HIV HIV/AIDS MEDIA GUIDE Media Guide AIDS HIV

The development and printing of this guide were supported by the United States Agency for International Development (USAID) through the POLICY Project. Media Guide

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 AIDS 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.

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

he National AIDS Authority wishes to express special thanks to the United States Agency for International Development for its financial and technical assistance through Tthe POLICY Project, , 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 , 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 Puy Kea Dy Many Dr. Sim Kim San Fabrice Laurentin Leu Pannasith Keo Chhen Kim Dara Reach Sambath Phan Sopheap Lan Van Seng 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

t is now 12 years since HIV was first HIV/AIDS also remains a highly stigmatized On behalf of the National AIDS Authority, diagnosed in Cambodia. Since then, tens disease associated primarily with sex, I thank everyone who participated in Iof thousands of Cambodians have died prostitution and infidelity. Stigma and developing this valuable guide, and hope of AIDS, and many more have lost family discrimination is widespread against those that its use will contribute to promoting members. infected and affected by HIV, with poor respect for human rights and human and inaccurate media coverage often dignity in the face of this epidemic. In terms of actual numbers, Cambodia has contributing to negative attitudes towards fewer HIV cases than some of its neighbors. those living with HIV/AIDS.This also results But Cambodia's relatively small population in stereotyping and victimization. has long had the highest rate of infection among all Asian countries, posing a huge Misleading information about and negative challenge to the government and agencies perceptions of those infected by HIV must that work with HIV/AIDS. be addressed.The media has a crucial role to play in any HIV/AIDS program and is a Cambodia has been quick to recognize central actor in disseminating accurate the importance of educating people about information as well as shaping community prevention, and its response is often cited attitudes towards those most affected. abroad as one of the rare "success stories" in curbing the epidemic. In 1997, for Mainstream media in Cambodia have example, three out of every one hundred helped to raise public awareness about Cambodians between the ages of 15 and HIV prevention, but much care needs to be HE Dr. Hong Sun Huot 49 had HIV.Today, that number is less than taken to prevent sensationalism.We need two. to promote balanced media coverage that Senior Minister and Chairman, helps rather than hinders our response to National AIDS Authority But much work remains to be done.While the epidemic.A valuable partnership needs the number of new infections among men to be formed to further support the has plunged, the number of newly-infected government ministries and agencies women has barely changed. Women are working with HIV/AIDS in Cambodia. now almost four times more likely than men to be among the newly infected. What's With this comprehensive media guide, more, more than 120,000 people living with Cambodia now joins a small but growing HIV/AIDS need care and treatment, group of countries that seeks to help particularly access to high quality but journalists navigate their way through the affordable drugs and medical services. complexities of writing about HIV/AIDS.

2 FOREWORD 3 CONTENTS AND EXECUTIVE SUMMARY 4 ETO 5 MULTILATERAL AGENCIES 15. SECTION FACTS 4. SECTION SECTION 5. STIGMA AND DISCRIMINATION STIGMAAND 5. SECTION EXECUTIVE SUMMARY ETO .W 7. SECTION ETO 6 SELECTEDBILATERAL DONORS 16. SECTION TREATMENTCARE AND 12. SECTION MEN AND OLDERPEOPLE 9. SECTION DATA 6. SECTION HIV/AIDS AND THE SECTION 2. MEDIA ETO 1 SELECTED REFERENCES 21. SECTION ABBREVIATIONS ANDACRONYMS 20. SECTION GLOSSARY OF TERMS (A-Z) 19. SECTION WEBSITES 18. SECTION NON-GOVERNMENT ORGANIZATIONS 17. SECTION GOVERNMENT INSTITUTIONS 14. SECTION THENEXT10 YEARS 13. SECTION COUNSELING TESTINGAND 11. SECTION VACCINESMICROBICIDES AND 10. SECTION CHILDRENAND PEOPLE YOUNG 8. SECTION LANGUAGE 3. SECTION FIGURES QUESTIONS AND BASIC TIMELINE, 1. SECTION OMEN ...... CONTENTS ...... 