (OEB)
Battambang
Local organization helping children and
disabled people to become self-reliant.
Also helps abandoned AIDS patients with
counseling as well as material and financial
support. Works with UNICEF in training
Buddhist nuns.
National Prosperity
NON-GOVERNMENT ORGANIZATIONS 115
NON-GOVERNMENT ORGANIZATIONS
Director:
Tith Davy
(053-952-752, 012-910-095)
Email:[email protected]
Pact Cambodia
Phnom Penh
SECTION 17
Independent corporation based in
Washington. Works with Cambodia
People Living with HIV/AIDS Network
(CPN+) and the HIV/AIDS Coordinating
Committee (HACC) in developing information materials such as booklets and
calendars.
Country Director:
Kurt MacLeod
(023-217-820, 012-811-705)
HIV/AIDS contact:
Phon Yut Sakar (012-956-389)
Email: [email protected],
[email protected],
[email protected]
Website: www.pactworld.org
Partners for Development
(PFD)
Phnom Penh
American-based organization offering
counseling on HIV prevention, sales of
pills and condoms, referrals to health
centers and training of barbers and
motorcycle taxi drivers. Also works with
sports clinics, pagodas, primary school
teachers. Activities cover Kratie and
Chlong operational districts in Kratie and
Sre Ambel and Smach Meanchey districts
in Koh Kong.
Country Director:
Chris Smith
(023-213-335, 012-404-156)
HIV/AIDS contact:
116
Judi Harris (012-492-348)
Email: [email protected],
[email protected],
[email protected]
www.partnersfordevelopment.org
Partners for Health
Reformplus (PHR)
Phnom Penh
USAID-project providing information
support to four referral hospital pilot
sites in Banteay Meanchey, Battambang,
Sihanoukville and Phnom Penh. The
four sites are supported by the Japan
International Cooperation Organization
(JICA), the Centers for Disease Control
(CDC), the World Health Organization
(WHO) and Family Health International
(FHI).
Coordinator:
Jayaseeli Bonnet
(023-222-420, 012-315-152)
Technical Manager:
Kunrath Seak (012-958-347)
Email: [email protected],
[email protected]
Website: www.phrplus.org
Partners in Compassion
Takeo
Works with monks in providing home
care for PLHA in Takeo Bati and Prey Kabas
operational districts. Also makes referrals
to government and USAID-supported
clinics. Runs a hospice and community
center for PLHA as well as orphans
and vulnerable children and provides
food support through the World Food
Programme.
Coordinator:
Or Van Din
(011-926-037,012-975-873)
Email: [email protected]
Pharmaciens sans
Frontières (PSF)
Phnom Penh
French organization which provides
consultations and education on sexuallytransmitted infections at mobile clinics in
bars and is also working to improves access
to anti-retroviral treatment by proving a
long-term reliable supply of drugs. Partners
include NCHADS, Mith Samlanh and
Medecine de l'Espoir Cambodge.
Country Coordinator:
Jean Yves Dufour
(023-216-594, 012-867-500)
HIV/AIDS contact:
Emmanuel Wintx (012-633-021)
Email: psf_cambodia@online. com.kh
Website: www.psfci.org
Phnom Srey Association
for Development (PSAD)
Kampong Cham
Works with sex workers and brothel
owners in three operational districts in
partnership with Family Health International.
Country Director:
Hany Fiya (012-684-528)
HIV/AIDS contact:
Real Sophy (042-941-670)
Email: [email protected]
POLICY Project
Phnom Penh
A five-year project funded by USAID with
operations in more than 40 countries
including Cambodia and Vietnam. The
project is implemented by the Washingtonbased Futures Group, a Constella company,
in collaboration with the Centre for
Development and Population Activities
and Research Triangle Institute. In
Cambodia, initiatives include working with
monks to combat stigma and discrimination, protecting human rights, empowering
people infected and affected by HIV/AIDS,
and strengthening partnerships between
government and civil society. Other
activities include developing guidelines
for the HIV/AIDS law passed in 2002,
and working with marginalized groups.
HIV/AIDS contact:
Candice Sainsbury (023-726-255)
Email: [email protected]
Website: www.policyproject.com
Population Services
International (PSI)
Phnom Penh
American-based organization which
launched Number One condoms in
Cambodia in late 1994. By the end of
2003, more than 120 million had been
sold and the brand had an estimated 80
percent share of the market. In 2002, PSI
launched the United Health Network
(UHN) of local and international NGOs
and the Sun Quality Health Network
(SQHN) of private-sector clinics. PSI has
also introduced Care female condoms,
a water-based lubricant called Number
One Plus, which mainly targets sex workers
and men who have sex with men, as well
as OK condoms, which are targeted at
couples.
Country Director:
Andrew Boner (023-210-814)
NON-GOVERNMENT ORGANIZATIONS 117
NON-GOVERNMENT ORGANIZATIONS
Deputy Director:
Jaqueline Devine
Website:www.psi.org
Program for Appropriate
Technology for Health
(PATH)
SECTION 17
Phnom Penh
American-based organization with projects
targeting migrant workers in Prey Vaeang.
Also targets sex workers, police and
military, men who have sex with men,
orphans and vulnerable children. Partners
include Cambodian Women for Peace
and Development and Family Health
International. In addition to Prey Veng,
activities cover Banteay Meanchey, Siem
Reap, Battambang, Pursat, Koh Kong,
Kratie and Phnom Penh.
Country Director:
Stephen Croll (012-902-690)
Email: [email protected],
[email protected]
Website: www.path.org
Reproductive and Child
Healthcare Alliance
(RACHA)
Phnom Penh
HIV/AIDS and sexually-transmitted
infections form one of six focus areas of
RACHA's program in Cambodia.Although
it works closely with the Ministry of Health,
it also works extensively with local volunteers and businesses as well as other
NGOs and international agencies. It
supports voluntary counseling and testing
and access to nevirapine treatment for
pregnant women. Also targets migrant
couples and sex workers in rural areas,
and works with the Ministry of Health
to build social acceptance of condoms
and address issues of vulnerability
118
among young people to HIV transmission.
Operates in Kampot, Pursat, Battambang,
Banteay Meanchey, Siem Reap and Phnom
Penh.
[email protected],
[email protected],
[email protected],
[email protected],
[email protected],
[email protected]
Country Director:
Chan Theary
(023-213-724, 023-726-257)
HIV/AIDS contact:
Vong Chesda (012-866-099)
Email: [email protected]
Website:www.rc.racha.org.kh
Rural Association for
Development of Economy
(RADE)
Reproductive Health
Association of Cambodia
(RHAC)
Works with sex workers and brothel
owners in Pursat town as well as Krakor
and Sampeameas districts, in partnership
with Family Health International.
Phnom Penh
Educates adolescents, garment factory
workers, sex workers and fishermen about
HIV/AIDS. Provides diagnosis and treatment
of sexually-transmitted infections, voluntary
counseling and testing, pre-marital counseling, youth friendly services and services
to prevent mothers transmitting HIV to
their children. In addition to Phnom Penh,
RHAC operates in Battambang, Siem Reap,
Sihanoukville,Takeo, Kampong Cham, Svay
Rieng and Kampong Speu.
Country Director:
Dr. Ouk Vong Vathiny
(023-855-135, 012-720-022)
Health contact:
Dr.Var Chivorn (012-982-294)
Phnom Penh, Psa Depo
(023-885-135, 016-865-215)
Phnom Penh, Psa Toul Tompong
(023-218-504, 012-777-216)
Battambang (053-952-616,
012-877-830)
Kampong Cham (012-855-055)
Sihanoukville (034-933-942,
012-818-807)
Takeo (012-823-595)
Siem Reap (063-964-960)
Email: [email protected],
Pursat
Director:
Var Bunny
(052-951-709, 012-893-134)
HIV/AIDS contact:
Chea Sokny (011-704-166)
Email: [email protected],
[email protected]
Rural Economic
Development Association
(REDA)
Svay Rieng
Provides care and support for more than
200 people including almost 70 children
affected by HIV/AIDS. Also provides
education in 40 villages located in eight
communes and supports three self-help
groups. Has created jobs for HIV/AIDS
households to earn money from making
bags, weaving baskets and feeding animals.
Country Director:
Sim Kalyan
(044-945-820, 012-940-755)
Email:[email protected],
[email protected]
Sacrifice Families and
Orphans Development
Association (SFODA)
Phnom Penh
Runs an orphanage and a home-care
program. Also has an education program.
Director:
Pen Sophan
(016-859-005, 012-936-805)
HIV/AIDS contact:
Ouk Moninarom (012-936-805)
Salvation Center
Cambodia (SCC)
Phnom Penh
Provides home care and support for PLHA
as well as orphans and vulnerable children.
Also provides education about sexuallytransmitted infections and makes referrals
to government and RHAC clinics.
Country Director:
Prum Theoun
(023-365-311,012-901-738)
HIV/AIDS contact:
Yai Bun Chhen (012-886-510)
Email: [email protected]
Save the Children
Australia (SCA)
Phnom Penh
Australian organization that works with
adolescents, children affected by HIV/AIDS,
and monks. Education programs target
adolescents in rural areas in Kratie, slums
in Phnom Penh and poor areas in Prey Veng
NON-GOVERNMENT ORGANIZATIONS 119
NON-GOVERNMENT ORGANIZATIONS
and Takeo provinces. Pagoda HIV/AIDS
committees are located in the Chbar
Ampeou area of Phnom Penh, Prey Veng
town and Bati district in Takeo.
SECTION 17
Country Director:
Carol Mortensen (023-214-334)
Email: [email protected],
[email protected]
Website: www.savethechildern.org.au
Country Director:
Craig Greenfeld
(023-425-045, 012-947-462)
HIV/AIDS contact:
Or Ee (011-880-471)
Email: [email protected]
Website: www.servantsasia.org
Seek of the Pious Friend's
Association (SPFA)
Social Environmental
Agricultural Development
Organization (SEADO)
Siem Reap
Banteay Meanchey
Has prevention and care activities including
referrals to key health services, raising
awareness of HIV/AIDS and reducing stigma
and discrimination.
Has HIV/AIDS activities in Au Chrov,
Serey Sophon and Svay Check districts,
covering five communes including three
high schools and six cement factories.
Also supports home-care teams in Poipet,
Kop and Au Bhey Jhon.
Director: Soun Chea (012-635-649)
Servants for Health in
Asian and African Regions
(SHARE)
Japanese organization with health education projects including HIV/AIDS awareness
and prevention. Targets include young
people, school teachers, health workers
and traditional birth attendants.
Country Coordinator:
Miki Ueda (023-212-427)
Email: [email protected]
Servants to Asia's
Urban Poor
Phnom Penh
Faith-based organization with project
helping children whose parents are dying
or have died from AIDS. Provides rice,
loans, advice, clothing, education and school
uniforms. Also provides basic medicine,
food and nutritional supplements for HIVpositive children and operates a weekly
clinic for sex workers in Phnom Penh's
120
Mean Chey district.
Director:
Kong Sam Nang
(054-958-843, 012-867-480)
Email: [email protected]
Sihanouk Hospital Center
for Hope (SHCH)
Phnom Penh
HIV/AIDS prevention activities for children
and young people. Also helps fund programs
run by Servants to Asia's Poor and World
Relief as well as the Evangelical Fellowship
of Cambodia.
Organizes group discussions and distributes
condoms.Also provides nutrition counseling
and makes referrals for testing.
HIV/AIDS contact:
Pang Sophany (023-214-106)
Email: [email protected]
University Research
Company (URC)
24-Hour Television
Charity
Committee - Cambodia
(24HTV-CA)
Phnom Penh
Kandal
Japanese organization providing home-care
in Kandal Stung. Affiliated with Nippon
Television, one of Japan's biggest television
networks which is also affiliated with
Japan's leading newspaper, the Yomiuri
Shimbun.
Project Advisor:
Masahiro Ishizeki (023-216-256)
Representative:
Naoki Takeda
Email: [email protected]
Website: www.bigpond.com.kh/users/
ca24h/
Government hospital supported by the
non-government organization Hope Worldwide, which cares for up to 400 PLHA.
Provides anti-retroviral treatment with
support from Belgium's Institute of Tropical
Medicine and the Global Fund to Fight
AIDS,Tuberculosis and Malaria.
Unaccompanied
Association (Unacas)
Hospital Director:
Dr. Gary Jacques (023-882-484)
HIV/AIDS contacts:
Dr. Sok Phorn (023-882-484)
Contact:
Pen Chantha (012-921-015)
Email: [email protected]
Kandal
Operates a hospice and also provides
home care including counseling, medicine
and support.
Tearfund
United Neutral Khmer
Students (UNKS)
British faith-based organization implementing
Phnom Penh
Director:
Dr. Nea Seryotanak (012-891-827)
American-based organization that plans,
manages and implements HIV/AIDS
and family health programs Koh Kong,
Kratie, Banteay Meanchey, Siem Reap,
Pursat, Battambang and Phnom Penh.
Compiled the comprehensive Directory
of Organizations Implementing or Supporting HIV/AIDS Activities in Cambodia,
on which much of this list is based.
Country Director:
Margaret Peggy Cook
(023-222-420)
Email: [email protected]
Website: www.urs-chs.com
Urban Sector Group (USG)
Phnom Penh
Works with Family Health International
in providing education and support for
sex workers in eight operational districts
in Phnom Penh. Many of those targeted
are park or street-based sex workers.
Collaborates with other non-government
organizations as well as NCADS, municipal
AIDS offices and clinics for sex workers.
Director:
Lim Phai (023-721-188, 012-859-226)
Program Assistant:
Meas Chanthan (011-728-397)
Program Officer:
Tun Samphy (012-636-798)
Email: [email protected]
Vithey Chivit
NON-GOVERNMENT ORGANIZATIONS 121
NON-GOVERNMENT ORGANIZATIONS
SECTION 17
Phnom Penh
Phnom Penh
orphans and vulnerable children.
Provides care, support and counseling.
Also provides home-care, conducts hospital
visits, and conducts advocacy workshops
in hospitals.
Runs education programs for garment
factory workers and young people out of
school. Also trains volunteers from villages
and factories.
Director:
Chear Sarith
(023-884-271, 012-949-982)
Email: [email protected]
Director:
Hout Totem
(023-308-090, 012-864-193)
Country Director:
Soreach Sereithida
(023-720-807, 012-955-105)
Project Manager:
Un Chanthol (012-945-745)
Email: [email protected]
Womyn's Agenda for
Change (WAC)
Wat Norea Peaceful
Children's Home
Battambang
Educates monks about HIV/AIDS care,
prevention and support. Monks then
disseminate information, organize selfhelp groups and make referrals. Work is
integrated into the monks' daily duties.
Director:
Kim Ngoun Chea
(053-370-246, 012-754-613)
Other contact:
Dol Samphan: (012-911-602)
Woman and Youth Action
(WYA)
Kratie
Working with Family Health International
to reduce transmission and vulnerability
to HIV among sex workers in Kratie.
Country Director:
Phoeuk Phalkun (012-614-862)
HIV/AIDS contact:
Van Serey Lakena (012-771-158)
Women’s Development
Association (WDA)
Women's Network for
Unity (WNU)
Phnom Penh
Supports 5,000 members in 13 provinces
and municipalities. Targets sex workers,
garment factory workers and self-help
groups. Receives financial and technical
support from Womyn's Agenda for Change.
Operates in Phnom Penh, Kandal, Kampong
Speu, Kampong Cham, Kampong Thom,
Kampong Chhnang, Kampot, Battambang,
Pailin, Pursat, Banteay Meanchey, Siem Reap
and Takeo.
Director:
Keo Tha (012-471-093)
HIV/AIDS contact:
Sou Sotheavy (011-660-152)
Email: [email protected]
Women's Organization for
Modern Economy
and Nursing (WOMEN)
Phnom Penh
Provides home care, supports self-help
groups, makes referrals and also supports
Phnom Penh
Works to empower women through
a network in Phnom Penh and 13
provinces. Targets include sex workers,
men who have sex with men, lesbians, garment workers and beggars.
Sex Worker Project:
Pry Phally Puong (012-988-054)
Tel: 023-722-314
Email: [email protected]
Website: womynsagenda.org
World Education
Cambodia (WEC)
Phnom Penh
Works with the Ministry of Education,
Youth and Sports in providing HIV/AIDS
education to students and teachers in
targeted provinces. Has also completed
an HIV/AIDS curriculum for Grades One
to Six.
Country Director:
Mark Kowalski (023-216-854)
Program Manager:
Mr Chum Thou
(012-858-807, 012-811-501)
Email: [email protected],
[email protected]
Website: www.worlded.org
World Relief
Phnom Penh
developing a mobile HIV/AIDS resource
center and a faith-based AIDS network in
Kampong Cham. A second project in
Kampong Cham, Kampong Thom, Kandal
and Phnom Penh promotes sexual purity
and supports families affected by HIV/AIDS.
Country Director:
Tim Astutz
(023-214-085, 012-898-265)
HIV/AIDS contact:
Geof Bowman (012-401-371)
Project Director:
Joke van Opstal (023-881-827)
Email: [email protected]
Website: www.wr.org
World Vision
Phnom Penh
American faith-based organization that
has projects covering prevention, voluntary
testing and counseling as well as home
and community-based care. Works with
the Ministry of Health and the World
Food Program in providing food to PLHA
in four provinces.Targets include children,
pregnant and lactating women, factory
workers and youth. Operates in Phnom
Penh as well as Kandal, Takeo, Kampong
Speu, Kampong Chhnang, Battambang and
Kampong Thom.
