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(13).  HIV/AIDS 

Under 3.1.5. (Vulnerability)  HIV/AIDS, the NPRS observes that HIV/AIDS can and does have a devastating effect on families with members who have HIV/AIDS and that it forces rural households to reallocate labour from agriculture to patient care, as well as divert a greater share of household resources for care and treatment. In many cases, it is the first step toward [even deeper] impoverishment.

The NPRS also observes that “It is also increasingly recognized that vulnerability to infection especially for women, stems from influence of socio cultural, economic and political factors. These factors include discrimination and marginalisation of certain groups of people such as sex workers and people living with HIV/AIDS, illiteracy and lack of educational opportunities and ignorance about STI/HIV/AIDS.”

In Section 3.4. (Gender Disparities) The impact of HIV/AIDS on  women is discussed: “The HIV/AIDS epidemic has diversified and multiplied burdens on women. As of 1998, 2.4 percent of pregnant women, 42.6 percent of commercial sex workers, and 19.1 percent of indirect commercial sex workers were infected with HIV. At the same time as progress has been made on the use of condoms in the sex industry, there is evidence of an increasing incidence in married women the group of which should not be overlooked by HIV/AIDS strategy and programme. Women also bear primary responsibility for caring for family member with HIV/AIDS, as they do for victims of land mines and other disabilities and illnesses.”

In Section 4/3 (Improving Capabilities under 4.3.1. (Health), HIV/AIDS is referred to one of the “key diseases which disproportionately affects the poor…”

In Section 4.5.3. under 4.5. (Reducing Vulnerability and Strengthening Social Inclusion), HIV/AIDS is addressed more extensively, observing that “poverty is unequivocally linked with HIV/AIDS….” And that “women are particularly vulnerable to HIV infection, as gender relations form part of the broader set of social relations in society, and are essentially relations of power between men and women.”

The NPRS says that the National Aids Authority aims to “lessen the vulnerability of women and girls to HIV/AIDS and to increase their status by seeking to offset prevailing discriminatory attitudes in society, especially among men.”

The NPRS also suggests that prevention programs involving public information and education should be tailored to specific target audiences because even though more and more people are aware of HIV/AIDS, “behavioural changes in certain groups remain limited.” It is also essential to introduce programs to prevent mother-to-child transmissions. It is interesting to note that in Section 4.3.3. (Education), there is a reference to HIV/AIDS awareness programs in schools under “Improved Access Programs.”

There is also a need for “increasing the number of institutional facilities to provide all care needs,” and a campaign should be launched to “convince people to take good care of and provide social support foe people living with AIDS.”

The priorities for poverty reduction include the following measures:

·        Extending the continuum of care, “aimed at enabling those infected with HIV, and particularly the poorest, to access appropriate, low-cost care and support in forms that are most acceptable and effective;”

·        “Targeted community prevention programmes for fishing villages, source communities for migrant workers, and migrant labour, among which the poor are to be found;”

·        “Significant political commitment to HIV/AIDS prevention and care;” and

·        “A budget decentralization strategy exists, and provincial structure composed of PAC, PAS (Provincial Aids Secretariat) and District Aids committee.”

The overall indicator used in section 6.1 is the HIV/AIDS prevalence rate for ages 15-49. The target is 2.3%in 2005, down from 2.6% in 2002.

The Annex 3 Matrix  5.3. (HIV/AIDS) refers to only one strategic objective: strength and support programs for PLWA and families affected by HIV/AIDS or other vital diseases. As actionable measures, it lists: “expand awareness programs; train service providers; and strength community-based safety nets and expand program for the vulnerable.” The target is   a “significant 10% decrease in new HIV/AIDS infection in 10 target provinces including rural areas,” by 2005. “HIV/AIDS awareness education” is also referred to in Section 3.1. (Better Health Outcomes), along with the same target.

Note: In this sense, the objectives listed in the NPRS text provide more guidance than do the two sections concerning indicators, targets, and actionable measures, which in fact appear surprisingly vague and ambiguous given the reasonable quality of the discussion in the text.  

NGO Action:

The NGO CG Statement observes that “Although Cambodia has achieved some success in HIV prevention efforts reducing risk behaviours, vigorous efforts including continued funding assistance and scaling-up of existing intervention programs nationwide, are needed to sustain and accelerate the decline in HIV infections.”

• Monitor the enforcement of laws relating to sex work and trafficking, and promote efforts to strengthen legal framework against such practices;
• Monitor resource mobilization (promote donor coordination) and budget allocations, as well as financial disbursements;
• Continue providing relevant information to policy makers and implementers about lessons learned and best practices, including in the APRI process;
• Promote, participate and collaborate with RGC to provide knowledge about self-care and services in prevention and treatment;
• Promote, participate in and collaborate with RGC to increase understanding, and reducing stigma and discrimination;
• Support PLWA group roles in policy and planning;
• Advocate for multi-sectoral action, including in the context of the APRI process.

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