183-186 173-182 133-172 125-132 95-124 35-40 53-56 45-52 31-34 79-84 85-90 69-72 57-60 41-44 91-94 77-78 73-76 65-68 61-64 25-30 9-24 5 syndrome virus between thehumanimmunodeficiency the body'simmune system.To distinguish causes AIDS by destroying cellsintegralto thevirusthat immunodeficiency virus, HIVstandsfor human nical terminology. on HIV/AIDSissuesinvolves highly tech- Correct reporting andlanguage. the media, HIV/AIDSand Sections 1-4lookatfacts, HIV/AIDS issues. coveringreporters theincreasingly complex guide tomeetthegrowing demandsof of recognition thatthere wasnomedia resource hasbeendeveloped asaresult This as victimsorobjectsofsympathy. with HIV/AIDSwhowere usually depicted respect for thedignityofpeopleliving displaying little tionalist orvoyeuristic, wasoftensensa- that HIV/AIDSreporting the printmediainCambodia2003found However, astudyof against thoseaffected. and reducing stigmaanddiscrimination in educatingpeopleabouttheepidemic media isrecognized ashaving avitalrole andthe prevention isnow relatively high, Awareness ofHIV Cambodia in1991. HIVwasfirstdetectedin of Cambodians. misconceptions surrounding HIV/AIDS fear and prejudices, Stigma, by HIV/AIDS. toward HIV/AIDSandpeopleaffected Language hasastrong influenceonattitudes ("AIDS-disease") for AIDS. ("AIDS virus")for HIVand T and theacquired immune deficiency euiy andeconomicwell-being security, crisis thatthreatens thehealth, he globalHIV/AIDSepidemicisa thetermsusedare , chumngeou eith merok eith SUMMARY EXECUTIVE a national surveillance systemfor HIV a nationalsurveillance ofHealthhasbeenoverseeing Ministry The 6looksatHIV/AIDSdata. Section AIDS. similarly affect familiesofpeoplewithHIV/ Stigmaanddiscrimination can school. parents towithdraw theirchildren from and eroding income-- sometimes forcing businesses alsosuffer declinesincustomers Many peoplerunning left todie. where they are sometimes health facilities, from homesandvillages orabandonedat ejected AIDS are shunnedby theirfamilies, Many peoplewithHIV/ for gettinginfected. People withHIV/AIDSare oftenblamed as HIVcarriers. buy condomsoutoffear ofbeinglabeled thatsomepeoplearereported afraidto Ithaseven been out ofembarrassment. their HIVstatusmay beafraidtotested --wh people programs Itisalsoamajorbarrier toHIV needlessly. delay treatment andsuffer avoid testing, risk, leadingpeopletodeny prevention efforts, HIV/AIDS continues toprofoundly affect Stigmaassociatedwith status andrace. economic sexualorientation, gender, to especially thoserelated and prejudices, both ofwhichstrengthen socialinequa Section 5studiesstigmaanddiscrimination, anddoesnotcauseprejudice. stereotypes, doesnotfuel language isconstructive, Appropriate when covering HIV/AIDS. of themediausingappropriate language theethicalimportance therefore, emphasize, Onecannotover- are only tooabundant. EXECUTIVE SUMMARY o wanttoknow small lities 5 EXECUTIVE SUMMARY 6 "large numbers ofbothmarried and transmission in Cambodiaisfueledby HIV about sexortosuggestcondom use. ropriate for women tobeknowledgeable Cambodian customsthatmake itinapp- alongwith vulnerable toHIVinfection, Domestic violencemakes women more pregnancies. transmitted diseasesandunwanted sexually- increasing theirvulnerabilitytoHIV, ability tocontrol their own bodies, Thislimitswomen's seeking" behavior. practices decisions relating toreproductive many mendetermine InCambodia, women. women are more susceptiblethanolder andyounger to HIV infection thanmen, Women are more physically susceptible unchanged from 6,393in2002. 1,694 new infections inmenandvirtually almost four timeshigherthanthe 2003, of new infections inwomen at6,350in Diseases (NCHADS)estimatedthenumber andSexually AIDS Dermatology Transmitted theNationalCenterfor HIV/ Cambodia, as amainsource ofnew HIVinfection in With husband-to-wife transmissionemerging more thanathird ofthe AIDS deaths. half oftheHIVcasesinCambodiaand estimated thatwomen accountfor almost 7intr Section have beenincluded. groups being monitored. they are susceptibletoaninfection thatis whichmeans known assentinelgroups, The groups includedinsurveys are and thenumber ofdeathsfrom AIDS. for theactualnumber ofpeoplewithHIV alongwithestimates prevalence are made, collected, Basedonthedata behavior since1997. infection since1994andfor high-risk as well assexualand"health- national estimatesofHIV dcswmnadHV Itis oduces women andHIV. Eleven different sentinel hlrna ela rhn.Despitetheir children aswell asorphans. people are lookingaftertheir sickadult older Inareversal ofroles, structures. HIV/AIDS ischangingfamily andcommunity sex. engaging incommercial orextra-marital risk duetoanelevated likelihood of are at seafaringandthemilitary, driving, inantly mobileoccupationssuchastruck Menemployed inpredom- peer pressure. w to "ritualsofmasculinity"as mption amongCambodianpolicer Alcoholconsu- alcohol whensocializing. expected todrinklargequantitiesof are usually for example, Cambodian men, in men'svulnerabilitytoHIVinfection. expectations ofmalebehavior play arole Traditional older peopleintheepidemic. 