Country Director:
Talmage Payne
(023-216-052, 012-816-536)
HIV/AIDS contact:
Srey Mony (012-692-920)
Email: [email protected]
Website: www.wvi.org
Youth Council of
Cambodia (YCC)
Phnom Penh
American faith-based organization
122
NON-GOVERNMENT ORGANIZATIONS 123
NON-GOVERNMENT ORGANIZATIONS
Program Coordinator:
Mek Sarath
(023-220-861, 012-992-401)
Health Program Officer:
Sok Sopha (012-777-454)
Email: [email protected]
SECTION 17
Youth With A Mission
(YWAM)
Steung Treng
[email protected],
[email protected]
18.
WEBSITES
American faith based organization working
to educate young people about HIV/AIDS.
Country Director:
Philip John Scott (012-590-667)
HIV/AIDS contact:
Touch Sidana (012-664-808)
Email: [email protected],
As HIV enters the host cell, it loses it outer envelope.
Picture and text: Boehringer Ingleheim
124
WEBSITES
SECTION 18
WEBSITES
T
he following sites are part of a
multimedia training kit developed
by Julie Clayton, HIV/AIDS coordinator at the Science and Development
Network of science journalists reporting
in developing countries, with contributions from TV Padma of Panos India
(www.itrainonline.org/itrainonline/mmtk/
hivaids.shtml). For the specific websites of
institutions operating in Cambodia see the
preceding sections.
HIV/AIDS News and
Information Portals
Health-E
AIDS Education Global
Information System (AEGIS)
HIV Insite
The World Bank AIDS Media Website
launched in late 2004 can be found at:
AfroAIDSinfo.org
www.aidsmedia.org
HIV/AIDS Quick Guide produced by the
Science and Development Network
describes the content and usefulness of
sites:
www.scidev.net/quickguides/index.
cfm?fuseaction=links&
qguideid=1&subcat=22
The International AIDS Economics Network
provides a table of HIV/AIDS-related
information resources most commonly
used by its members:
www.iaen.org/files.cgi/9821_iaen_
survey_summary.pdf
www.aegis.com
AIDSchannel guide to AIDS
www.aidschannel.org/guide/
www.afroaidsinfo.org
AIDScience
www.aidscience.org
A web site providing researchers with
an online source of HIV/AIDS research
updates.
All Africa.com
www.allafrica.com/aids/
AmFAR
www.amfar.org
Global Treatment Access Campaign
www.globaltreatmentaccess.org
Health and Development Networks
www.hdnet.org/home2.htm
www.health-e.org.za
www.hivinsite.com
Integrated Regional Information
Networks (IRIN)
www.irinnews.org/AIDSfp.asp
Kaiser Network
www.kaisernetwork.org
Science and Development
Network
www.scidev.net/
The Body
www.thebody.com
Global Treatment Access
Campaign
www.globaltreatmentaccess.org/
UNAIDS
www.unaids.org/
National AIDS Map
www.aidsmap.com
Mostly UK and Europe based
information.
New Mexico AIDS Info Net
www.aidsinfonet.org
Mostly US based information and
links.
HivNet.ch
www.hivnet.ch/e/index-frame.html
Swiss information and exchange site on
HIV/AIDS.
You and AIDS
www.youandaids.org
The United Nations Development
Programme's HIV/AIDS Portal for Asia
Pacific.
International HIV/AIDS Alliance
www.aidsalliance.org/_docs/
index_eng.htm
Support for communities in developing
countries in tackling the spread and impact
of HIV /AIDS.
The HIV/AIDS Search
www.kaisernetwork.org
A search engine for links relating to living
with HIV/AIDS.
IAEN: International AIDS
Economics Network
www.iaen.org/
126
WEBSITES 127
WEBSITES
HIV and Development
www.hivandevelopment.org/
SECTION 18
The United Nations Development Programme's South East Asia HIV and Development Programme.
World Health Organization SouthEast Asia Regional Office HIV/AIDS
Home Page
w3.whosea.org/hivaids/
Program for the Collaboration
Against AIDS and Related
Epidemics
www.procaare.org/
Discussion forum and e-mail alert.
Family Health International
www.fhi.org
International AIDS Vaccine Initiative
(IAVI)
www.iavi.org
International Meeting
Calendars
ELDIS
www.eldis.org/hivaids/hivaidsevents.
htm
Johns Hopkins University AIDS
Service
www.hopkins-aids.edu/resources/
calendar/calendar1.html
128
International AIDS Society
www.ias.se
Kaiser Network
www.kaisernetwork.org
Conference and Other
Reports
Health and Development Networks
www.hdnet.org/home2.htm
Kaiser Network
www.kaisernetwork.org
Medscape
www.medscape.com/
conferencedirectory/hiv
Microbicides 2002
www.itg.be/micro2002/
The Body
www.thebody.com/confs/reports.html
Missing the Message?
http://www.comminit.com/ma2003/
sld-9136.html
This report by Thomas Scalway argues
that while "current international interest,
funding and mobilisation for AIDS are
creating a unique opportunity to build an
effective response to the crisis, few of the
lessons of the past are contributing to
current approaches."
HIV/AIDS, Gender and
Human Rights
Gender, HIV/AIDS and human rights
section: Inter Press Service (IPS)
Media
www.ipsnews.net/aids_2002/index.
shtml
Gender and HIV/AIDS Information
Pack
www.ipsnews.net/hivaids_form.shtml
Media tool for gender sensitive
reporting on HIV/AIDS
www.genderandaids.org/modules.php?
name=News&file=article&sid=268
Centre for Advocacy and Research
(CFAR) in Delhi, UNIFEM and Positive
Women's Network (PWN+).
Gender and Photojournalism in
Southern Africa: A manual for
beginners
and
Gender
and
HIV/AIDS: A training manual for
Southern African media and
Communicators
Follow link to "publications" from this site.
www.genderlinks.org.za
ELDIS Gender and HIV/AIDS page
www.eldis.org/gender/dossiers
Gender and AIDS
www.genderandaids.org/
International Center for Research
on Women
www.icrw.org
HIV/AIDS, Gender and Rights:
Training Manual for the Media
www.ipsnews.net/hivaids_form.shtml
IPS Inter Press Service International
Association, Rome, Italy.
United Nations Development Fund
for Women
www.unifem.undp.org/human_
rights/hiv_aids.html
United Nations Population Fund
www.unfpa.org/hiv/prevention/
hivprev4a.htm
World Health Organisation
www.who.int/gender/hiv_aids/en/
International Guidelines on
HIV/AIDS and Human Rights
www1.umn.edu/humanrts/instree/
t4igha.html
The Asia Pacific Forum of National
Human Rights Issues
www.asiapacificforum.net/human/
issues/hiv_aids.htm
United Nations High Commission
on HIV/AIDS and Human Rights
www.unhchr.ch/hiv/index.htm
WEBSITES 129
WEBSITES
HIV and Human Rights: A Training
Manual
www.undp.org.vn/mlist/health/
022003/post28.html
SECTION 18
United Nations Development Programme,
Vietnam.
Scientific and Medical
Literature
British Medical Journal
www.bmj.com
Nature
www.nature.com
New England Journal of Medicine
www.nejm.org
PUBMED database of scientific and
medical publications
www.ncbi.nlm.nih.gov/
The Lancet
www.lancet.com
Reporting on HIV/AIDS
African Women's Media Center
www.awmc.com/pub/p-4680/e-4681/
AIDS Reports: Investigating an
Epidemic
www.panos.org.np/resources/
publications/
Panos South Asia.
130
Media tools for sensitive reporting,
extracted from HIV/AIDS Media
Guide, 2nd Edition
www.actoronto.org/website/home.
nsf/pages/mediaguide?opendocument&menuitem=mediaitem
HIV/AIDS and Human Rights: a training manual for NGOs, community
groups and people living with
HIV/AIDS
w w w. c o m m i n i t . c o m / m a 2 0 0 3 /
sld-8241.html
How to spot HIV/AIDS Fraud
www.aidsinfonet.org/articles.php?
articleID=206
Reports on Media
Coverage of HIV/AIDS
What's New: Perspectives on
HIV/AIDS in the South African
Media, 2002
w w w. c a d re . o r g . z a / p d f / W h a t s
%20news.pdf
Centre for AIDS Development, Research
and Evaluation (CADRE), Johannesburg,
South Africa.
HIV/AIDS and the Mass Media:
a Literature Review, 2001
www.cadre.org.za/pdf/LITREV%20
media%20and%20HIVAIDS.pdf
Centre for AIDS Development, Research
and Evaluation (CADRE), Johannesburg,
South Africa.
Media & HIV/AIDS in East and
Southern Africa
www.unesco.org/webworld/publications/media_aids/
United Nations Educational, Scientific and
Cultural Organisation (UNESCO).
HIV/AIDS Media Guide, 2nd Edition
w w w. a n c a h r d . o r g / p u b s / p d f s /
mediaguide.htm
Australian National Council on AIDS,
Hepatitis and Related Diseases.
Multimedia Presentations
Video cast plus transcript from
Kaiser Network on HIV/AIDS in
India
www.kaisernetwork.org/health_
cast/hcast_index.cfm?display=detail
&hc=919
www.kaisernetwork.org/health_
cast/uploaded_files/062703_kff_
indiaaids_transc.pdf
www.kaisernetwork.org/health_
cast/hcast_index.cfm?display=detail
&hc=994
Radio programme about HIV
vaccine research in South Africa
www.radio.oneworld.net/index.php?
fuseaction=audio.view&audio_
id=3916
HIV/AIDS images
AIDS Clock
www.unfpa.org/aids_clock/
Boehringer-Ingleheim
www.boehringer-ingleheim.com
Textbook of AIDS pathology
w w w. m e d l i b . m e d . u t a h . e d u /
WebPath/TUTORIAL/AIDS/AIDS.
html
The Big Picture Book of Viruses:
Retroviridae
www.virology.net/Big_Virology/
BVretro.html
AVERT
www.avert.org/pictures.htm
Center for Diseases Control Public
Health Image Library
http://phil.cdc.gov/Phil/default.asp
Aaron Diamond AIDS Research
Center
www.adarc.org/hiv/stages/index.htm
HIVinsite online chapter "Molecular
Insights into HIV Biology"
www.hivinsite.com/InSite?page=
kb-02-01-01
Johns Hopkins University AIDS
Service
www.hopkins-aids.edu/hiv_lifecycle/
hivcycle_txt.html
WEBSITES 131
WEBSITES
Fighting Back
www.pbs.org/wgbh/nova/aids/
immune.html.
SECTION 18
"See HIV in Action" http://www.pbs.org
/wgbh/nova/aids/action.html
National Institutes of Health Image
Archive
http://aidshistory.nih.gov/imgarchive
/#HIV
Museum of Science and Industry,
Chicago
http://www.msichicago.org/exhibit/
AIDS/AIDSlc1.html
AIDSMeds
www.aidsmeds.com/lessons/Life
CycleIntro.htm
HIV quizzes
AVERT Quizzes on condoms, sex,
statistics and general knowledge.
19.
GLOSSARY OF
TERMS
www.avert.org/hivquiz.htm
The nucleoapsid contains the genetic information
of HIV (viral RNA) and viral proteins including
reverse transcriptase.
Picture and text: Boehringer Ingleheim
132
GLOSSARY OF TERMS
SECTION 19
GLOSSARY OF
TERMS
abacavir
An anti-retroviral drug used to treat HIV
infections. See nucleoside analogue reverse
transcriptase inhibitors.
abbreviations and acronyms
With the exceptions of HIV and AIDS,
avoid if possible -- unless you're writing or
broadcasting to a medical audience.
Abbreviations and acronyms are great for
taking notes. But they can confuse readers,
listeners and viewers. By all means, use
such terms if they are widely known such
as CPP (an abbreviation) and Funcinpec
(an acronym). But why alienate your
audience by saying that NAA and
NCHADS plan to tackle OI with ARV?
ABC approach
Abstaining from sexual activity, mutual
monogamy, and condom use are three key
behaviours that can prevent or reduce the
likelihood of sexual transmission of HIV.
These behaviours are often included
together under a comprehensive “ABC”
approach: “A” for Abstinence (or delayed
sexual initiation among youth), “B” for
being faithful (or reduction in number of
sexual partners), and “C” for correct and
consistent condom use, especially for
casual sexual activity and other high-risk
situations.
abstinence
Abstaining from sexual activity to prevent
or reduce the likelihood of sexual transmission of HIV.
134
Acquired Immune
Deficiency Syndrome
(AIDS)
A collection of symptoms and illnesses
known as opportunistic infections that
develop as a result of damage to the
immune system caused by years of attack
by HIV. The term was adopted by the
Centers for Disease Control in 1982.
People with AIDS often have infections of
the lung, brain, eyes and other organs, and
frequently suffer debilitating weight loss.
People with HIV do not necessarily have
AIDS. But all people with AIDS have HIV.
A diagnosis of AIDS can be based on the
presence of one or more opportunistic
infections in a person with HIV. Another
way of diagnosing AIDS is when the CD4
cell count of people with HIV falls below
500 cells per microliter (the CD4 cell
count of person with a normal immune
system usually ranges from 500 to 1,500
cells per microliter). Note that AIDS does
not stand for Acquired Immunodeficiency
Syndrome (which would be AIS) or
Acquired Immuno Deficiency Syndrome
(the prefix is never detached). Most writers
use upper-case AIDS but some prefer Aids
to make it clear that it's a pronounceable
word.
acute HIV infection
The four to seven-week period of rapid
viral replication that immediately follows
exposure to HIV. Most people exposed
develop this primary infection which is
characterized by flu-like symptoms such
as fever, malaise, sore throat, headache
and sometimes a rash. Following the
primary infection, the body's immune
system develops antibodies to the virus,
usually within an average of three weeks
but sometimes several months. It was
previously thought that the virus was
relatively dormant during this phase.
acyclovir
A drug used to treat two of the herpes
viruses that can become opportunistic
infections for people with AIDS.
ADC
See AIDS dementia complex.
adherence
The extent to which a patient takes
medicine according to the prescribed
schedule.
adolescent
with children defined as those below the
age of 15. This definition overlaps with a
separate UN definition which classifies
children as all young people below the age
of 18. See defining the young.
affected community
People with HIV/AIDS and others such as
families and friends whose lives are
directly influenced by HIV infection and
its physical, psychological and social
ramifications.
AIDS
See Acquired Immune Deficiency Syndrome.
AIDS carrier
There's no such thing as an AIDS carrier.
People with the virus are usually referred
to as being HIV-positive which means their
immune system has developed antibodies
to the virus in the three-month period
after exposure.
UN agencies define adolescents as young
people between 10 and 19 years of age.
Early adolescence is defined as 10 to 14
years and late adolescence as 15 to 19
years. See defining the young.
AIDS-defining illness
adult
Also known as AIDS-related dementia
and HIV-associated dementia. A brain
disorder which can affect people with
advanced AIDS. Symptoms include loss of
coordination, mood swings, loss of inhibition
and widespread cognitive dysfunction.
Although it usually occurs after the
development of major opportunistic
In comparing rates of HIV prevalence
worldwide, UN agencies focus on the
adult population between 15 and 49 years
of age. For the actual number of people
with HIV, the global survey by UNAIDS and
the WHO includes children and adults
See opportunistic infections.
AIDS dementia complex
GLOSSARY OF TERMS 135
GLOSSARY OF TERMS
infections, AIDS dementia complex can
appear before such complications.Treatment
consists of anti-retroviral drugs. See opportunistic infections.
SECTION 19
AIDS patient
A person with AIDS who is being treated
in a hospital or some other medical establishment. Most people with HIV are not
patients.
AIDS sufferer
Be careful with this expression. Many
people object to the term because it was
widely misused in the early years of the
epidemic to refer to all HIV-positive
people regardless of whether they were
sick, suggesting a loss of power and control
over their lives. Many people with HIV are
not suffering from AIDS. But those who
develop opportunistic infections after five
or 10 years of living with the virus may be,
albeit to varying degrees.
AIDS test
There is no such thing as an AIDS test.
See HIV test.
AIDS victim
Avoid this term as it is often misused to
refer to people with HIV. Many people with
HIV/AIDS feel these terms imply they are
powerless with no control over their lives.
This may be true, and HIV-positive people in
some countries insist that they are indeed
victims of the failure of their societies to
warn them of the risks of contracting the
virus. But this is largely not the case in
Cambodia, and most victims of AIDS are
those people who have died. Others may
be victims of something other than
HIV/AIDS. See victims.
136
AIDS wasting syndrome
antibodies
ART
The loss of at least 10 percent of the body
weight of people with HIV accompanied by
either chronic diarrhea (two loose stools
a day for more than 30 days) or chronic
weakness and fever (for 30 days or more,
intermittent or constant).
Proteins produced by the body's immune
system to destroy foreign organisms, or at
least render them harmless. Antibodies
stick to antigens -- tiny portions of foreign
organisms such as viruses, bacteria, fungi
and parasites -- and tag them for removal.
People with HIV produce antibodies but
they do not get rid of the virus because it
hides inside cells and changes its outer
surface so that antibodies fail to stick.
