New approach needed in Cambodia to reach zero AIDS-related deaths

The goal to reach zero new infections in Cambodia by 2020 will not be possible without new innovative approaches to provide people living with HIV with antiretroviral therapy.

The goal to reach zero new infections, zero discrimination and zero AIDS-related deaths in Cambodia by 2020 will not be possible without new innovative approaches to provide people living with HIV with antiretroviral therapy.

Stigma and discrimination remains a major issue that needs to be addressed as many people living with HIV feel compelled to travel far from their home to access services because they are frightened to reveal their status to family members, friends and neighbors.

Take the example of Sou Sarin, 33, who was living with HIV.  In 1993, he got a job with a good salary away from home and as the eldest son he was supporting his family. He met a man and they fell in love. But when his parents learned that they were together, they intervened and separated them.

In 2012, Sarin was facing problems with the owner of a beauty salon in Siem province and eventually moved away to live in a very quiet part of Prah Sihanouk province where, for a year, he had no access to a hospital where he could access antiretroviral treatment.  Sarin has since passed away.

Reducing the HIV prevalence

Last November, Cambodia’s Minister for Health Dr Mam Bunheng signed up to a standard operating procedure for Continuous Quality Improvement for Continuum of Care for people living with HIV.

The procedure was produced by the National Center for HIV/AIDS, Dermatology and STD Control (NCHADS) which works in close collaboration with development partners including non-governmental organizations and people living with HIV.  According to NCHADS, Cambodia is one of the most successful countries in the western Pacific region in the HIV response and reduced HIV prevalence among people aged 15-49 years-old from 1.7 per cent in 1998 to 0.8 per cent in 2010.

Yet there is still room for improvement. NCHADS also reported that in 2013, 305 people living with HIV who did not access treatment services and 47 had died by the end of year.

New code to improve access to medication

Dr Bunheng notes that the number of people living with HIV who attend clinics for pre-antiretroviral and antiretroviral therapy has increased year by year. “The quality of care at the pre-ART/ART level has been improved, but we need to continuously improve the quality of health services at these facilities to maintain and improve the quality of life of people living with HIV,” he said.

One proposed initiative is to use a ‘unique identifier code’ so people living with HIV can access antiretroviral therapy or any other services wherever they show the card to service providers. This will also help with follow up and access to services without fear of revealing identity to family, friend and co-workers.

This innovation can also be used by a group of service providers to monitor the multiple services and facilitate links between them. Under the HIV/AIDS flagship project funded by USAID, a number of organisations including KHANA, FHI 360 and PSI will work closely with NCHADS and other stakeholders to develop this new system to support client tracking, case management, and to improve links between services. This system will be widely implemented in May 2014.

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