9explor Section adolescents of HIVpreven thefocus HIV infections inCambodia, age of24accountingfor halfofthenew Withyoung peopleunderthe and drugs. vulnerabletosexualexploitation particularly developed andsuchchildren canbe safety netsare poorly Cambodia, about HIV/ are livingwithfamily memberswith many otherchildren orphaned by AIDS, the tensofthousandschildren Inaddition to than adultswiththevirus. immune systemsbreak down much faster especially vulnerabletoHIVastheir children are retroviral drugtreatment, anti- children andyoung people.Without examines theimpactofHIV/AIDSon as well asduringbr to infantsduringpregnancy oratbirth, HIV-positive motherscan passthevirus amounts ofcommercial sex." single menwhocontinue tobuylarge IS o rhn,whoaccountfor For orphans, AIDS. nine percent ofallchildren in and youth. tion ismovingtowardstion es therole of menand east feeding. eto 8 Section elates ell as both before andafterevery HIVtest. take must Counseling individual. voluntary Alltestingissupposedto be VII. Chapter for confidentialityare contained in HIV/AIDS adoptedin2002andprovisions the Law onthePrevention andControl of Cambodia are speltoutinChapter IVof Theguidelinesfor testingin infection. and candetectHIVwithintwo weeks of reaction (PCR)testsfor thevirusitself polymerase chain However, to thevirus. testing itfor thepresence ofantibodies HIV involves takingabloodsampleand Themostcommontestfor counselling. we 11, In Section companies andacademicinstitutions. non-profit companies, biotechnology Most oftheproduct developers are small against infections from micro-organisms. lining ofthevaginaoranus toprotect foams orgelsthatcanbeapplied tothe Microbicides are chemicalorantibiotic destroying theimmune systemitself. eliminate orneutralizetheviruswithout medical resear fight viruses. immune systemthatisdesignedto very corporates itsgeneticmaterialintothe against HIVisdifficultasthevirusin Developing apreventive vaccine organism. itself -andprotect againstinfection by the immune response -butnotthedisease antigensare usedtostimulate an vaccines, With system toproduce antibodies. called antigensthatcausetheimmune Infectious organismshaveof HIV. proteins Section 10introduces thescientificaspects most HIV/AIDSprograms. asbeingtypicallyreported excludedfrom olderpeopleare growing responsibilities, with theinformed consent ofthe chers istofindaway to The mainchallengefor discuss HIVtestingand place therapy by 2015. advanced anti-retro with advancedHIVinfection to bereceiving people of seventh targetisfor 50percent The transmitting thevirustochild. retroviral drugstoreduce theriskof to bereceiving acomplete percent ofallpregnant w Anothertargetfor 2015isfor 50 at risk. married women whoidentifythemselves and10percent for ages of15and24, people between the percent for young 95 rise to98percent for sexworkers, Condom useismeanwhiletargetedto have already beenmetaheadofschedule. thetargetsfor 2005and2010 percent, showing declinesinbothratesto1.9 the clinics.With pregnant women attendingante-natal and1.5percent for young for adults, reducing HIVprevalence to1.8percent seven HIV/AIDStargetsfor 2015include Cambodia isexplainedin The outlinefor thenexttenyears in nursing nizations, collaboration with teammembersbeingtrainedin is care system advanced suchasthe life threatening illnesses, relief to comfort care is designed toprovide symptomatic active anti-retroviral drugs from thesethr anti-retroviral drugshadbeendeveloped. three classesof By2004, viruses like HIV. kill orprevent thereplication ofretro- Anti-retroviral drugsare drugsthat 12. Treatment andcare are covered inSection Doctors refer tousingacombinationof tgso IS Thehome-based stages of AIDS. being expandednationwide, with non-government orga- EXECUTIVE SUMMARY NCHADS survey of2003 schools andNCHADS. and support patients and support hrp.Home-based therapy. ee classesashighly viral omen withHIV eto 13.The Section course ofanti- combination with 7 SECTION 1 TIMELINE, FIGURES 8 1. replication machinery. It enterslivingcellsandusesthehostcell’s the causative agent ofAIDS, isaretrovirus. The HumanImmunodeficiency Virus(HIV), AND BASICQUESTIONS TIMELINE, FIGURES Picture andtext: Boehringer Ingleheim TIMELINE TIMELINE