Anti-retroviral therapy. See highly active
anti-retroviral therapy.
amprenavir
An anti-retroviral drug used to treat HIV
infections in people with HIV/AIDS. See
protease inhibitors.
anal sex
Sex involving a man inserting his penis
into the anus of the other partner. Carries
a high risk of HIV transmission without a
condom if one of the partners is infected.
Abstinence is the safest way to protect
against HIV from sexual transmission. See
sexual transmission.
ante-natal
Adjective describing the medical care
given to pregnant women. In Cambodia,
women attending ante-natal clinics have
been one of the main sentinel groups
included in the HIV Sentinel Surveillance
program since 1994. See sentinel groups.
anonymity
See confidentiality and anonymity.
antibiotic
A natural or synthetic substance that kills
or inhibits the growth of bacteria but not
a virus. Often used to treat diseases caused
by bacterial infection. In Cambodia, antibiotics are often used inappropriately as
distribution is unregulated. As a result,
antibiotics are frequently sold by pharmacists
unqualified to prescribe such drugs.
antifungal
A substance that kills or inhibits the
growth of a fungus.
antigen
A substance that causes the immune
system to produce antibodies. Usually a
protein or a protein with sugar molecules.
Antigens can be on the surface of a live
organism or be a fragment of an organism.
anti-retroviral drugs
Drugs that kill or prevent the replication
of retroviruses like HIV. The three main
classes of drugs used for treating HIV are
nucleoside analogue reverse transcriptase
inhibitors, protease inhibitors and nonnucleoside reverse transcriptase inhibitors.
Using a combination of drugs from three
classes is known as highly active anti-retroviral
therapy. Although such treatment reduces
the amount of HIV in the bloodstream,
the virus is still present and can rise again
to dangerous levels. In addition, the drugs
can have serious and even potentially lifethreatening side effects including
diarrhea, liver problems, rashes, nerve
damage and neurological problems.
anti-viral drugs
Drugs that kill or prevent the replication
of a virus.
ARV
See anti-retroviral drugs.
Asian Business
Coalition on AIDS
A partnership between companies
that aim to prevent and control HIV/
AIDS in the workplace and non-profit
organizations that provide related
technical services. With a secretariat in
Bangkok, the coalition has partners in 11
countries -- Bangladesh, Cambodia, India,
Indonesia, Malaysia, Myanmar Nepal,
the Philippines, Singapore, Thailand and
Vietnam. It has also had a formal partnership
with the Global Business Coalition on AIDS
since 2002.The Asian Business Coalition's
Cambodian partner, CARE International,
operates a reproductive health program
including HIV prevention in more than 20
garment factories in Phnom Penh. The
program targets mostly young female
workers, although there is also training
for middle managers in Chinese. The
companies participating are Gennon
Garment Manufacturing Ltd., Supreme
Garments Pte. Ltd., June Textiles Co. Ltd.,
Tack Fat Garment Ltd., Pak Shun Knitting
Factory Ltd., Thai Pore Garment
Manufacturing Co. Ltd., PCCS Garments
Ltd., PDC Garment Ltd., Wearwel
Cambodia Ltd., QMI Industrial Co. Ltd.,
Wilson Garment Co. Ltd., Sportex
Industry Co. Ltd., Suntex Pte. Ltd., Leun
Thai Co. Ltd., Cambodia Sportwear Mfg.
Ltd.,Archid Garment Cambodia Ltd., New
Island Clothing (Cambodia) Ltd., Yung
Wah Industry (Cambodia) Co. Ltd., Jusca
Garment Ltd., CHP Garment Factory Co.
Ltd., San San Garment (Cambodia) Co.
GLOSSARY OF TERMS 137
GLOSSARY OF TERMS
Ltd., You Cheng Garment Co. Ltd. and
Eternity Apparel (Cambodia) Co. Ltd.
Asian Development Bank
SECTION 19
Regional development bank set up in
Manila in 1966 with Cambodia as one of
the founding members. Working with
UNAIDS, the ADB has been involved in
estimating the amount of money needed
for a successful response to HIV/AIDS in
the Asia-Pacific region. The ADB has also
co-authored a series of joint studies with
UNAIDS including Comparing the Impact
of HIV/AIDS at National and Selected
Sub-national Levels in Cambodia, India,
Thailand and Vietnam (ADB/UNAIDS
Study Series Paper II) and The Impact of
HIV/AIDS on Poverty in Cambodia, India
Thailand and Vietnam (ADB/UNAIDS
Study Series Paper I, II and III).
azdotymidine (AZT)
One of the first anti-retroviral drugs used
to treat HIV. Originally developed for
cancer, American scientists announced in
1986 that AZT appeared to benefit
people with HIV. See nucleoside analogue
reverse transcriptase inhibitors.
AZT
See azdotymidine.
bacteria
The simplest and smallest forms of plant
life. Bacteria exist in large numbers in air,
water and soil, and also in living and dead
creatures and plants. They are often a
cause of infection. The word is plural.
The singular form is bacterium and the
adjective is bacterial. Drugs that fight
bacteria are called antibiotics.
138
bauk
A Cambodian term that literally means
'plus', or more than one. Recently, this
term has been used within the health sector
to refer to gang rape.
beer-promotion girls
In Cambodia, women who work in
restaurants and bars promoting certain
brands of beer. Some are also sex workers.
The Khmer term (srey langseh) is based on
the French expression for launching new
products.
Behavioral Surveillance
Survey
A survey of the risk behavior of sentinel
groups carried out by NCHADS since
1997. Commonly known as the BSS and
not to be confused with HIV Sentinel
Surveillance, which is also carried out by
NCHADS. See page 153.
BFR syndrome
Body Fat Redistribution syndrome. See
fat redistribution.
blood-borne transmission
In reference to HIV, when blood infected
with the virus enters the bloodstream of
an uninfected person.HIV can be transmitted
through blood, blood products, tissue and
organs. The most common method is
through contaminated needles and syringes
that often contain a small amount of
blood after injections. Needles used for
tattoos or acupuncture can also transmit
HIV if not sterilized.
blood products, tissue and
organs
In Cambodia, all blood products, tissue
and organs have to be tested for HIV
before they are used under Article 14 of
the Law on the Prevention and Control of
HIV/AIDS. Article 15 stipulates that nobody
can keep any donated blood, tissue or
organs that have not been tested for HIV
in advance. First-time violators face a fine
of up to one million riel and up to one
year in jail. The law also provides for
relatives or other recipients of donated
blood, tissue or organs the right to
demand a second test, except in medical
emergencies.
blue virus
English translation of an incorrect
Cambodian term for HIV. Derived from
merok (virus) and hiou, the way HIV is
pronounced as a Cambodian acronym
based on the letter V which can denote a
final diphthong when transliterating
Khmer into Roman script. When spoken
quickly, the two words form merokiou,
with kiou being the Cambodian word for
blue.The National AIDS Association does
not use merok hiou to describe the virus
but merok eith ("AIDS virus") as distinct
from chamngeu eith ("AIDS disease").
Body Fat Redistribution
Syndrome
See fat redistribution.
body fluids
Avoid if referring to HIV transmission.
This used to be a polite term which
oversimplifies how HIV is transmitted
("through the exchange of body fluids").
But it is misleading as HIV can only be
transmitted by some body fluids - blood,
semen, pre-ejaculate, vaginal fluids and
breast milk. HIV cannot be transmitted via
other body fluids such as saliva, sweat,
tears or urine.
bridge group
A group of people at high risk of HIV
infection who may transmit the virus to a
larger population at lower risk of infection.
One example is male clients of sex workers.
NCHADS has also identified injection drug
users, fishermen and garment factory workers as other possible bridge groups in
Cambodia. The term needs to be used
with care, however, as it can imply that
high rates of HIV infection or risk activities
in bridge groups can be ignored if the larger
population is unlikely to be affected. It can
also falsely imply that being part of a
group -- rather than risky behavior -- makes
people susceptible to HIV infection.
Bristol-Myers Squibb
A US pharmaceutical company that
produces the anti-retroviral drug known as
d4T for use in WHO-recommended first
lines of drug treatment or first-line
regimens. The company has a policy of not
letting its patents prevent access to
affordable HIV treatment in sub-Saharan
Africa. See separate entries for anti-retroviral
drugs and Roche.
BSS
See Behavioral Surveillance Survey.
cachexia
A state of weakness and weight loss that
can occur in people with HIV. See AIDS
wasting syndrome.
GLOSSARY OF TERMS 139
GLOSSARY OF TERMS
SECTION 19
candidiadis
children
cocktail therapy
A common fungal infection, generally
known as Candida albicans. It most
commonly involves the skin, oral mucosa,
respiratory tract and vagina. Candidiasis
of the oesophagus, trachea, bronchi, or
lungs is an indicator disease for AIDS.
Oral or recurrent vaginal candida infection is an early sign of immune system
deterioration. Oral candida, also known as
thrush, can be controlled by fungicidal
lozenges, mouthwashes and other medications. See opportunistic infections.
In estimating the number of people with
HIV, children are defined by UN agencies
as young people below 15 years of age.
This definition overlaps with a separate
UN definition which classifies children as
young people below the age of 18. See
defining the young.
See highly-active anti-retroviral therapy.
catch AIDS
People don't catch AIDS but can be infected
with HIV. If people with the virus do not
receive treatment, they will eventually
develop AIDS-related illnesses.
CD4 cells
The type of cell mainly targeted by HIV.
The cells have a docking molecule called
"cluster designation 4" on their surfaces.
Also known as CD4+ (positive) cells and
T cells, they coordinate the response of
the immune system to infections such as
viruses. HIV replicates inside these cells,
destroying them and weakening the
immune system. A CD4 count is a test
measuring the number of these cells and
is commonly used to monitor the health
of people with HIV.
chancroid
A highly-contagious sexually-transmitted
disease. The bacterial infection causes
ulcers and symptoms which may facilitate
HIV transmission. Symptoms usually appear
three to five days after exposure.
140
chlamydia
A sexually-transmitted disease that infects
the genital tract.The infection often shows
no symptoms and can cause infertility in
women if left untreated.
circulating recombinant
forms
New types of HIV that can be created
when a person infected with one strain of
the virus is re-infected by another strain,
causing different parts of the virus to
"recombine" into a new form that can be
transmitted to another person. The most
efficient way of recombining HIV is through
blood transmission, especially among
injection drug users. See HIV strains.
combination therapy
See highly-active anti-retroviral therapy.
commercial sex
Sex involving payment for services.
commercial sex workers
Sex work is a form of commerce so the
adjective is redundant. This cumbersome
expression to be avoided also implies
there are such people as non-commercial
sex workers, which is absurd.
communicable disease
Illness caused by an infection that can be
transmitted from an infected person to a
susceptible host.
compulsory HIV testing
clade
Testing for HIV with no option to refuse.
In Cambodia, compulsory testing is
allowed only if ordered by a court. Any
testing for employment, education, housing,
travel, medical services and other services
is "strictly prohibited" under Article 20 of
the Law on the Prevention and Control of
HIV/AIDS.
Sub-type. See HIV strains.
complementary treatment
clinical trial
A broad range of healing philosophies,
approaches and therapies that conventional
Western medicine does not commonly
use to promote well being or treat health
conditions. Examples include herbs and
acupuncture. Some complementary
treatments can relieve symptoms of HIVrelated illnesses.
circumcision
See male circumcision.
Study involving volunteers testing the
effects of a new drug or vaccine.
CMV
See cytomegalovirus.
confidentiality and
anonymity
Confidentiality is when you expect
someone to keep a secret. Anonymity is
the state of remaining unknown to most
other people. Under Articles 33 and 34
of the Law on the Prevention and Control
of HIV/AIDS, the confidentiality of all
people with HIV/AIDS has to be maintained
except in cases involving court orders,
government monitoring and health
workers directly or indirectly involved in
treatment or care. First-time violators
face a fine of up to 200,000 riel and up to
six months in jail. Anonymity for all HIV
testing is guaranteed under Article 22 of
the law. Under Article 31, the government's
program for monitoring HIV/AIDS has
to use a coding system that promotes
anonymity.
contagious
Any infection that can be transmitted by
casual contact between people. Casual
contact means normal day-to-day contact
such as between people at home, school
or work. Chicken pox and SARS are
contagious. HIV is infectious not contagious
as it is transmitted by direct or intimate
contact (such as unprotected sex).
continuum of care
A continuum is a series of items in which
each is almost the same as the ones next
to it but the last is very different from the
first. In HIV/AIDS, the term refers to care
across a continuum ranging from homes
and communities to health centers and
hospitals. Home care might include people
caring for themselves or care given by
family, friends, neighbors, health workers
and social workers. Community care
GLOSSARY OF TERMS 141
GLOSSARY OF TERMS
SECTION 19
might include nurses, midwives, trained
volunteers, community health workers,
traditional healers, non-government
organizations, local leaders, teachers,
youth groups and lay or religious leaders.
Care in health centers might involve
nurses, midwives, counselors, social
workers, traditional healers and volunteers. Hospital care might involve doctors,
nurses, counselors, social workers, education services and legal aid.
cryptococcal meningitis
A life-threatening fungal infection of the
membranes around the brain and spinal
chord. Symptoms include headache,
dizziness and a stiff neck. If left untreated,
it can result in coma and death. See
opportunistic infections.
CRF01_AE
The circulating recombinant form of HIV
that is dominant in Southeast Asia. See
HIV strains.
CSW
See commercial sex worker.
cure
Eradication of a medical condition to
restore normal health, including the
elimination an infectious organism from
the body. As far as HIV is concerned a
cure is non-existent as of 2004. The Law
on the Prevention and Control of HIV/AIDS
also recognizes that "there is no known
cure."
cytokine
A natural protein produced by the body
which acts as a chemical messenger. See
immune-based therapies.
142
cytomegalovirus
See herpes viruses.
ddC, ddI and d4t
Three types of anti-retroviral drug used to
treat HIV infections in people with HIV/
AIDS. The drug d4t is one of three drugs
used in the most widely-prescribed fixed
dose combination (with 3tc and nevirapine),
enabling patients to take one pill twice a
day instead of six pills a day if taken separately. In Thailand, the combination drug is
known as GPOvir.The US pharmaceutical
company Bristol-Myers Squibb produces d4t
for use in WHO-recommended first line
regimens. See separate entries for antiretroviral drugs, highly-active anti-retroviral
therapy, nucleoside analogue reverse transcriptase inhibitors and GPOvir.
decentralization
Recommended by the UNDP for government efforts in the field of HIV/AIDS. In
Cambodia, the agency's "community
enhancement program" works with the
Ministry of Rural Affairs to encourage
communes to develop their own strategies.
The program includes collecting and
analyzing HIV/AIDS data. Most commune
councilors have identified HIV/AIDS as a
local priority and have said they are willing
to create detailed care and prevention
plans.
defining correct and
consistent use of condoms
Definitions vary.The Behavioral Surveillance
Survey of 2003, for example, asked direct
sex workers if they used condoms
consistently with clients and boyfriends
over the previous week. But surveyors
asked indirect sex workers if they did so
over the previous three months, the same
period used when surveying military,
police and motorcycle taxi drivers about
their use of condoms with sex workers
and girlfriends. The separate Youth Risk
Behavior Survey in 2003 meanwhile asked
those who were sexually-active if they
used condoms always, most of the time,
sometimes or never.
defining the young
UN agencies define young people as all
people between 10 and 24 years of age.
Youths are defined as those between 15
and 24 years of age. Adolescents are
between 10 and 19 years of age, with
early adolescence defined as 10 to 14
years and late adolescence as 15 to 19
years. In estimating number of people
with HIV, children are defined by UN
agencies as young people below 15 years
of age. This definition overlaps with a
separate UN definition which classifies
children as young people below the age of 18.
delavirdine
A different type of anti-retroviral drug used
to treat HIV infections in people with
HIV/AIDS. See non-nucleoside analogue
reverse transcriptase inhibitors.
dental procedures
In Cambodia, dental procedures are
subject to precautions determined by the
National AIDS Authority under Article 14
of the Law on the Prevention and Control
of HIV/AIDS. Dentists who fail to follow
correct infection control precautions can
face a fine of up to one million riel and up
to one year in jail for first-time violations.
Denver Principles
Principles against stigma and discrimination
adopted at America's Second National
Forum on AIDS in Denver in 1983. The
principles called for support for HIVpositive people opposing stigma and
discrimination. People with HIV should
"be involved at every level of decision
making" and "serve on the boards of
directors of provider organizations, and
participate in all AIDS meetings with
as much credibility as other participants
to share their own experiences and
knowledge." These principles were the
precursor to the formation of coalitions
for people with HIV/AIDS in dozens of
countries, including; the Global Network
of People Living with HIV/AIDS (GNP+),
the International Community of Women
Living with HIV/AIDS in 1992, and the
GIPA principle adopted in Paris in 1994. In
Cambodia, the Cambodian People Living
with HIV/AIDS Network (CPN+) has
been actively involved in policy development
and helped draw up a successful funding
proposal to the Global Fund to Fight
AIDS, Tuberculosis and Malaria. See
Greater Involvement of People Living with
HIV/AIDS.
deoxyribonucleic
acid (DNA)
The molecular chain that carries the genetic
information for cells to reproduce. Found
in genes within the nucleus of each cell.
direct sex workers
In surveys by NCHADS, the term "direct
sex workers" (srey roksiplauphet ptoll)
applies exclusively to female brothel-based
sex workers. But the NAA defines direct
sex workers as people who either have
no other job besides selling sex or derive
most of their income from such activities.
