Monogamous married women are becoming one of the most at risk groups from HIV infection in Cambodia, the International Federation of Red Cross and Red Crescent Societies is warning in the run-up to a major international AIDS conference in Bangkok.
In contrast to neighbouring Thailand, which has been praised for slowing its HIV/AIDS epidemic, Cambodia is facing a situation where AIDS is now spreading beyond traditionally high-risk groups and into the wider population.
Cambodia has an HIV prevalence rate of 2.68 per cent among people aged 15–49, the highest rate in the Asia Pacific region, and every day, 20 new HIV infections occur. Of these, seven are housewives and seven are babies.
Married, monogamous women now make up 42 per cent of new HIV infections in the country. This reflects a trend in the Asia Pacific region, where, according to UNAIDS, 80 per cent of infected women have no risk behaviour by conventional definitions.
“We’re now seeing that women are being infected at a faster rate than men in Cambodia and one of the biggest risks is actually being married,” says Julie Hoare, Australian Red Cross Cambodia HIV/AIDS Programme adviser. “And with an increase in infection among women, we’re also seeing a higher rate of transmission from mothers to children.”
Mobile groups such as the police can act as a bridge to move HIV/AIDS from high risk groups like sex workers to broader sections of the population, including married women and children, producing a more generalised epidemic, says Captain Lim Sarun, deputy chief of the Kampung Cham Police Health Unit, and an HIV/AIDS peer trainer.
“Often when policemen are away from home they like to engage in high-risk activities including casual sex, especially when they are drunk,” he says.
Many of the sex workers are young. By the time they have acquired the confidence to insist on condom use, they may have already acquired HIV from a client.
If the trend towards a more generalised epidemic continues, Cambodia, already one of the world’s poorest countries, faces the prospect of losing the core of its society and economy - men and women in the prime of their lives who support children and elderly parents, and contribute to their communities.
Already a Cambodian Red Cross police peer education programme is seeing changes in behaviour – less drinking, fewer visits to brothels with their colleagues, more condom use and men taking more responsibility at home.
The theme of the Bangkok AIDS Conference is Access for All. This means not only access to treatment, but also access to the right information, empowering people to protect themselves and their families. Peer education programmes like the one being run by the Cambodian Red Cross with the police can play a crucial role in reversing what is a worrying trend.