1959 1984 1991 The National Assembly passes the Press Law which identifies respect for the truth A Haitian-born sailor in New York dies Dr Robert Gallo, of the National Cancer Cambodia detects HIV for the first time and the right to individual privacy among of a form of pneumonia called PCP Institute in the United States, announces during screening of donated blood. basic principles for journalists. The law (pneumocystis carinii pneumonia). A the discovery of the virus that causes says journalists should avoid publishing blood sample is taken from an African port AIDS after isolating it from the blood of 1993 SECTION 1 information that incites discrimination and (present-day Kinshasa in the Democratic healthy sex workers in West Africa. The Doctors diagnose the first cases of HIV in provides for fines of up to five million riel Republic of Congo). Twenty-seven years virus is named Human T-cell Leukemia Cambodia. for false advertising. later, the blood tests positive for HIV. Virus (HTLV) III.After a dispute, Montagnier The National Authority for Combating 1979 and Gallo agree to be named co- The National AIDS Program is established. discoverers of the virus which is renamed Drugs is set up. Doctors in New York and San Francisco as the Human Immunodeficiency Virus (HIV). 1994 Cambodia is rocked by rumors that people observe increasing numbers of cases of 1986 people sick with PCP, Kaposi's Sacoma, The Ministry of Health establishes the can be infected with HIV by eating morning glory grown in Boeng Tumpun. cytomegalovirus and candidiasis. The World Health Organization estimates HIV Sentinel Surveillance system. 50,000 people with AIDS in eight countries 1981 Social marketing of condoms is launched. 1996 in central Africa. Scientists in the United The Joint United Nations Program on The Centers for Disease Control and States announce that zidovudine (AZT), a A summit of 42 countries in Paris agrees HIV/AIDS (UNAIDS) is set up in Geneva. Prevention in Atlanta publishes a report drug developed for cancer, seems to benefit to "strengthen the capacity and coordination on the growing incidence of PCP. By the people with AIDS. of networks of people living with HIV/ The Ministry of Health expands the HIV end of 1981, the number of cases in the 1988 AIDS and community-based organizations." Sentinel Surveillance system. United States reaches 270. The principle becomes known as Greater 1982 The World Health Organization adopts a Involvement of People with HIV/AIDS The international AIDS conference in resolution calling for the regulation of (GIPA). Vancouver hears promising evidence of Three studies published in the New discrimination against people infected and a new range of drugs called protease England Journal of Medicine link PCP and affected by HIV/AIDS. 1995 inhibitors which prove to be effective when Kaposi's Sacoma to immune deficiency. 1989 used in combination with other drugs. The Centers for Disease Control and Cambodia establishes its first HIV voluntary testing and counseling center at the Prevention adopts the term Acquired The United Nations Center for Human The National AIDS Committee endorses Institut Pasteur in Phnom Penh. Five more Immune Deficiency Syndrome (AIDS). Rights and the World Health Organization the National Policies on HIV/AIDS/STD are set up over the following year with 1983 hold the First International Consultation Prevention and Control. on HIV/AIDS and Human Rights. another two centers in Phnom Penh and The journal Science publishes a paper by one each in Battambang, Kampong Cham The office of the United Nations High Dr Luc Montagnier of the Institut Pasteur Cambodia passes the Law on Marriage and Siem Reap. Commissioner for Human Rights and in Paris, reporting the isolation of a virus and the Family, setting the age of consent UNAIDS organizes the Second International Authorities launch an outreach program from West Africa that caused AIDS. The for marriage at 20 years for men and 18 Consultation on HIV/AIDS. The meeting virus is named Lymphadenopathy Associated years for women unless the parents give for sexually-transmitted infections in urban identifies 12 international guidelines for Virus (LAV). their consent and the woman is pregnant. centers in all provinces. state action.