In addition to women working in brothels,
this broader definition would include people
such as orange sellers and male sex workers.
GLOSSARY OF TERMS 143
GLOSSARY OF TERMS
SECTION 19
In the narrower definition used by
NCHADS,most women working in brothels
are Cambodian but some migrate (or are
trafficked) from other countries.According
to a POLICY Project study on sex workers
and condom use in 2003, many have been
sold into prostitution with bonds as high
as 700 dollars that have to be repaid to
brothel owners. Many are from rural
areas, lured by brokers offering honest
and well-paid jobs.Those who "voluntarily"
enter the profession may also have big
debts if they borrow money to send back
to their families or are charged for rent,
food, clothing, make-up or jewelry. Direct
sex workers commonly live in the brothel
where they work. A profile by NCHADS
in 2001 showed that a typical direct sex
worker was female, 22 years old and had
more than four clients a day, earning
about 550,000 riel a month. She had been
in the business for less than two years
including about five months in the latest
brothel. Almost 60 percent had regular
clients and about 50 percent had boyfriends.
A typical brothel had nine workers.
discrimination
An infringement of the human rights that
often leads to people being subjected to
various forms of abuse (UNAIDS definition
in 2004). In Cambodia, any discrimination
in the workplace based on a person's
actual, perceived or suspected HIV/AIDS
status is prohibited under Article 35 of
the Law on the Prevention and Control of
HIV/AIDS. Termination of employment on
the same basis is unlawful. Other articles
guarantee freedom of abode, lodging and
travel and the right to seek public office
for people with HIV/AIDS and prohibit
discrimination by educational, financial and
health institutions.While the law does not
144
spell out penalties for discrimination in
the workplace, first-time violators of the
other provisions face a fine of up to one
million riel and up to six months in jail.
DNA
See deoxyribonucleic acid.
Doha Declaration
See World Trade Organization.
drug companies
See pharmaceutical companies.
economic impact of
HIV/AIDS
In 1999, the United Nations estimated the
potential cost of HIV/AIDS in Cambodia at
more than two billion dollars. The
burden of illness and death is expected to
fall heavily on households, increasing
indebtedness, asset sales, malnutrition and
school dropout rates. A joint report by
UNAIDS and the Asian Development Bank
(ADB) in 2004 noted that studies had
estimated that HIV/AIDS would slow
Cambodia's poverty reduction by 60
percent a year between 2003 and 2015.
That compares with estimated slowdowns
of only 38 percent in Thailand and 23
percent in India during the same period.
efavirenz
An anti-retroviral drug used to treat HIV
infections in people with HIV/AIDS. See
non-nucleoside analogue reverse transcriptase
inhibitors.
ELISA
See enzyme-linked immunosorbent assay.
embalming
In Cambodia, embalming is subject to
infection-control precautions determined
by the National AIDS Authority under
Article 13 of the Law on the Prevention and
Control of HIV/AIDS. There are penalties
for failing to follow specified precautions.
First-time violators face a fine of up to
one million riel and up to one year in jail.
enzyme-linked
immunosorbent assay
The most commonly used HIV test.
Known as ELISA, it tests for the presence
of antibodies to HIV not the virus itself.
See HIV testing.
epidemic
UNAIDS defines epidemic as a disease that
spreads rapidly through a demographic
segment of the human population. Such
segments can be everyone in a given
geographic area or a military base or
everyone of a certain age or sex, such
as the children or women of a region.
Epidemic diseases can be spread from
person to person or from a contaminated
source such as food or water. Smaller
than a pandemic. UNAIDS tends to use
epidemic.
violate National AIDS Authority guidelines or lack a medical or scientific basis.
Under the Law on the Prevention and
Control of HIV/AIDS, first-time violators
face a fine of up to one million riel and up
to one year in jail. Under the Press Law,
false advertising carries a penalty of up to
five million riel.
fat redistribution
Change in body fat distribution that can
occur in people taking two of the three
classes
of
anti-retroviral
drugs.
Accumulation of abdominal fat is known
as "protease paunch" while increased
deposits of fat between the shoulder
blades is sometimes referred to as "buffalo
hump." Women may also experience narrowing of the hips and enlargement of the
breasts. Also known as Body Fat
Redistribution
Syndrome
and
Lipodystophy Syndrome.
first-line regimen
See regimen.
fishermen
The estimated 30,000 Cambodian men
who cross the border to work as fishermen
in Thailand have been identified as being
vulnerable to HIV infection.
epidemiology
fixed-dose combination
The study of the causes, spread and
control of diseases within a population. A
person who specializes in this field is an
epidemiologist.
A combination of three anti-retroviral
drugs in one pill that only has to be taken
twice a day instead of different pills several
times a day. Cheaper to produce and
easier for doctors, pharmacists and
patients to deal with. Such combinations
increase the likelihood of patients adhering
to the treatment, thereby reducing the
chances of resistance developing. See
false advertising
In Cambodia, misleading information or
advertisements on HIV/AIDS treatment and
prevention are strictly prohibited if they
GLOSSARY OF TERMS 145
GLOSSARY OF TERMS
highly active anti-retroviral drugs.
full-blown AIDS
SECTION 19
Avoid. The term was initially coined to
distinguish between healthy people with
HIV and sick people with AIDS. But it
implies that there is such a thing as "halfblown AIDS" and is therefore misleading.
It is also an affront to people with AIDS.
funding requirements
The Asian Development Bank (ADB) and
UNAIDS estimated that the countries
of the Asia-Pacific region needed more
than 1.5 billion dollars to finance a
comprehensive response to the HIV/AIDS
epidemic in 2003. But only 200 million
dollars was available from donors and
governments. The ADB and UNAIDS have
also estimated that the region will need
5.1 billion dollars a year for HIV/AIDS
care prevention and treatment by 2007.
This amounts to only 4.4 percent of the
region's health spending and 0.2 percent
of gross national income in 2001.
fungus
A group of primitive organisms including
mushrooms, yeasts, rusts and moulds.
Fungus is singular. The plural is fungi and
the adjective is fungal. Drugs that fight
fungi are called anti-fungal drugs.
FSW
Female sex worker. See sex workers.
gancyclovir
A drug used to treat people infected
with the cytomegalovirus, an opportunistic
infection that can be developed by people
with AIDS. See herpes viruses.
garment factory workers
146
An estimated 170,000 young rural
women working in garment factories
in Phnom Penh, Kandal, Kampong Cham
and Sihnoukville have been identified as a
"bridge group" to HIV transmission. See
Asian Business Coalition on AIDS.
GBC
See Global Business Coalition on HIV/AIDS.
gender
The Oxford dictionary defines gender as
"the fact of being male or female" while
UNAIDS defines gender as "differences
in social roles and relations between
men and women" (unlike sex which refers
to biological differences only). USAID
defines gender as the "economic, social,
political and cultural attributes and
opportunities associated with being male
or female" and a "socio-cultural expression of particular characteristics and roles
that are associated with certain groups of
people with reference to their sex and
sexuality." Definitions vary and change
over time. See also transgender.
generic drugs
Drugs made by companies that don't own
the patents. Such manufacturers use the
international non-proprietary name, which
is the official name given to the molecule
or medicine rather than the registered
brand name. Generic drug companies
can often manufacture drugs more cheaply
than the companies that own the patents.
Indian generics producers Cipla and
Ranbaxy have developed fixed-dose
combinations allowing three anti-retroviral
drugs to be taken in one capsule or tablet.
As of mid-2004, the WHO had approved
these two combinations for use in first-line
regimens along with a third produced by
British drugmaker GlaxoSmithKline.
GFATM
See Global Fund to Fight AIDS, Tuberculosis
and Malaria.
GIPA Principle
See Greater Involvement of People Living
with HIV/AIDS.
GlaxoSmithKline
British based drugmaker producing one of
three fixed-dose combinations of antiretroviral drugs approved by the WHO.
As of mid-2004, Indian generics producers
Cipla and Ranbaxy were producing two
other fixed-dose combinations for first-line
regimens recommended by the WTO. See
separate entries for anti-retroviral drugs
and highly-active anti-retroviral therapy.
Global Business Coalition
on HIV/AIDS
Established in 1997 as an alliance of
international companies, the coalition
entered a formal partnership with the
Asian Business Coalition on AIDS in 2002
and had more than 100 members by 2004.
Located in the New York headquarters of
Viacom, one of the 22 companies that
founded the Global Media AIDS Initiative.
Richard Holbrooke, the former US
ambassador to the United Nations, was
appointed president and chief executive
officer in 2001. The coalition has been
chaired by GlaxoSmithKline (1997 to 2000),
television operator MTV Networks
International (2000 to 2002) and GermanAmerican carmaker DaimlerChrysler.
Many members are establishing HIV treatment programs as called for by the
International Labor Organization. Coalition
members with a presence in Cambodia
include BHP Billiton, British American
Tobacco, Chevron Texaco (Caltex), DHL
Worldwide, FedEx Corporation, Heineken
NV, PepsiCo, Siemens, Standard Chartered
Bank,Total and Unilever.
Global Fund to Fight AIDS
Tuberculosis and Malaria
Set up by government, civil society and
the private sector in 2002 to find new
money and create news ways to finance
the fight against three diseases that kills
more than six million people every year.
By the end of 2003, the fund had approved
227 grants worth 2.1 billion dollars with
about 60 percent earmarked for AIDS. By
2004, almost five billion dollars had been
pledged up to 2008 and beyond, although
only 2.1 billion dollars had been paid into
the fund's bank account by the middle of
the year. By August 2004, approved funding
for HIV/AIDS grants to Cambodia exceeded 25 million dollars. In the longer term,
the fund is seeking more money from the
private sector, which accounted for only
two percent of contributions in 2004.
About 100 non-government organizations
have started a "Fund the Fund" campaign
to increase support for the initiative.
Global Media AIDS
Initiative
Launched by senior executives of 22 global
media companies during a special meeting
with United Nations Secretary General
Kofi Annan in January, 2004. In a statement,
the media executives resolved to "expand
public knowledge and understanding
about HIV/AIDS" through their companies.
For details, see page 26.
Glycoprotein 120
A protein on the outer surfaces of HIV
which is used as an antigen in some
vaccines.
GLOSSARY OF TERMS 147
GLOSSARY OF TERMS
gonorrhea
hemophilia
A sexually-transmitted disease which can
also be transmitted from mother to child
during birth.
A hereditary blood disorder that prevents
blood clotting. Treatment involves lifelong
injections of a synthetic version of the
clotting factor extracted from normal
blood. If it is not heat treated, the clotting
factor can carry HIV. In many developed
countries, the early cases of HIV infection
were among hemophiliacs who had
received contaminated blood products.
SECTION 19
Gp120
See Glycoprotein 120.
GPOvir
A combination drug made in Thailand as
part of the government's anti-retroviral
treatment program which offers free
treatment to HIV-positive patients. The
drug -- a combination of d42, 3tc and
nevirapine -- has reduced the cost of treating
a patient from 300 dollars a month to 29
dollars a month. See highly active anti-retroviral therapy.
Greater Involvement of
People Living with
HIV/AIDS
A principle recognized by 42 countries at
an AIDS summit in Paris in 1994 when
they agreed to "strengthen the capacity
and coordination of networks of people
living with HIV/AIDS and communitybased organizations." The United Nations
endorsed the principle in 2001. The
principle was also upheld by the WHO
in the Three by Five Initiative in 2003. See
Denver Principles
health-seeking behavior
The way in which people seek health
services. Health services in Cambodia range
from traditional healers, traditional birth
attendants, doctors, nurses, midwives,
pharmacies and drug sellers.
148
HAART
See highly-active anti-retroviral therapy.
herbal remedy
Treatment usually based on plant extracts.
Some complementary treatments can
relieve symptoms of HIV-related illnesses
and some have been tested and scientifically
proven by randomized control trials. But
many remain scientifically unproven. See
complementary treatment.
herpes viruses
Troublesome and sometimes fatal opportunistic infections that can affect people with
AIDS. Two of the viruses, herpes simplex
and varicella zoster (related to chicken
pox), are usually treated with acyclovir, an
anti-viral drug. A third virus, cytomegalovirus (CMV), can cause an eye condition
called CMV retinitis which can lead to
blindness. It is treated with gancyclovir
which can have bad side effects including
bone marrow suppression and severe
nausea.
hiou, heuw
A Cambodian term for HIV which is not
used by the National AIDS Authority.
Derived from the way the abbreviation
HIV is pronounced as an acronym based
on hi/he for HI and V which can denote
the Cambodian letter for the final diphthong
ou/uw when transliterating Khmer into
Roman script. Hiou is a French spelling,
Heuw is English.
high-risk behavior
Behavior that can lead to HIV-infected
blood, semen, pre-ejaculate or vaginal fluids
of one person entering the bloodstream
of another. Sex without condoms, known
as unprotected sex, is the most common
form of high-risk behavior, along with the
sharing of needles used for injections.
Tattooing and acupuncture carry a risk if
needles are not sterilized properly.
high-risk group
Avoid. The term wrongly implies that
membership of a group (soldiers or beer
girls, for example) is a significant factor in
HIV transmission.As a result, non-members
tend to be lulled into a false sense of
security. HIV is mainly transmitted by
high-risk behavior not high-risk groups.
The preferred term is sentinel group.
highly-active
anti-retroviral therapy
Treatment involving at least three classes
of drugs which inhibit the replication of
HIV in different ways. Until recently,
treating HIV involved a class of anti-retroviral drugs called nucleoside analogue reverse
transcriptase inhibitors. These drugs, which
target a protein known as reverse transcriptase, were only moderately effective.
Since 1996, however, a new class of
drugs called protease inhibitors has been
developed.These drugs target the protease
enzyme which the virus needs to
replicate. A third class of drugs known as
non-nucleoside reverse transcriptase inhibitors also targets the reverse transcriptase
protein. Combinations can include two
nucleoside reverse transcriptase inhibitors
with either a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor.
Whatever the combination, people taking
the medication have to be monitored regularly with tests to determine whether
the combination is effective. Adhering to
the therapy is important to avoid resistance, and this can be difficult due to the
number of tablets that have to be taken,
the frequency of doses and side effects.
People taking these drugs still have HIV,
even if the presence of the virus falls to
levels which cannot be detected using
routine methods. As of mid-2004, the
WHO had approved three fixed-dose
combinations under its pre-qualification
quality assessment program. Two were
being produced by Indian manufacturers
of generic drugs, Cipla and Rambaxy, and
the third was being made by British pharmaceutical company GlaxoSmithKline.
Patients taking the most widely available
fixed-dose combinations of d4t, 3tc and
nevirapine -- marketed as GPOvir in Thailand
where it also produced -- can take one pill
twice a day instead of six pills a day if the
three drugs are taken separately. Medecins
sans Frontieres strongly advocates such
combinations, saying it pays only 270 dollars
a year for each patient for such treatment
compared with 562 dollars if the drugs
are bought separately from the originators.
HIV
See human immunodeficiency virus.
HIV/AIDS
Non-specific term for both HIV and AIDS.
Not always necessary. For example, a
GLOSSARY OF TERMS 149
GLOSSARY OF TERMS
SECTION 19
person infected with the virus who is not
sick is HIV positive not HIV/AIDS positive.
And an HIV-positive person who dies from
opportunistic infections has died from
AIDS not HIV/AIDS. See also people with
HIV/AIDS.
HIV-associated dementia
See AIDS dementia complex.
HIV positive
The presence of antibodies to HIV in a
person's bloodstream. Different types of
HIV tests can detect the antibodies or the
virus itself. Antibodies usually develop
within three months of infection. Positive
results indicate antibodies. Negative
results indicate no antibodies. Hyphens
are only used when the word is written
as a compound adjective, as in “HIV-positive
man”. But “the man is HIV positive”. See
seropositive.
HIV Sentinel Surveillance
A regular NCHADS survey of HIV infection
in sentinel groups in Cambodia.The survey
is commonly abbreviated as HSS and
should not to be confused with the
Behavioral Surveillance Survey (BSS) which
is also conducted by NCHADS. See page 49.
HIV strains
By 2002, scientists had classified HIV
strains into three groups and many
sub-types (known as clades). Major strains
(M) have at least 10 sub-types that are
classified as A, B, C, D, E, F, G, H, I and J.
Outer strains (O) may have a similar
number of sub-types. A strain found by
French researchers in a woman with AIDS
in Cameroon fell into neither category
group and was classified into a third group
known as non-M non-O (N). Among the
major strains, sub-type B is most common
150
in developed countries including those
in East Asia (hence the focus on this subtype for vaccine research) and sub-type C
is most common in developing countries.
If a person is infected with different strains
of the virus, different parts can "recombine" into a new form which can be transmitted to others. These are known as
circulating recombinant forms (CRF). One
of these sub-types, known as CRF01_AE,
is dominant in Southeast Asia. Formerly
known as the Thai-A sub-type, it is closely
associated with female sex workers and
their clients. Some researchers believe
CRF01_AE is easier to transmit than subtype B which is more closely associated
with men who have sex with men and
injection drug users. According to the
Monitoring the AIDS Pandemic (MAP)
Network, a unique variant of CRF01_AE
has been found among injection drug
users in northern Vietnam and southern
China. And a new recombinant of subtypes B and CRF01_AE, known as CRF0101B, is reported to be circulating widely in
Thailand among injection drug users as
well as female sex workers and their
clients. The MAP report for 2004 said
sharing infected needles was believed to
be a particularly efficient way of recombining HIV sub-types into new forms of
the virus. In Ho Chi Minh City, where
injection drug users are a major sentinel
group, the report said researchers in 2001
had found that eight percent of the HIV
isolated was a combination of at least two
sub-types. In Yunnan province in China,
researchers have even found recombinants
of two different recombinants.These were
reported to be circulating among nine
percent of one group of injection drug users.