10 TIMELINE 11 SECTION 1 TIMELINE 12 to broaden thegovernment's response The National AIDS Authority isestablished 1999 Sihanoukville. with brothel-based sexworkers in Percent CondomUse Program islaunched A pilotschemecalledtheOneHundred themselves. ofthesemenandsex workerspartners the wives and soldiers andpolicemen, like workers andhighly mobilepeople behavior.These include and groups ofpeople with high-risk (1998-2000) identifiespriorityprovinces AIDS Prevention andCare in Cambodia The NationalStrategicPlanfor STD/HIV/ established. andSTDs(NCHADS)is Dermatology The NationalCenterfor HIV/AIDS, and Control. National Policy onHIV/AIDS/STDPrevention The MinisterofHealthapproves the 1998 of Sunday onHIV/AIDS. articles aspecialseries Rasmei Kampucheastarts of Drugs. Cambodia passestheLaw ontheControl of 3.7percent oftheadultpopulation. Cambodia's HIVprevalence risestoahigh 1997 effective vaccineagainstHIV. set uptoacceleratethesearch for an The International AIDS Vaccine Initiative is on theManagementofPharmaceuticals. of Exploitation Trafficking and ression ofKidnapping, Cambodia passestheLaw ontheSupp- Human BeingsandtheLaw men whovisit sex oterwvsadgrfins andthat a to theirwives andgirlfriends, thatHIVisalready spreading in Cambodia, to buylargeamountsofcommercial sex" that many married andsinglemen"continue Thepolicyrecognizes developed in2000. Cambodia asanupdatetothestrategic plan and Care intheHealthSector Policy for HIV/AIDSandSTIPrevention The MinisterofHealthapproves the 2001 adult rateat2.8percent. Cambodia withNCHADSestimatingthe HIV prevalence continues to fallin countries. for HIVanti-retroviral drugsindeveloping manufacturers tonegotiate lower prices a jointinitiative withfive majordrug WHOandothersannounce UNAIDS, Eight summitinJapan. HIV/AIDS resources duringtheGroup of Russia agree ontheneedfor more Germany, Japan, Leaders oftheUnitedStates, Care for 2001to2005. Plan for HIV/AIDSandSTIPrevention and ofHealthdevelopsThe Ministry aStrategic 2000 population. dropped to3.1percent of the adult that HIVprevalence inCambodiahas The annual NCHADSsurvey indicates center issetupinSihanoukville. A seventh testingandcounseling voluntary framework. a broad response withinahumanrights settingout and Control for 1999to2004, Strategies for HIV/AIDSandSTDPrevention to publishtheNationalPolicy andPriority Oneofitsfirstmoves is to theepidemic. rne rti,Iay Canadaand Italy, Britain, France, municipalities. with distributioninall24provinces and Cambodian condomsalesreach 16million AIDS for 2001to2005. to ehensive andMultisectorResponse the NationalStrategicPlanfor a adopts National AIDSAuthority The people withHIV/AIDS. "elimination ofdiscrimination"against silenceanddenial"the stigma, of apositive environment inconfronting The declarationpromotes the"creation Summit DeclarationonHIV/AIDSinBrunei. Southeast Asian leadersadoptthe ASEAN Prime MinisterHunSenandother HIV/AIDS for 2002to2005. Second ASEAN Work Program on ASEAN HeathMinistersendorsethe workers andallplayers intheindustry. recognizes theneedtotargetallsex 1995, in whichstarted phase oftheprogram, Sex the T andguidelinesfor implementing strategy The MinisterofHealthapproves the Assembly SpecialSessiononHIV/AIDS. a declarationattheUnitedNationsGeneral Cambodia joinsothercountriesinadopting HIV. of Transmission Policy onPreventing MothertoChild ofHealthdevelopsThe Ministry aNational and deathisinevitable. "significant burden" ofincreased sickness fHVAD,prohibiting discrimination of HIV/AIDS, committed topromoting publicawareness Cambodiais Under itsgeneralprovisions, the Prevention andControl ofHIV/AIDS. The National Assembly passes theLaw on 2002 argeted Outreach Program for netimn evcs Thenew Services. Entertainment Compr- HIV/ SECTION 1 HIV/AIDS IN NUMBERS 14 infection are "stillwoefully low" and of standing expresses "profound concern"thatunder- It AIDS Initiative toincludeprintmedia. UNAIDS toexpandtheGlobal Media (IFJ) offers with towork inpartnership The InternationalFederation ofJournalists five with"strong" support. will "probably" bemet andoneofonly only three outof25overall targetsthat reducing thespread ofHIV/AIDSisone nium Development Goalsshows that A progress onCambodia's Millen- report through theircompanies. knowledge andunderstandingofHIV/AIDS leadersresolveindustry toexpandpublic The the GlobalMedia AIDS Initiative. to givingbirth global mediacompanies, Annan meetswithseniorexecutives of 22 GeneralKofiUnited NationsSecretary 2004 living withHIV/AIDS. promotes therightsofwomen andgirls the GirlChildandSTI/HIV/AIDSwhich Affairs adoptsarevised Policy on Women, of The Ministry Women's and Veteran's receiving anti-retroviral drugs. Cambodians withadvancedHIVare NCHADS estimatesthat2.75percent of 2003 enrolled insuchprograms. estimates thatonly 250peopleare CPN+ Atthetime, Network (CPN+). training andamedia guide. for journalists for an educationstrategy HIV/AIDS andways toavoid with calls AIDS for 2006to2010. to ehensive andMultisectorResponse the NationalStrategicPlanfor a develops National AIDSAuthority The 2005 estimate of2.6perce Theprevious showing falseresults. downwards following qualitycontrols Estimates for previous years are revised HIV prevalence hasdropped to1.9percent. The NCHADSsurvey for 2003shows that journalists. news aswell astoolsandresources for Center withbreaking andembargoed The World Banklaunchesan AIDS Media sometimes. while anotherthird only usecondoms sexually-active youths never usecondoms 11 to18findsthatathird ofthecountry's from Risk Behavior Survey ofyoung people ofEducation'sNational The Ministry Youth sex workers. drug tenofovir following objectionsfrom a controversial trialoftheanti-retroviral to Prime MinisterHunSenintervenes andUNDP.Authority,TVK withtheNational partnership AIDS the andMediaForum forArts Life in journalists travel toSihanoukvillefor and more than100artists the epidemic, To develop amore effective response to tisadjustedto2.1. nt Compr- 2002 HIV/ halt for DiseaseControlGlobalAIDSProgramin2001 Sources: CambodiafiguresareNCHADSestimatesfor 2003andotherfiguresareUNAIDSfortheendofexcept for 2005.Allestimatesarerounded. HIV/AIDS innumbers 15,000,000 17,500,000 25,000,000 25,800,000 40,300,000 2,300,000 3,100,000 5,100,000 5,300,000 8,300,000 123,000 220,000 330,000 570,000 840,000 17,900 19,800 20,000 55,000 57,000 66,000 1,700 7,300 6,400 22 49 (2) estimate byNationalAIDSAuthority Cambodian adultsinfected by HIVevery day Cambodians dyingfrom AIDS every day Newly-infected