HIV tests
The most common test is the enzymelinked immunosorbent assay (ELISA) which
tests for the presence of antibodies. But as
it takes up to three months for the
immune system to produce the antibodies,
the result of tests during this window
period can be negative even if the person
is infected by HIV. Another test known as
polymerase chain reaction (PCR) tests for
the virus itself and can detect HIV within
two weeks of infection. A special blood
test involving a process called nucleic acid
amplification can detect HIV infection
during the window period. With the
exception of court orders, all testing
in Cambodia is required by law to be
voluntary. See compulsory HIV testing.
HIV transmission
HIV is transmitted through semen, preejaculate, blood, vaginal fluids and breast
milk. The ability of the virus to survive
outside of the body is very limited. So
compared with other diseases, HIV is not
particularly easy to transmit. HIV is not
contagious like air-borne viruses such as
influenza or SARS, and you cannot get it
by shaking hands, coughing or sneezing.
Nor can it be transmitted by glasses,
forks, spoons, chopsticks, mosquito
bites, toilets or swimming pools.
Transmission through kissing is extremely
rare - the one noted case in the United
States involved two people with severe
dental disease. For similar reasons, transmission through households items like
toothbrushes or razor blades is considered extremely unlikely. See separate
entries for sexual transmission, blood-borne
transmission and mother to child transmission.
HIV virus
The V in HIV stands for virus. HIV virus is
redundant as it would mean Human
Immunodeficiency Virus virus, which is like
saying TVK television or the CPP party.
hospital inpatients
One of the main sentinel groups included
in HIV Sentinel Surveillance system between
1997 and 2000. Dropped in the 2002
survey. See HIV Sentinel Surveillance on
page 46.
HPV
See human papilloma virus.
HSS
See HIV Sentinel Surveillance on page 46.
Human Immunodeficiency
Virus (HIV)
The virus that causes AIDS. First isolated
in 1983 by a team led by Dr Luc Montagnier
at the Institut Pasteur in Paris.Taken from
a West African blood sample, it was
named Lymphadenopathy Associated Virus
(LAV).The virus was also isolated in 1984
by an American team led by Dr Robert
Gallo of the National Cancer Institute.
Taken from the blood of Senegalese
sex workers, it was called the Human
T-Cell Leukemia Virus (HTLV) III. Following
a dispute over the discovery, Montagnier
and Gallo agreed to be named
co-discoverers of the virus which was
renamed as HIV. Note that HIV does not
stand for Human Immune Deficiency
Virus (which would be HIDV) and that the
V stands for virus so "HIV virus" is wrong.
Upper-case HIV is universal. As the
letter V is often used to denote a final
diphthong when transliterating Khmer
into Roman script, some people pronounce
HIV as hiou in which case hiv makes more
sense. See also VIH.
human papilloma virus
GLOSSARY OF TERMS 151
GLOSSARY OF TERMS
SECTION 19
The virus that causes genital warts.
Transmitted through sexual contact, the
virus has also been linked to cervical
cancer. In HIV-positive women, infection with
the virus increases as CD4 counts decline.
Although there is no cure, anti-retroviral
drugs are used to treat genital warts. The
warts can also be removed by laser treatment or conventional surgery.
IL-2
See Interleukin 2.
immune-based therapies
Treatment used to maintain, stimulate or
repair the immune system. For HIV, the
most extensive trials have involved
Interleukin-2, a natural protein produced
by the body that can dramatically raise the
number of CD4 cells.
immune system
The body's natural defense against
disruption caused by invading foreign agents
such as microbes and viruses. There are
two aspects of the immune system's
response to disease: innate and acquired.
The innate part is mobilized very quickly
in response to infection and does not
depend on recognizing specific proteins
or antigens foreign to an individual's normal
tissue. It includes macrophages, dendritic
cells and granulocytes. The acquired, or
learned, immune response arises when
dendritic cells and macrophages present
pieces of antigen to lymphocytes, which
are genetically programmed to recognize
very specific amino acid sequences. The
ultimate result is the creation of cloned
populations of antibody-producing B cells
and cytotoxic T lymphocytes primed to
respond to a unique pathogen.
immunomodulating
152
See immune-based therapies.
incidence
The number of new cases -- of a disease,
for example -- occurring in a given population
over a certain period of time.
infectious
An infection that can be transmitted by
intimate contact (sex, for example) as
opposed to casual contact (such as shaking
hands). See also contagious.
indinavir
An anti-retroviral drug used to treat HIV
infections. See protease inhibitors.
indirect sex workers
In recent NCHADS surveys, the term
"indirect sex workers" (srey roksiplauphet
proyol) has referred to "beer girls" (srey
langseh) and "karaoke girls " (srey karaokeh)
who sell sex. But the term previously
included "massage girls" (srey massa) and
"bar girls" (srey baa) who sell sex, referred
to as "freelance sex workers" in the HIV
Sentinel Surveillance of 1999. The NAA
has a broader definition that defines indirect sex workers as people who have
other work besides selling sex or who
derive most of their income from other
work.
In between these two extremes is a third
definition used in a 2003 study by the
POLICY Project.This defined indirect sex
workers as anyone who sells sex outside
a brothel. Settings include karaoke bars
(with sex taking place either on or off the
premises) as well as regular bars and
restaurants (where beer promotion girls
or waitresses may sell sex in addition to
their jobs, usually at a guest house or
hotel). Other settings include private
houses (freelancers working from home
or independent sex workers managing their
own house) as well as streets and parks
(both male and female sex workers).
Under this definition, indirect sex workers
also includes female factory workers and
orange sellers engaged in informal sex
work. NCHADS surveys indicate that the
proportion of beer-promotion girls involved
in indirect sex work in five provinces
almost doubled from 21 percent in 1997
to 39 percent in 1999.The POLICY Project
study in 2003 said the apparent surge may
have reflected direct sex workers leaving
brothels to enjoy more freedom, avoid
police raids or increase earnings.Another
possible factor was increased numbers
of urban poor. NCHADS data released
in 2004 indicated that the proportion
of beer promotion girls and karaoke
hostesses involved in sex work had
dropped to 37 percent of those surveyed
in 2003, down from 40 percent in 2001.
injection drug user
People who inject illegal drugs into their
blood stream. Without sterilization, HIV
can easily be transmitted from one injection
drug user to another if they are using the
same needle. In the former Soviet Union
and Eastern Europe, and more recently in
Vietnam, the HIV epidemic has been heavily
concentrated in injection drug users. In
2004, UNAIDS said contaminated needles
were believed to account for two thirds
of new HIV infections in Vietnam. In addition
to HIV outbreaks among injection drug
users in Ho Chi Minh City, recent outbreaks have been reported in several
Vietnamese provinces including Can Tho
on the Mekong Delta. Injection drug
users are not thought to have significantly contributed to the epidemic in
Cambodia. But there is cause for concern
given Cambodia's role as an alternative
trading route for heroin -- and more
recently, amphetamines -- from the Golden
Triangle region of Laos, Myanmar and
northern Thailand.A survey in 2001 found
that nine percent of Phnom Penh street
children had injected drugs, up from three
percent a year earlier. A separate survey
found that three percent of men who
have sex with men had injected drugs
over the previous 12 months. According
to an unpublished estimate, the number
of injection drug users in Cambodia
exceeded 1,000 in 2004.
innocent victim
Avoid. The discriminatory notion of
innocence and guilt in relation to HIV/
AIDS suggests that some people deserve
to be punished and that others don't.
It also fails to take into account limited
access to HIV testing facilities. Such
language lacks objectivity, putting journalists
in the position of judging who is innocent
and who is guilty. Leave that to the judicial
system. Such language could also be
defamatory. Describing an HIV-positive
baby as an innocent victim could imply
that the father is guilty for contracting the
virus and passing it to his wife. Saying a
recipient of HIV-contaminated blood is an
innocent victim could imply that a hospital is guilty of negligence.As a government
campaign launched in Australia in 1993
put it, “HIV doesn't discriminate -- people
do.”
interleukin-2
A natural protein produced by the body
that can dramatically raise the number
of CD4 cells. Recent evidence suggests
that injections of Interleukin-2 combined
with anti-retroviral drugs can halt the
progression of HIV by keeping a person's
CD4 cell count within the normal range.
GLOSSARY OF TERMS 153
GLOSSARY OF TERMS
See immune-based therapies.
International
Vaccine
Initiative
AIDS
SECTION 19
A global not-for-profit organization
working to accelerate the search for a
vaccine to prevent HIV/AIDS, focusing
on developing countries. Founded in 1996
and operating in 22 countries, the
network researches and develops vaccine
candidates. In 2004, it had partnerships
with more than 25 private companies and
academic and government institutions.
International Labor
Organization
Established in 1919 and based in Geneva.
One of the 29 individual UN agencies and
one of 10 cosponsors of UNAIDS as of
2004.The work of ILO in the field of AIDS
focuses on HIV and the workplace. See
separate entry for Global Business Coalition
on HIV/AIDS.
Kaposi's Sacoma
A rare skin cancer caused by a virus,
originally seen almost exclusively in central
Africa and among elderly Mediterranean
men but now an opportunistic infection
for people with AIDS. The cancer attacks
internal organs and can cause purple
lesions on the skin. Controlled through
chemotherapy. See opportunistic infections.
karaoke hostesses
Women who work in karaoke lounges.
Some are also sex workers. See indirect
sex workers.
khteuy
The Chuon Nath dictionary defines khteuy
as "as a person whose sex is not completely
male or completely female" (menou min
154
phed steu proh steu srey). On this basis,
khteuy refers either to an "incomplete male"
(steu proh) or an "incomplete female" (steu
srey). The term is widely used and understood in Cambodia and similar words
derived from Sanskrit are used in Laos,
Myanmar and Thailand and as far away as
India and Sri Lanka.The term is considered
pejorative by some Cambodians but not by
others. See also men who have sex with
men.
KS
See Kaposi's Sacoma.
Law on the Prevention and
Control of HIV/AIDS
The law, passed by the National Assembly
on June 14, 2002, is modeled on a 1998
Philippine law considered as best practice
legislation by the United Nations. The
law states that HIV/AIDS has a "serious
impact on social security, stability and
socio-economic development" in Cambodia.
Under its general provisions, Cambodia
is committed to promoting public awareness of HIV/AIDS, prohibiting discrimination against people with the virus, taking
precautions, addressing all factors behind
the epidemic, promoting a greater public
role for people with HIV/AIDS and making
prevention and control a priority in
national development plans. Additional
chapters have provisions for education,
safe practices and procedures, testing and
counseling, health and support services,
monitoring, confidentiality, discrimination
and the role of the National AIDS
Authority. The law provides for penalties
for first-time violators of several articles
with fines of up to one million riel and jail
terms of up to one year. Administrative
sanctions apply to civil servants who
break the law and professional licenses
can be revoked for people who violate
articles dealing with false advertising and
safe practices for medical and other procedures. Penalties are doubled for repeat
offenders. The Khmer version has been
printed into a booklet which is available
from the National AIDS Authority.
LDC
See least developed countries.
lentivirus
A "slow" virus that takes a long time for
symptoms to develop after infection. HIV
is a lentivirus, as is the Simian Immunodeficieny Virus (SIV) which effects nonhuman primates.
least developed countries
The United Nations determines the
criteria for least developed countries that
qualify for special treatment under the
World Trade Organization, including cheaper access to drugs. Under these criteria,
Cambodia, Laos and Myanmar are all least
developed countries while Vietnam has
"graduated" to a higher level. The World
Bank uses different criteria and different
terms. Under these criteria, all four countries
are classified as low-income economies.
See World Trade Organization.
life expectancy
The Asian Development Bank (ADB) and
UNAIDS have estimated that Cambodia's
life expectancy in 2007 will be 2.3 years
lower than it otherwise would have been
without HIV/AIDS. In Siem Reap province,
where HIV prevalence is nearly double
the national average, life expectancy is
estimated to be 7.3 years lower.The ADB
and UNAIDS have noted that this sharp
reduction in life expectancy in Siem Reap
is as severe as that experienced in African
countries such as Ethiopia and Nigeria
which have much higher HIV prevalence
rates of about six percent.
lipodystophy syndrome
See fat redistribution.
lubricant
The "Number One" brand condoms
marketed by Population Services International (PSI) in Cambodia are lubricated.
Lubricant is often recommended for use
with condoms. Water-based lubricants
should always be used. Oil-based lubricants should never be used as they can
weaken the latex. PSI has recently started
marketing a conveniently packaged lubricant in Cambodia under the name Number
One Plus.
low-income countries
See least developed countries.
lymphatic cancer
People with advanced AIDS can develop a
type of cancer known as non-Hodgkins
lymphoma. In these types of cancers, cells
of the lymphatic system grow abnormally
and develop into tumors that can appear
in the stomach, liver, brain and bone
marrow of people with AIDS. Treatment
involves chemotherapy or radiotherapy
but complete remission is uncommon.
See opportunistic infections.
MAC
See mycobacterium avium complex.
male circumcision
Cutting and removing the foreskin that
covers the penis.Widely practiced by the
GLOSSARY OF TERMS 155
GLOSSARY OF
TERMS
SECTION 19
Muslim and Jewish faiths, and some other
religions. Some studies suggest that
circumcision may help protect against HIV
infection as the foreskin contains cells
that could pick up HIV if the penis comes
into contact with the skin, semen or vaginal
fluids of another person.
MAP Network
See Monitoring the AIDS Pandemic Network.
men who have sex
with men
In the world of HIV/AIDS, a relatively new
term that is now used internationally
and by Cambodian government and non
government agencies. It recognizes that
some men who have sex with other men
also have sex with women.The term also
recognizes that men who have sex with
men (proh delrourm phet jimoi proh
dôchknir) may not "identify" with being
homosexual (nea rourm rea phet dôchknir).
In its HIV Sentinel Surveillance of 2002,
NCHADS recognized men who have sex
with men as a "highly-vulnerable population" but said that more information was
needed on how many were involved. The
NAA says the group is "difficult to
address" and that more research was
required to determine sexual behavior,
culture and identities. In 2000, a survey in
Phnom Penh found that 14 percent of
men who have sex with men were HIV
positive. Separate surveys have found
comparative rates of 5.7 percent in Ho
Chi Minh City and 17 percent in Bangkok.
UNAIDS has noted that men who have sex
with men in North America, Europe and
Australia were "early HIV-prevention
pioneers" in the early 1980s. Such leadership
in promoting safe sex has also been seen
in some developing countries, notably in
Malaysia, where the Pink Triangle group has
156
been strongly supported by the daughter
of the former prime minister. See also
Section 9 and khteuy in glossary.
microbicide
A chemical or antibiotic foam or gel that
can be applied to the lining of the vagina
or anus to protect against viral and other
infections.
military
Male members of the Royal Cambodian
Armed Forces have been one of the main
sentinel groups included in the Behavioral
Surveillance Survey carried out by NCHADS
since 1997. In the 2002 survey, men
serving in the military and policemen
were combined into a single group with
equal numbers. See sentinel groups and
Behavioral Surveillance Survey.
Monitoring the AIDS
Pandemic Network
A group of epidemiologists and public
health professionals from around the
world who have produced independent
reports on trends in the HIV epidemic
since 1995. Many MAP members work
in prominent positions in government,
international organizations and community
groups but come together under the
network without their institutional affiliations. As a result, MAP conclusions are
sometimes not in step with the priorities
of communities, international organizations or donor agencies.The MAP report
"AIDS in Asia: Time to Face the Facts"
published in July, 2004, was financed
by UNAIDS, WHO, UNICEF, the Japanese
Foundation for AIDS Prevention, the
United States Agency for International
Development and Family Health International.
morbidity
nelfinavir
Sickness.
An anti-retroviral drug used to treat HIV
infections Produced by the Swiss pharmaceutical company Roche for use in WHOrecommended second-line regimens. See
protease inhibitors, Roche and regimens.
mother-to-child
transmission
Perinatal infection and breast feeding
are the two main routes of mother to
child transmission, also known as MTCT
and vertical transmission. Perinatal
infection involves an HIV-positive mother
transmitting the virus to the child during
pregnancy or at birth. See mother to child
transmission on page 56.
motorcycle taxi drivers
One of the main sentinel groups included
in the Behavioral Surveillance Survey
carried out by NCHADS since 1997. See
sentinel groups and Behavioral Surveillance
Survey.
MSM
See men who have sex with men.
MTCT
See mother to child transmission.
mycobacterium avium
complex
People with advanced AIDS can develop
this bacterial infection which usually
starts in the stomach before spreading
to other parts of the body. Symptoms
include night sweats, high fever, cough,
weight loss, poor absorption of food
and diarrhea. Treatment involves a
combination of drugs. Few people without
HIV develop the disease. Also known as
MAC.
neo-natal
The first six weeks of life after birth.
nevirapine
An anti-retroviral drug used to treat
HIV infections. Nevirapine is used to
prevent mother to child transmission in
Cambodia. It is also one of three drugs
used in the most widely-prescribed fixeddose combination (with d4t and 3tc),
enabling patients to take one pill twice a
day instead of six pills a day if taken
separately. The combination drug is
produced in Thailand, where it is known
as GPOvir. See non-nucleoside analogue
reverse transcriptase inhibitors and GPOvir.
NNRTI
See non-nucleoside analogue reverse transcriptase inhibitor.
non-nucleoside analogue
reverse transcriptase
inhibitor
A class of anti-retroviral drugs which
target reverse transcriptase, the enzyme
HIV uses to convert its genetic material
into DNA. NNRTI drugs include nevirapine,
delavirdine and efavirenz. See highly-active
anti-retroviral therapy.
nucleic acid
A substance found in all living cells that
stores hereditary information.
GLOSSARY OF TERMS 157
GLOSSARY OF TERMS
SECTION 19
nucleic acid amplification
opportunistic infections
A test that can detect very small amounts
of genetic material in blood, plasma or
tissue. It can also detect HIV during the
window period of up to three months
before the immune system produces
antibodies to the virus.
Infections that take advantage of a weak
immune system. People with AIDS can
die from opportunistic infections that are
treatable, and many infections can be
cured with drugs. In Cambodia and many
African countries, tuberculosis (TB) is the
most common life-threatening oppotunistic infection for people with
HIV/AIDS. In the United States, doctors
linked two opportunistic infections -- a
type of pneumonia and a rare form of
cancer -- to immune deficiency in 1982.
The first, known as pneumocystis carinii
pneumonia (PCP), is caused by a microorganism that usually lies dormant in the
lungs of people with healthy immune systems. Treatment involves regular doses of
common antibiotics. The second, known
as Kaposi's Sacoma, is a rare skin cancer
caused by a virus that can be controlled
through chemotherapy. Other common
opportunistic infections are the herpes
viruses and candidiasis, a common fungal
infection of the mouth, airways and vagina. Among opportunistic infections that
occur after significant immune damage
are lymphatic cancer, a gastro-intestinal
condition called mycobacterium avium
complex (MAC) and a major brain disorder
called toxoplasmosis. A fungal infection
called cryptococcal meningitis can also
affect the brain.
NRTI
See nucleoside analogue reverse transcriptase
inhibitor.
nucleoside analogue reverse
transcriptase inhibitor
The class of anti-retroviral drugs first
used to treat HIV. The most famous is
azdotymidine (AZT), an anti-cancer drug
found to benefit people with HIV in 1986.
Others are ddI, ddC, 3tc, d4t and
abacavir. NRTI drugs target reverse
transcriptase, the enzyme HIV uses to
convert its genetic material into DNA. See
highly-active anti-retroviral therapy.
NVP
See nevirapine.
OI
See opportunistic infections.
opiates
The WHO has produced guidelines
indicating that drugs derived from opium
including oral morphine are necessary for
palliative care for people suffering from
AIDS. Although morphine and other
strong painkillers are often illegal in many
countries, they are legal in Cambodia
when prescribed by a doctor.
158
oral sex
Sex involving the mouth of one partner
coming into contact with the genitals of
another. Carries a much lower risk of HIV
transmission, but the risk rises if there are
cuts or sores in the mouth. Many other
infections (e.g., syphilis and herpes viruses)
can be easily transmitted by oral sex.
Abstinence is the safest way to protect
against HIV from sexual transmission.The
risk of HIV and STI transmission by oral
sex can be reduced by the use of a barrier
method such as a male condom or a dental
dam.
oral thrush
See candidiasis.
organs
See blood products, tissue and organs.
orphans and other
vulnerable
children / children
affected by HIV/AIDS
Children who have lost either or both
parents to an AIDS-related illness as well
as children who are affected by the
prolonged illness of one or both parents,
by stigma and discrimination associated
with HIV/AIDS, and by other burdens on,
or changes in, their social, educational and
financial well-being as a result of HIV/
AIDS. Do not refer to AIDS orphans as
this sets them apart from other orphans
who share and experience the same issues
affecting their health and well-being.
See epidemic.
Paris Summit on HIV/AIDS
See Greater Involvement of People Living
with HIV/AIDS.
PCP
See pneumocystis carinii pneumonia.
PCR
See polymerase chain reaction.
people living with
HIV, AIDS or HIV/AIDS
The term emerged over the past decade
to counter the perception that people
with HIV will die immediately and encourage
the idea that infected people can lead
normal lives. But it can be misleading.
People who have access to anti-retroviral
drugs may be living with HIV or AIDS. But
people without access to such drugs may
be dying. The abbreviation PLWHA and
similar constructions are unfamiliar to
most people.
people with HIV, AIDS
or HIV/AIDS
Treatment involving symptomatic relief to
comfort and support patients and their
families who are living with a life-threatening
illness, such as the advanced stages of
AIDS.
A woman with HIV and an HIV-positive
man are people with HIV (neah min merok
eith). A woman with AIDS and a man with
an AIDS-defining illness are people with
AIDS (neah min chumngeou eith). Under
Cambodian law, they are collectively
referred to as people with HIV/AIDS (neah
min merok eith/neah min chumngeou eith).
See also HIV/AIDS.
pandemic
PEP
A disease prevalent throughout an entire
country, continent or the whole world.
See post-exposure prophylaxis.
palliative care
GLOSSARY OF TERMS 159
GLOSSARY OF TERMS
perinatal
Around the time of birth.
perinatal infection
SECTION 19
See mother to child transmission.
PHA
Most people are not familiar with this
abbreviation, which stands for people with
HIV/AIDS. See Cambodian terminology on
page 33.
pharmaceutical companies
Manufacturers of anti-retroviral drugs
mentioned in the Report on the Global
AIDS Epidemic by UNAIDS in 2004
include BristolMyersSquibb (United States),
Cipla (India), GlaxoSmithKline (Britain),
Ranbaxy (India) and Roche (Switzerland).
But UNAIDS stresses it does not endorse
or recommend these companies in
preference to others not mentioned.
PI
See protease inhibitor.
PLA, PLH, PLHA, PLWHA
Most people are not familiar with these
abbreviations, which stand for people
living with AIDS, people living with HIV and
people living with HIV/AIDS.
PMTCT
Prevention of mother-to-child transmission.
See mother-to-child transmission on page 56.
pneumocystis carinii
pneumonia
Caused by a micro-organism that usually
lies dormant in the lungs of people with
160
healthy immune systems. Can also occur in
the skin, eye, spleen, liver or heart.Treatment
involves regular doses of common antibiotics. Known as PCP, it was initially the
biggest killer of people with AIDS. It was
also the topic of the first report on the
HIV/AIDS epidemic, published by the
Center for Disease Control in Atlanta in
1981-- more than a year before the term
AIDS was adopted and two years before
the virus was first isolated. The link with
HIV/AIDS goes back to 1959 when a
Haitian sailor died of PCP in New York. A
blood sample taken from a person in what
is now the Democratic Republic of
Congo later tested positive for HIV antibodies in 1986.
policemen
One of the main sentinel groups included
in NCHADS surveys since 1997. In the
Behavioral Surveillance Survey of 2003,
policemen and men serving in the military
were combined into a single group with
equal numbers. See sentinel groups, HIV
Sentinel Surveillance and Behavioral Surveillance Survey.
polymerase chain reaction
A sensitive laboratory technique that can
detect and quantify HIV in a person's
blood or lymph nodes. See also HIV tests.
post-exposure
prophylaxis (PEP)
A potentially preventative treatment using
anti-retroviral drugs within 72 hours of
high-risk exposure to HIV (a needlestick
injury or unprotected sex, for example).
The drugs are highly toxic and their use
over several weeks can be difficult and
demanding.
pre-ejaculate
prophylaxis
A clear liquid that lines the male urethra
during sexual stimulation. Released before
ejaculation, it can transmit HIV
Treatment or drugs to prevent an
infection or disease. See post-exposure
prophylaxis.
President’s Emergency
Plan for AIDS Relief
(PEPFAR)
prostitution
The President’s Emergency Plan for AIDS
Relief was announced by US President
George W. Bush during his ‘State of the
Union’ address in January 2003. In May,
President Bush signed the U.S. Leadership
Against HIV/AIDS, Tuberculosis and
Malaria Act of 2003 into law. The plan
calls for $15 billion over five years, with
nearly $10 billion being new funding.
About $9 billion will be directed to 15
heavily-affected target countries, One billion
is pledged to the Global Fund, and the
remaining five billion will be used to
support current HIV/AIDS, tuberculosis,
and malaria programs. The Emergency
Plan’s three long-term objectives are to
avert seven million new HIV infections;
provide ARV treatment to two million
people; and provide a range of care and
support to 10 million people living with
HIV/AIDS and orphans and vulnerable
children.
In Cambodia, the term is usually used in
the negative sense, especially in reference
to human trafficking. This is in line with
Article 46 of the Cambodian constitution,
which prohibits "running a business in the
field of prostitution" without any mention
of prostitutes or sex workers.
protease
An enzyme that HIV needs to replicate
(reproduce).
protease inhibitors
One of three classes of anti-retroviral
drugs. Drugs that inhibit protease, an
enzyme needed by HIV to replicate, include
saquinavir, indinavir, ritonavir, amprenavir
and nelfinavir.
protected sex
Sex with condoms where there is no
exchange of semen, pre-ejaculate, vaginal
fluids or blood.
prevalence
PWA, PWHA
The proportion of individuals in a population having a disease at a given time. For
example, Cambodia's rate of HIV prevalence in 2003 was 1.9 percent of the adult
population (defined as those between 15
and 49 years old), down from 3.3 percent
in 1998.The actual number of adults with
HIV was estimated at almost 158,000,
down from 175,000 in 1998.
Most people are not familiar with these
abbreviations, which stand for people with
AIDS and people with HIV/AIDS.
regimen
When referring to HIV/AIDS, a drug or
treatment combination and the way it is
taken. In the broader sense, a regimen is a
set of rules about food and exercise or
GLOSSARY OF TERMS 161
GLOSSARY OF TERMS
SECTION 19
medical treatment that is followed to stay
healthy or improve one's health. A firstline regimen is used when starting
treatment for the first time. If a first-line
regime is too toxic or fails to control HIV
replication in an infected person, a secondline regimen may be used. The cause of
treatment failure may be complex and
there is no clear evidence to guide the
choice of replacement drugs.
In poorer countries, the World Health
Organization was recommending in 2004
that a single first-line regimen should be
identified to treat most new patients.
This would consist of two nucleoside
analogues and either a non-nucleoside or
abacavir, or a protease inhibitor. Zidovudine
(ZDV)/3tc was the initial recommendation
for a dual nucleoside analogues with d4t/
3tc, ZDV/ddI and ddI/3tc as possible
alternatives. Efavirenz and nevirapine were
recommended non-nucleosides, while
recommended protease inhibitors included
ritonavir-boosted protease inhibitors (indinavir, lopinavir, saquinavir) or nelfinavir. A
second-line regimen should be chosen to
substitute first-line regimens when needed
(for toxicity or treatment failure). An
entirely new second-line regimen could be
prescribed in some cases. In others -when toxicity or resistance is related to
an identifiable drug in the regimen -- the
offending drug could be replaced. The
WHO also noted that countries planning
anti-retroviral programs should also have a
HIV-drug-resistance sentinel surveillance
system to detect drug resistance among
people and modify regimens accordingly.
See also highly-active anti-retroviral treatment.
replication
What a virus does to reproduce.
162
reproductive health
ritonavir
saquinavir
Reproductive health is defined by the
WHO as a state of physical, mental, and
social well-being in all matters relating to
the reproductive system at all stages of life.
An anti-retroviral drug used to treat HIV
infection. See protease inhibitors.
retrovirus
A virus such as HIV that stores its genetic
information on a single-stranded RNA
molecule instead of the more usual doublestranded DNA. Retrovirus is singular.
The plural form is retroviruses and the
adjective is retroviral. Drugs that fight
retroviruses are called anti-retroviral drugs.
A Swiss pharmaceutical company that
produces the anti-retroviral drugs saquinavir
and nelfinavir for use in WHO-recommended
second line of drug treatment or secondline regimens. The company has a written
policy that it will not file or enforce existing
patents on HIV-related medicines in
sub-Saharan Africa and least-developed
countries such as Cambodia.
An anti-retroviral drug used to treat
opportunistic infections in people with
HIV/AIDS. Produced by the Swiss pharmaceutical company Roche for use in WHOrecommended second-line regimens. See
protease inhibitor.
reverse transcriptase
safe sex
An enzyme important for the functioning
of HIV.
Using a condom during sex. Also known
as protected sex. Some people use the
term safer sex, as condoms can never be
100 percent effective if they are not used
properly. Problems include failing to use
new condoms after each ejaculation, failing
to unroll them completely and failing to put
condoms on before genital contact. With
unlubricated condoms, problems include
failing to use a water-based lubricant.
Oil-based lubricants weaken the latex.The
safest sex is between two people who have
twice tested negative at three month
intervals and who have not risked HIV
infection during the same period, which
is the time it can take for antibodies to
develop. Unprotected sex with a person
who tests negative for HIV after having
sex with someone else last week, is not
safe. Abstaining from sexual activity is the
safest way to protect against HIV from
sexual transmission.
reverse transcriptase
inhibitors
Two separate classes of anti-retroviral drugs.
The drugs inhibit reverse transcriptease, an
enzyme important to the functioning of
HIV, and were among the first used to
treat people with the virus. Drugs in the
first class are called nucleoside analogue
reverse transcriptase inhibitors, sometimes
known as NRTI drugs. Drugs in the second
class are called non-nucleoside analogue
reverse transcriptase inhibitors, also known
as NNRTI drugs.
ribonucleic acid (RNA)
A nucleic acid used to synthesize
proteins. Mostly found in the cytoplasm of
cells rather than the nucleus. Some viruses
such as HIV carry RNA instead of the
more usual genetic material.
Roche
saliva
Saliva cannot transmit HIV. See body fluids.
second-line regimen
See regimen.
sentinel
A soldier who guards something. In epidemiology, it is used as an adjective denoting
people susceptible to an infection being
monitored for the appearance or recurrence of the microorganism that causes it.
sentinel groups
In Cambodia, NCHADS has been monitoring different sentinel groups through
HIV Sentinel Surveillance (HSS) dating back
to 1994 and Behavioral Surveillance Surveys
(BSS) since 1997. While HSS estimates
HIV prevalence in specific groups of people,
BSS monitoring focuses on the high-risk
behavior of such groups. The five HSS
sentinel groups in the 2003 survey were
direct female sex workers, indirect female
sex workers, policemen, pregnant women
attending ante-natal clinics and tuberculosis patients. The four BSS sentinel groups
in the 2003 survey were direct female sex
workers, beer and karaoke hostesses, men
serving in the military and policemen, and
motorcycle taxi drivers. Other sentinel
groups targeted by the two surveys over
the years have included women who
work, vocational students, tuberculosis
patients and hospital in-patients. Men who
have sex with men, young people, fishermen,
GLOSSARY OF TERMS 163
GLOSSARY OF TERMS
garment factory workers and other migrant
populations have been identified as
vulnerable to HIV infection.
seroconversion
SECTION 19
The development of a detectable level of
antibodies that occurs after a person has
been exposed to and infected by a virus
such as HIV. No hyphen.
seropositive
Carrying antibodies to any virus. No hyphen.
Rarely used in English outside medical
circles although séropositif and séropositive
are widely used in French, both as an
adjective and noun, and are commonly
understood to mean HIV positive. Séropo is
an informal abbreviation. Related terms
are seropositivity (séropositivité) along
with seronegative (séronégatif, séronégative) and seronegativity (séronégativité).
A serologist (sérologiste) is a person who
specializes in serology (sérologie).
Serological (sérologique) work might
involve serodiagnosis (sérodiagnostic) and
serotherapy (sérothérapie). In English,
serosity (sérosité) is also known as serous
fluid.
serosurveillance
Surveys of HIV infection rates in sentinel
groups. See sentinel groups and HIV Sentinel
Surveillance.
sex workers
Individuals who engage in sexual activity
for money. Avoid commercial sex workers,
which can be misleading. See separate
entries for direct sex workers and indirect
sex workers.
sexual transmission
HIV can be transmitted during sex. The
164
virus can enter the body through linings
of the vagina, vulva, penis and anus. The
presence of sexually-transmitted diseases
increases the risk of transmission. In
addition to causing open sores, such
diseases bring immune cells to the site of
the infection, enhancing the ability of HIV
to enter the body. Women with sexuallytransmitted diseases are at greater risk
and are often unaware they have the
disease due to an absence of symptoms.
sexually-transmitted
disease or infection
A disease spread by the transfer of organisms during sexual activity. Strictly speaking,
the term STD excludes HIV, which is not
a disease but an infection transmitted in
several ways, including sex. The wider
term, sexually-transmitted infection (STI),
includes HIV. Both terms are now used in
preference to venereal disease (VD),
which is somewhat dated. People with
STDs can be more susceptible to HIV
infection than people without STDs. See
separate entries for candidiasis, chancroid,
chlamydia, gonorrhea, herpes viruses, human
papilloma virus, syphilis.
SIDA, Sida
French acronym for AIDS. Written in
both upper and lower case, it stands for
Syndrome d'immunodéficience acquise. The
adjective acquise agrees with the feminine
noun immunodéficience rather than syndrome,
which is masculine.
side effects
The effects of a drug other than those
desired. Side effects of anti-retroviral drugs
can include headaches, diarrhea, skin
irritations, liver damage, nerve damage and
neurological effects. Some of the side
Simian Immunodeficiency
Virus (SIV)
Control of HIV/AIDS. Failure to follow the
authority's guidelines can result in a fine
of up to one million riel and up to one
year in jail for first-time violators.
An HIV-like virus that infects monkeys,
chimpanzees and other non-human
primates.
syphilis
effects are potentially life-threatening.
spread
A sexually-transmitted bacterial infection
which can also be acquired in the uterus
during pregnancy. Curable with antibiotics.
Handy for headlines. The medical terms
are transmit and transmission.
tattooing
STD
See sexually-transmitted disease.
STI
Sexually transmitted infection. See sexually
transmitted disease.
stigma
Devaluation that tends to reinforce
negative connotations by associating
HIV and AIDS with already-marginalized
groups. Stigma lies at the root of discriminatory actions that exclude people who
need AIDS-related services (UNAIDS
definition in 2004). See also discrimination
on page 42.
susceptible
Very likely to be influenced, harmed or
affected by somebody or something.
sweat
In Cambodia, tattooing is subject to
precautions determined by the National
AIDS Authority under Article 14 of the
Law on the Prevention and Control of
HIV/AIDS. First-time violators face a fine
of up to one million riel and up to one
year in jail. See high-risk behavior.
TB
See tuberculosis.
T-cells
See CD4 cells.
tears
Tears cannot transmit HIV. See body fluids.
tenofovir
A protease inhibitor found to be effective in
treating HIV infections. In July 2004, Prime
Minister Hun Sen intervened to halt a
controversial trial planned for Cambodia
following objections from sex workers.
Sweat cannot transmit HIV. See body fluids.
Three by Five Initiative
surgical procedures
A plan unveiled by the World Health
Organization (WHO) in 2003 to provide
treatment to three million HIV-positive
people in low and middle-income countries
by 2005. WHO and UNAIDS have urged
In Cambodia, surgical procedures are
subject to precautions determined by
the National AIDS Authority under
Article 14 of the Law on the Prevention and
GLOSSARY OF TERMS 165
GLOSSARY OF TERMS
SECTION 19
non-government organizations and the
private sector to support expanded
treatment programs. By mid-2004, 40
countries had said they wished to take
part in the initiative while Canada, Sweden
and Britain had provided important
financial support.
Three Ones
The UNAIDS-recommended approach
to national responses to HIV/AIDS -- one
action framework, one coordinating
authority and one monitoring and evaluation
system. Donors as well as low and middleincome countries adopted the principles
at a meeting chaired by UNAIDS, Britain
and the United States in Washington in 2003.
Trade-Related Aspects of
Intellectual Property
Rights
3tc
See World Trade Organization.
An anti-retroviral drug used to treat
opportunistic infections in people with
HIV/AIDS. The drug is one of three drugs
used in the most widely-prescribed fixed
dose combination (with d4t and nevirapine),
enabling patients to take one pill twice
a day instead of six pills a day if taken
separately. In Thailand, the combination is
known as GPOvir. See also anti-retroviral
drugs, highly-active anti-retroviral therapy,
nucleoside analogue reverse transcriptase
inhibitors.
transgender
thrush
See candidiasis.
tissue
See blood products, tissue and organs.
toxoplasmosis
A bacterial infection caused by a parasite
found in cats, birds and other animals as
well as in soil contaminated with cat feces
166
and meat, especially pork. In most healthy
people, the immune system prevents the
parasite from causing disease. But in
people with HIV, the parasite can start
to multiply and cause severe disease.
One condition known as toxaplasmosis
encephalitis forms lesions on the brain
which can disrupt mental processes and
sometimes lead to personality change.
Toxoplasmosis is an opportunistic infection
almost exclusively associated with very
advanced stages of AIDS and can be treated
with antibiotics.
A newly-invented adjective to refer to
both transsexuals and transvestites (see
below). The word literally means "across
gender" or "beyond gender" and is usually
defined by dictionaries as an adjective
meaning transsexual. But the term is
sometimes used as a noun and even a
verb. In Cambodia, the term is usually
translated as khteuy. A more literary
translation might be the Pali-derived neak
bongsak galeung ("person with no specific
genitals") or simply akleung referring to
a person's appearance. A more clinical
term is op pakdau leung ("person with
incomplete genitals"). But unlike khteuy,
the terms are not widely understood.
In the absence of an English definition,
the UNAIDS Terminology Database translates transgender and transgendered as
transsexual in French, Spanish and Russian.
Some countries now have laws that
prohibit transgender discrimination. See
also khteuy and men who have sex with
men.
more common in people with HIV.
A transsexual is a person who feels
emotionally that they want to live and
dress as a member of the opposite sex,
especially one who has a medical operation
to change their reproductive organs. A
transvestite is a person, especially a man,
who enjoys dressing as a member of the
opposite sex. In Cambodia, some researchers call transsexuals and transvestites
"long-haired men who have sex with men" to
distinguish them from less-easily identifiable "short-haired men who have sex with
men." The Cambodian term khteuy is
more widely understood and less cumbersome, although many transvestites in
Phnom Penh say they find khteuy offensive
and prefer to be known as srey sros ("beautiful girl"). See also transgender, khteuy and
men who have sex with men.
One of the main sentinel groups included
in the HIV Sero-Surveillance by NCHADS
since 1997. Discontinued as of 2003. See
sentinel groups and HIV Sero-Surveillance.
transsexual, transvestite
TRIPS
Trade-related aspects of intellectual property
rights. See World Trade Organization.
tuberculosis (TB)
A bacterial infection affecting the lungs and
a leading cause of AIDS-related deaths in
Cambodia. Spread by airborne droplets
expelled when a person with TB coughs,
sneezes or speaks. In healthy people, TB
rarely spreads beyond a small area of the
lungs. But if the body’s immune
system is impaired by malnutrition, aging
or other factors including HIV infection,
the bacteria can spread more widely in
the lungs or other tissues. TB can also
occur in the larynx, lymph nodes, brain,
kidney and bones. Such extrapulmonary
TB infections (not involving the lungs) are
tuberculosis patients
UNAIDS
Joint United Nations Program on
HIV/AIDS. Established in 1995 and based in
Geneva, the program brought together 10
agencies as of mid-2004 -- the United
Nations Children's Fund (UNICEF), the United
Nations Development Program (UNDP), the
United Nations Population Fund (UNFPA),
the United Nations Drug Control Program
(UNDCP), the International Labor Organization (ILO), the United Nations Educational,
Scientific and Cultural Organization (UNESCO),
the Office of the United Nations High
Commissioner for Refugees (UNHCR), the
World Health Organization (WHO), the
World Bank and the World Food Program
(WFP).
undetectable viral load
A potentially misleading term that refers
to levels of HIV in the blood of people
taking anti-retroviral drugs that are so low
that they cannot be detected using standard
tests. Low levels of HIV do not mean that
a person is no longer infected with HIV.
The virus is capable of regrouping and rising
again to levels that are potentially dangerous.
UNDP
See United Nations Development Program.
UNESCO
See United Nations Educational, Scientific
and Cultural Organization.
GLOSSARY OF TERMS 167
GLOSSARY OF TERMS
UNFPA
See United Nations Population Fund
(formerly Fund for Population Activities).
UNGASS
SECTION 19
See United Nations General Assembly
Special Session on HIV/AIDS.
UNHCR
See United Nations High Commissioner for
Refugees.
UNICEF
See United Nations Children's Fund.
United Nations Children's
Fund
Established in 1946 and based in New
York. One of the 29 individual UN
agencies and one of the 10 cosponsors of
UNAIDS as of mid-2004. In AIDS-related
work, UNICEF specializes in orphans and
mother-to-child transmission.
United Nations
Development Program
Established in 1958 and based in New
York. One of 29 individual UN agencies
and one of the cosponsors of UNAIDS as
of mid-2004. UNDP work in the field of
HIV/AIDS focuses on HIV, governance and
development. See separate entry for
decentralization.
United Nations Educational,
Scientific and Cultural
Organization
Established in 1945 and based in Paris.
One of the 29 individual UN agencies and
one of the 10 cosponsors of UNAIDS
168
as of mid-2004. UNESCO specializes in
AIDS education.
United Nations General
Assembly Special Session
on HIV/AIDS
A special meeting of heads of state and
government in New York in 2001. The
assembly adopted a resolution known as
the Declaration of Commitment on HIV/
AIDS which calls for "strong leadership at
all levels of society" and additional
resources to respond to the global crisis.
The declaration sets out commitments
and targets in a wide range of areas from
prevention, care, support and treatment to
human rights, vulnerability, orphans and the
socio-economic impact of HIV/AIDS. It
also covers research and development as
well as HIV/AIDS in conflict and disaster
areas.
United Nations
Population Fund
Established in 1969 and based in New
York. One of the 29 individual UN
agencies and one of the 10 cosponsors of
UNAIDS as of mid-2004. The AIDS-related
work of UNFPA is concentrated on gender
and young people.
United Nations Secretary
General's Special Envoys
on HIV/AIDS
vaginal fluids
Vaginal fluids can transmit HIV. See body
fluids.
vaginal sex
A sexual activity that carries a high risk of
HIV transmission if a condom is not used
and one of the partners is infected.
Abstinence is the safest way to protect
against HIV from sexual transmission. See
sexual transmission.
varicella zoster
There are four special envoys-for Africa,
Asia, the Caribbean and countries in
transition in Eastern Europe and Central
Asia. The special envoys have increased
attention towards HIV/AIDS among
politicians, donors, civil society and the
media.
See herpes viruses.
United Nations High
Commissioner for Refugees
UNODC
See mother to child transmission.
United Nations Office on Drugs and Crime.
VIH
Established in 1950 and based in Geneva.
One of the 29 individual UN agencies and
one of the 10 cosponsors of UNAIDS as of
mid-2004. Formally known as the Office of
the United Nations High Commissioner
for Refugees and informally known as the
UN Refugee Agency. It has two technical
experts on HIV in Geneva and four HIV
regional coordinators in Africa. A regional
coordinator for Asia is planned for 2005.
unprotected sex
French abbreviation for HIV. Always
written in the upper case, it stands for
virus de l'immunodéficience humaine. The
adjective humaine agrees with the feminine
noun immunodéficience rather than virus
which is masculine.
United Nations Office on
Drugs and Crime
Established in 1997 and based in Vienna.
One of the 29 individual UN agencies and
one of the 10 cosponsors of UNAIDS as of
mid-2004. Its AIDS-related work focuses
on injection drug users.
Sex without a condom. See safe sex.
urine
Urine cannot transmit HIV. See body fluids.
vaccine
A substance that contains antigen
components from an infectious organism.
By stimulating an immune response -- but
not the disease itself -- it protects against
subsequent infection by the organism.
Preventive vaccines can stop people getting
sick from viruses such as measles or
mumps. Therapeutic vaccines, also known
as treatment vaccines, are being used in
people with HIV to stimulate an immune
system response. See immune-based therapies.
victims
See AIDS victims, innocent victims.
vertical transmission
viral load
The amount of HIV in the blood. Measured
as the number of copies in each milliliter
of blood plasma.Viral load can range from
many hundreds of thousand of copies per
milliliter in some people to less than 50
copies, which is the level of detection.
Viral load tests are seen as a better
indicator of the risk of AIDS developing
than CD4 cell counts - the lower the viral
load, the longer the time to AIDS diagnosis
and the longer survival time. See also
undetectable viral load.
GLOSSARY OF TERMS 169
GLOSSARY OF TERMS
virus
SECTION 19
Organism mainly comprised of nucleic acid
coated by protein. When viruses enter a
living plant or animal, they make use of the
host cell to replicate. Sometimes the host
cell is dissolved, sometime it becomes
cancerous. Some viruses cause illness and
then seem to disappear but later cause
another disease that is sometimes even
more severe. In humans, viruses cause
chicken pox, measles, mumps, yellow fever,
poliomyelitis, influenza and the common
cold. Drugs that fight viruses are called
anti-viral drugs.
vulnerable
Weak and easily hurt physically or
emotionally.
WFP
See World Food Programme.
WHO
See World Health Organization.
William J. Clinton
Presidential Foundation
A foundation that has engaged generic
drug manufacturers in India and South
Africa in moves to cut prices for anti-retroviral drugs. By the end of 2003, it
announced that it had negotiated prices
as low as 140 dollars a year.The foundation
has offered the same prices to UNICEF
and to beneficiaries of programs runs by
the World Bank and the Global Fund to
Fight AIDS, Tuberculosis and Malaria.
World Bank
One of the 29 individual UN agencies.
Based in Washington and one of the 10
170
cosponsors of UNAIDS as of 2004. Also
known as the International Bank for
Reconstruction and Development (its
official name), the World Bank oversees a
multi-country AIDS program.
World Food Programme
Established in 1963 and based in Rome.
One of the 29 individual UN agencies and
one of the 10 cosponsors of UNAIDS as of
mid-2004. The WFP executive director
has been involved in raising awareness of
the deadly combination of AIDS, drought
and shrinking human capacity in southern
Africa.
World
Organization
Health
Established in 1948 and based in Geneva.
One of the 29 individual UN agencies and
one of the 10 cosponsors of UNAIDS as of
mid-2004. In 2003, the WHO increased its
role in the global expansion of access to
anti-retroviral drugs. See separate entries
for anti-retroviral drugs and highly-active
anti-retroviral therapy.
developing countries were allowed a fiveyear transitional period ending in 2000
and least-developed countries were given
11 years up to 2006. At a meeting in the
Qatari capital of Doha in 2001, world
trade ministers extended the deadline
to 2016 for pharmaceutical patents in
least-developed countries. Recognizing
the importance of promoting access to
existing medicines as well as research and
development into new medicines, ministers
adopted a separate declaration on
interpreting the 1995 agreement.The Doha
Declaration on the TRIPS Agreement and
Public Health recognized difficulties faced
by countries with limited drug-making
capacity (Canada has since passed laws to
allow its producers of generic drugs to
export to such countries). On the eve of
the ministerial meeting in the Mexican
city of Cancun in 2003, the WTO agreed
to a case-by-case system to make it easier
for such countries to find sources for
generic drugs. But by mid-2004, this
new system had not been used by any
WTO member. UNAIDS subsequently
urged governments, civil society and the
private sector to "actively evaluate" the
new flexibility under the TRIPS agreement.
the agency said such action was "essential"
to promote access to affordable HIV drugs.
At the same time, UNAIDS noted that
some regional and bilateral trade agreements, especially those involving the
United States, had provisions that "overly"
protect patent rights, offsetting much of
the flexibility under the TRIPS Agreement.
WTO
See World Trade Organization.
young people
Anyone between 10 and 24 years of age.
See also defining the young.
youth
Anyone between 15 and 24 years of age
See also defining the young.
zidovudine (ZDV)
See azdotymidine.
World Trade Organization
Set up in 1995 to succeed the General
Agreement on Tariffs and Trade (GATT)
established in Geneva in 1947. World
trade ministers approved Cambodia's
membership application in 2003 and the
National Assembly ratified the legislation
in 2004, paving the way for Cambodia to
join the WTO. Under the WTO's TradeRelated Aspects of Intellectual Property
Rights Agreement, patents on industrial
property including new drugs are
protected under international law. When
the TRIPS agreement came into effect
in 1995, developed countries were given
one year to comply with the rules. But
GLOSSARY OF TERMS 171
GLOSSARY OF TERMS
SECTION 19
20.
ABBREVIATIONS
AND ACRONYMS
Many viral particles bud from the surface of an
infected CD4 cell. Measuring the amount of virus
in the plasma enables physicians to detect the levels.
Picture and text: Boehringer Ingleheim
172
ABBREVIATIONS AND ACRONYMS
ABBREVIAAND ACRONYMS
SECTION 20
T
he abbreviations and acronyms listed
here are commonly found in reports
relating to the Cambodian health
sector and the broader area of HIV/AIDS
worldwide. The use of abbreviations and
acronyms when writing for general audiences is discouraged.
ARH
adolescent reproductive
health
ARV
anti-retroviral
ADB
Asian Development Bank
BCC
ADRA
Adventist Development
Relief Agency
BFD
Buddhism For Development
AEM
Asian Epidemic Model
BS
birth spacing
AFD
Association for Farmer
Development
BSS
Behavioral Surveillance
Survey
AHRN
Asian Harm Reduction
Network
birth spacing/safe mother
hood
AIDS
Acquired Immune
Deficiency Syndrome
BS/SM
Australian Agency for
International Development
behavior change
communication
CHRHAN Cambodian Human Rights
and HIV/AIDS Network
CDA
Community Development
Action
CIDA
Canadian International
Development Agency
CDC
Centers for Disease Control
and Prevention (US); communicable disease control
CMS
central medical stores
CMV
cytomegalovirus
CDRCP
Cambodian Development and
Relief Center for the Poor
COERR
Catholic Office for Emergency
Relief and Refugees
CECI
Centre Canadien d'Etude et
de Cooperation Internationale
COHD
Cambodian Organization for
Human Rights and
Development
CEDPA
Center for Development and
Population Activities
COPHA
Cambodian Organization of
People Living with HIV/AIDS
CENAT
National Center for
Tuberculosis and Leprosy
Control
COTF
Central Outreach Task Force
CPA
complementary package of
activities
CPN+
Cambodian People Living With
HIV/AIDS Network
CPR
contraceptive prevalence rate;
Community Poverty
Reduction
CRC
Cambodian Red Cross
CAA
children affected by AIDS
CARAM
Coordination of Action
Research on AIDS and
Mobility
CFDS
Cambodia Family
Development Services
CARE
Cooperative for Assistance
and Relief Everywhere
CHC
Cambodia Health Committee
APHEDA Australian People for Health,
Education and Development
Abroad
CAS
Center for Advanced
Studies
CHEC
Cambodia HIV/AIDS
Education and Care
CAT
central advisory team
CHED
ARC
Cambodian Health
Education Development
ANC
ante-natal care
AOC
Asian Outreach Cambodia
Australian Red Cross
Cambodian Health and
Human Rights Alliance
Community of Cambodian
Women for Development
Battambang Women's AIDS
Project
Aide Medicale
Internationale
CHHRA
CCWD
BWAP
AMI
Cambodia Health Education
Media Service
Christian Care for Cambodia
Belgian Technical Cooperation
Association of Medical
Doctors of Asia
CHEMS
CCFC
BTC
AMDA
174
AusAID
CCASVA Cambodian Children Against
Starvation and Violence
Association
ABBREVIATIONS AND ACRONYMS 175
ABBREVIATIONS AND ACRONYMS
CRF
Croix-Rouge Francaise
CRS
Catholic Relief Services
CSCS
Cooperation for a Sustainable
Cambodian Society
SECTION 20
CSDA
CSES
176
Cambodian Socio-economic
Development Association
commercial sex and
entertainment services
DOTS
direct observation
treatment strategy
HACC
HIV/AIDS Coordinating
Committee
IEC
information, education and
communication
DSF
Douleurs Sans Frontieres
HAI
Help Age International
IFSW
indirect female sex worker
DSW
direct sex worker
HBC
home-based care
ILO
DYMB
Dhammayietra Mongkol Borei
HC
health center
International Labor
Organization
EC
European Commission
HCW
health care worker
INGO
international
non-government organization
ELISA
enzyme-linked
immunosorbent assay
HIF
Handicap International France
IPC
Institut Pasteur Cambodge
HIS
health information system
ESTHER
Ensemble pour une Solidarite
Therapeutique Hospitaliere
En Reseau
ISW
indirect sex worker
HIV
Human Immunodeficiency
Virus
ITF
Interim Trust Fund
ITM
Institute of Tropical Medicine
JCA
Jeannine's Children
Association
JICA
Japan International
Cooperation Agency
JOICFP
Japan Organization for
International Cooperation
in Family Planning
KAP
knowledge, attitude and
practice
KBA
Khmer Buddhist Association
CSW
commercial sex worker
CU
condom use
CUMEC
Condom Use Monitoring
and Evaluation Committee
EU
European Union
HKI
Helen Keller International
CUWG
Condom Use Working Group
EWC
East West Center
HPHAO
Hope for Persons with
HIV/AIDS Organization
CVD
Cambodian Vision for
Development
FAP
Friends Association Pioneer
HSS
CWDA
FHI
Family Health International
HIV/AIDS Sentinel
Surveillance
Cambodian Women's
Development Association
FSW
female sex worker
CWPD
Cambodian Women for Peace
and Development
FPP
Frontiers Prevention Project
GAP
Global Aids Program (CDC);
Global Action Project
CWS
Church World Service
DAC
district AIDS committee
GBV
gender-based violence
DFID
Department for
International Development
(Britain)
GIPA
greater involvement of
people living with or affected
by HIV/AIDS
DFSW
direct female sex worker
GO
government organization
DHAC
Drug and HIV/AIDS
Committee
GTZ
Gesellschaft für Technische
Zumsammenarbeit
DHS
Demographic and Health
Survey
HAART
highly-active anti-retroviral
therapy
HU-CHEMS
Health Unlimited Cambodian Health Education
Media Service
IBRD
International Bank for
Reconstruction and
Development
ICAAP
International Congress on
AIDS in Asia and the Pacific
KDFO
Khmer Development of
Freedom Organization
ICC
International Cooperation
Cambodia
KfW
Kreditanstalt für
Weideraufbau
IDA
International Development
Association, Indradevi
Association
KHANA
Khmer HIV/AIDS NGO
Alliance
KKVN
Kien Kes Volunteer Network
IDU
injection drug user
KOSHER
Key of Social Health
Education Road
ABBREVIATIONS AND ACRONYMS 177
ABBREVIATIONS AND ACRONYMS
KRDA
Khmer Rural Development
Association
MoRD
Ministry of Rural
Development
KT
Kaksekor Thmey
MoSVY
KWCD
Khmer Women's
Cooperation for Development
Ministry of Social Affairs,
Veterans and Youth
Rehabilitation
SECTION 20
KWWA
LKWD
Leadership's Khmer Women
for Development
Ministry of Women's Affairs
MPA
minimum package of activities
MSI
Marie Stopes International
MSF-B
Médecins Sans Frontières Belgium
LWF
Lutheran World Federation
MAP
Monitoring the AIDS
Pandemic
MSF-F
Médecins Sans Frontières France
MCD
Media Consulting and
Development
MSM
men who have sex with men
MSW
male sex worker
MTCT
mother-to-child transmission
MWVA
Ministry of Women's and
Veteran's Affairs
NAA
National AIDS Authority
NACD
National Authority for
Combating Drugs
NAP
National AIDS Program
NAPA
National Prosperity
Association
MCH
maternal and child health
MEC
Médecine de l'Espoir
Cambodge
MDM
Médecins du Monde
MHC
Men's Health Cambodia
MHD
municipal health department
MODE
Minority Organization
Development Economy
MoEYS
178
Kratie Women's Welfare
Association
MoWA
Ministry of Education, Youth
and Sport
MoH
Ministry of Health
MoI
Ministry of Interior
MoJ
Ministry of Justice
MoND
MoP
Ministry of National Defense
Ministry of Planning
NAS
Nak Akphivath Sahakum
NBP
national blood policy
NBTC
National Blood Transfusion
Center
NCHADS National Center for HIV/
AIDS, Dermatology and STDs
NCHECR National Center in HIV
Epidemiology and Clinical
Research
PAC
provincial AIDS committee
PAO
provincial AIDS office
NCHP
National Center for Health
Promotion
PAS
provincial AIDS secretariat
PATH
NGO
non-government
organization
Program for Appropriate
Technology for Health
PB
policy board
NHS
National Health Survey
PC
Partners in Compassion
NIPH
National Institute for Public
Health
PCP
pneumocystis carinii
pneumonia
NMCHC
National Maternal and Child
Health Center
PCR
polymerase chain reaction
NNRTI
non-nucleoside analogue
reverse transcriptase
inhibitor
PEP
post-exposure prophylaxis
PFD
Partners for Development
PHA
provincial health advisor;
people with HIV/AIDS
PHC
primary heath care
PHD
provincial health department
PHR
Partners for Health
Reformplus
PI
protease inhibitor
PLA
people living with AIDS
PLH
people living with HIV
PLHA
people living with HIV/AIDS
PLWHA
people living with HIV/AIDS
PMTCT
prevention of mother to
child transmission
POT
provincial outreach team
NPC
Norea Peaceful Children
NRHP
National Reproductive Health
Program
NRTI
nucleoside analogue reverse
transcriptase inhibitor
NSP
national strategic plan
NVP
nevirapine
OD
operational district
OEB
Operation Enfants de
Battambang
OHCHR
Office of the United Nations
High Commissioner for
Human Rights
OI
opportunistic infection
OVC
orphans and vulnerable
children
ABBREVIATIONS AND ACRONYMS 179
ABBREVIATIONS AND ACRONYMS
SECTION 20
PRSP
poverty reduction strategy
paper
SEDP
Socio-Economic
Development Plan
PSAD
Phnom Srey Association for
Development
SFODA
Sacrifice Families and Orphans
Development Association
UNACAS Unaccompanied Association
PSF
Pharmaciens Sans Frontières
(Pharmacists Without
Borders)
SH
sweet heart
UNAIDS
SHARE
Servants for Health in Asian
and African Regions
SHCH
Sihanouk Hospital Center
for Hope
UNCT
United Nations Country Team
SIDA
Swedish International
Development Cooperation
Agency
UNDCP
United Nations Drug Control
Program
SM
safe motherhood
UNDP
United Nations Development
Program
SPFA
Seek of the Pious Friends
Association
SQHN
PSI
Population Services
International
PTC
provincial transfusion center
PWA
people with AIDS
PWHA
people with HIV/AIDS
QSA
Quaker Services Abroad
RACHA
RADE
Rural Association for
Development of Economy
technical working group
UP
universal precautions
UHN
United Health Network
URC
University Research Company
USAID
United States Agency for
International Development
USG
Urban Sector Group
VC
Vithey Chivit
VCT
voluntary counseling and
testing
WAC
Womyn's Agenda for Change
WDA
Women's Development
Association
WEC
World Education Cambodia
WFP
World Food Programme
Sun Quality Health Network
UNESCO United Nations Educational,
Scientific and Cultural
Organization
WG
working group
SRA
situation and response analysis
UNFPA
WHO
World Health Organization
SSS
STI surveillance survey
WNU
Womyn's Network for Unity
REDA
Rural Economic Development
Association
STD
sexually-transmitted disease
RH
reproductive health, referral
hospital
STI
sexually transmitted
infection
RHAC
Reproductive Health
Association of Cambodia
SW
sex worker
TB
tuberculosis, technical board
TBA
traditional birth attendant
TOT
TRIPS
RTI
180
Reproductive and Child
Healthcare Alliance
TWG
reproductive tract infection;
Research Triangle Institute
SCA
Save the Children Australia
SCC
Salvation Center Cambodia
SCF
Save the Children Fund
SEADO
Social Environmental
Agricultural Development
Organization
Joint United Nations
Program on HIV/AIDS
UNCOHCHR
UN Cambodia Office
of the High Commissioner
for Human Rights
United Nations Population
Fund (Fund for Population
Activities)
UNGASS United Nations General
Assembly Special Session on
HIV/AIDS
UNHCR
United Nations High
Commissioner for Refugees
UNICEF
United Nations Children's
Fund
training of trainers
UNKS
United Neutral Khmer
Students
trade-related aspects of
intellectual property rights
UNODC
United Nations Office on
Drugs and Crime
WOMEN Women's Organization for
Modern Economy and
Nursing
WTO
World Trade Organization
WVC
World Vision Cambodia
WVI
World Vision International
WYA
Women and Youth Action
YCC
Youth Council of Cambodia
YWAM
Youth With A Mission
24HTV-CA24-Hour Television Charity
Committee - Cambodia
ABBREVIATIONS AND ACRONYMS 181
ABBREVIATIONS AND ACRONYMS
SECTION 20
21.
SELECTED
REFERENCES
Picture: Boehringer Ingleheim
‘You must be the change you
wish to see in the world.’
-- Mahatma Gandhi
182
SELECTED REFERENCES
SELECTED
REFERENCES
SECTION 21
African Women's Media Center; Reporting
on HIV/AIDS;
www.awmc.com/programs/77
Agence France-Presse; English Service
Stylebook; Paris, 2001
Asian Development Bank and Joint United
Nations Programme on HIV/AIDS; AsiaPacific's Opportunity: Investing to Avert an
HIV/AIDS Crisis; 2004
Brooks, Brian, James Pinson and Jean
Gaddy Wilson; Working With Words;
Bedford/St Martins, Boston, 2000
Clayton, Julie with contributions from
TV Padma and Joe Thomas; Reporting
on HIV/AIDS: Multimedia Training Kit;
www.itrainonline.org/itrainonline/mmtk/
hivaids.shtml
Department of Health and Human
Services (United States); Glossary of HIV/
AIDS-Related Terms - 4th edition; 2002
Family Health International; Sexual
Behavior, STIs and HIV among Men who
have Sex with Men in Phnom Penh;
Phnom Penh, 2002
Fowler, H.S; A Dictionary of Modern English
Usage; Oxford University Press, London,
1954
184
Garrett, Laurie; You Just Signed His Death
Warrant: AIDS Politics and the Journalists’
Role; Columbia Journalism Review; New
York, November-December, 2000
Joint United Nations Programme on
HIV/AIDS; Keeping the Promise: Summary
of the Declaration of Commitment on
HIV/AIDS; Geneva, 2002
Goldstein, Norm; The Associated Press
Stylebook and Briefing on Media Law;
Associated Press, New York, 2003
Joint United Nations Programme on
HIV/AIDS; The Media and HIV/AIDS:
Making the Difference; Geneva, 2004
HIV/AIDS Coordinating Committee;
Annual Report; Phnom Penh, 2003
Joint United Nations Programme on
HIV/AIDS, United Nations Children's
Fund and United States Agency for
International Development; Children on the
Brink 2004; United Nations Children's
Fund, New York, 2004
Institut Bouddhique; Dictionnaire Cambodgien,
Cinquieme Edition; Japan Committee for
Republication and Relief of Cambodian
Buddhist Books,Tokyo, 1989
John, Kylie, and Sainsbury, Candice; The
Impact of HIV/AIDS on Older People in
Cambodia; HelpAge International, 2003
Joint United Nations Programme on
HIV/AIDS; Glossary of HIV-Related Terms;
2004
www.unaids.org
Joint United Nations Programme on
HIV/AIDS; 2004 Report on the Global AIDS
Epidemic; Geneva, 2004
Joint United Nations Programme on
HIV/AIDS; 2002 Report on the Global AIDS
Epidemic; Geneva, 2002
Joint United Nations Programme on HIV/
AIDS and the World Health Organization;
Epidemic Update; Geneva, 2003
Kaiser Family Foundation; The Global
HIV/AIDS Epidemic: A Timeline of Key
Milestones; 2004
www.kff.org
Kha Sovannara and Chris Ward; Men Who
Have Sex with Men in Cambodia; POLICY
Project, Phnom Penh, 2004
Lowe, David; Perceptions of the Cambodian
100% Condom Use Program: Documenting
the Experiences of Sex Workers; POLICY
Project, 2003
Ministry of Education, Youth and Sport;
Cambodia National Youth Risk Behavior
Survey; Phnom Penh, 2004
Ministry of Education, Youth and Sport,
Interdepartment Committee for HIV/
AIDS; Strategic Plan 2001 - 2005
Ministry of Health; Strategic Plan for
HIV/AIDS and STO Prevention and Care in
Cambodia 2001 - 2005
Ministry of Planning; Cambodian Millennium
Development Goals Report; Phnom Penh,
2003
National AIDS Authority; Building a Better
Understanding of the Situation and Response
to HIV/AIDS in Cambodia; Phnom Penh,
2001
National AIDS Authority; National Strategic
Plan for a Comprehensive and Multisectoral
Response to HIV/AIDS 2001-2005
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; HIV
Sentinel Surveillance 2002; Phnom Penh,
undated
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; HIV
Sentinel Surveillance 2003: Results, Trends
and Estimates; Phnom Penh, 2004
SELECTED REFERENCES 185
SELECTED REFERENCES
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; National
Guidelines for the Selection of People Living
with HIV/AIDS for Antiretroviral Therapy;
Phnom Penh, 2003
SECTION 21
National Center for HIV/AIDS, Dermatology and Sexually-Transmitted Diseases
and World Health Organization; National
Policy for Preventing Mother-to-Child Transmission of HIV; Phnom Penh, 2001
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; Policy
for HIV/AIDS and STI Prevention and
Care in the Health Sector in Cambodia;
Phnom Penh, 2001
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; BSS
2003: Sexual Behavior Among Sentinel
Groups; Phnom Penh, 2004
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; Policy;
Strategy and Guidelines for HIV/AIDS
Counseling and Testing; Phnom Penh, 2002
National Center for HIV/AIDS, Dermatology
and Sexually-Transmitted Diseases; Strategy
and Guidelines for Implementation of the
Targeted Outreach Program for Sex Entertainment Services; Phnom Penh, 2001
National Institute of Statistics, Directorate
General for Health and ORC Macro;
Cambodia Demographic Health Survey 2000;
Phnom Penh and Calverton, Maryland,
2001
Pichara Leang and Kim Ann Oeun; Analysis
of Reporting on HIV/AIDS in Cambodia;
POLICY Project, Phnom Penh, 2004
Pillai, Gita, Barbara Donaldson and Sok
Keang; A Directory of Organizations Implementing or Supporting HIV/AIDS Activities in
Cambodia (Draft); Phnom Penh, 2004
Pisani, Elizabeth et al; AIDS in Asia: Face the
Facts; Monitoring the AIDS Pandemic, 2004
POLICY Project; HIV/AIDS in the Mekong
Region; 2003
Pollard, Ruth; HIV/AIDS Media Guide,
Second Edition; Australian Federation of
AIDS Organizations and the Australian
National Council on AIDS, Hepatitis C
and Related Diseases, 2000
Soul City Institute for Health and
Development Communication (South
Africa); HIV/AIDS: A Resource for Journalists;
Undated
UNAIDS Cambodia, the National AIDS
Authority and the POLICY Project; HIV/
AIDS and Human Rights in Cambodia:
Report to the Asia Pacific Regional Office of
the High Commissioner for Human Rights;
Phnom Penh, 2004
World Health Organization;
Promotion Glossary; Geneva, 1998
www.who.org
Health
Every effort has been made to ensure that the information contained in this report is accurate
and complete at the time of publication. Feedback and updates should be addressed to:
186
Dr. Sim Kim San
Chief of Advocacy and Communication Unit, National AIDS Authority
E-mail: [email protected]