Cambodianmenin2003 Cambodian children withHIV Newly-infected Cambodianwomen in2003 Cambodian AIDS deathsin2003 Cambodians with AIDS Cambodian menbuyingsexeachday Cambodian orphansdueto AIDS Cambodian women withHIV Cambodian menwithHIV Cambodians withHIV Vietnamese withHIV Burmese withHIV Thais withHIV Chinese withHIV Children worldwide withHIV deaths Global AIDS Indians withHIV South Africans withHIV Asians withHIV Orphans dueto AIDS Women withHIV Global AIDS deathssince1981 Africans withHIV People worldwide withHIV (3) NCHADS projectionfor2004and (3) (4) (1) (2) (1) 2001 estimatebyCenters (4) UNAIDS estimate SECTION 1 HIV/AIDS IN NUMBERS 16 Number ofpeoplewithHIV (2) (1) Source: UNAIDS,July2005 Figures don'tnecessarilycorrespond withNCHADSestimatesfor15to49year oldsin2003 South andSoutheastAsia, NortheastAsiaandOceania Children Adults Global estimates Caribbean North Africa +Middle East Western Europe America North Eastern Europe +Central Asia Latin America Brunei Mongolia Fiji New Zealand Hong Kong Sri Lanka Singapore South Korea Philippines Japan Australia Papua New Guinea Iran Nepal Pakistan Cambodia Myanmar China India Asia-Pacific Africa Adults andchildren (2) (1) End 2003estimate 35,700,000 37,800,000 25,800,000 2,100,000 1,000,000 1,300,000 1,600,000 5,100,000 8,300,000 430,000 480,000 580,000 110,000 170,000 220,000 330,000 570,000 840,000 12,000 14,000 16,000 31,000 52,000 61,000 74,000 1,400 1,700 2,600 3,500 4,100 8,300 9,000 <200 <500 600 End 2001estimate 32,900,000 34,900,000 23,800,000 2,000,000 3,970,000 6,604,000 1,400,000 400,000 340,000 540,000 950,000 890,000 110,000 170,000 150,000 280,000 630,000 660,000 12,000 12,000 10,000 18,000 42,000 45,000 63,000 1,200 2,700 2,200 3,400 5,600 4,400 <200 <200 <500 800 Rate ofadultHIVinfection(%) (3) (2) (1) Source: UNAIDS,July2004,exceptCambodiawhichisfromNCHADS,December2004 Northeast AsiacomprisesChina,HongKong,Japan,NorthKorea,SouthMongolia Oceania comprisesAustralia,Fiji,NewZealandandPapuaGuinea except PapuaNewGuineawhichwas0.6percent(0.4in2001) otes sa SouthAsia , Caribbean Africa 15 to49yearolds Global estimates Asia Northeast Oceania North Africa +Middle East, Western Europe North America Eastern Europe +Central Asia Latin America Rest of Asia-Pacific Singapore Vietnam Malaysia Nepal India Myanmar Thailand Cambodia (3) (2) SECTION 1 BASIC QUESTIONS 18 (2) (1) Number ofpeoplewhohavediedfromAIDS-relatedillnesses Source: UNAIDS,July2004 Figures don'tnecessarilycorrespondwithNCHADSestimatesfor15to49year-oldsin2003 South andSoutheastAsia,NortheastAsiaOceania Global estimates Western Europe North America North Africa +Middle East Caribbean Eastern Europe +Central Asia Latin America Rest of Asia-Pacific Bangladesh India Malaysia Indonesia Nepal Pakistan Vietnam Cambodia Myanmar China Thailand Asia-Pacific Africa Adults andchildren (2) (1) 2003 estimate 2,900,000 2,200,000 505,000 <1,000 16,000 24,000 35,000 49,000 84,000 15,000 20,000 44,000 58,000 6,000 2,000 2,400 3,100 4,900 9,000 ...... 2001 estimate 2,500,000 1,900,000 421,000 16,000 17,000 32,000 31,000 63,000 13,000 14,000 30,000 58,000 6,000 1,500 2,000 3,900 5,000 ...... 600 lo,smn pre-ejaculate semen, Blood, What transmitsHIV? but canalsobereduced. Sideeffects canbeserious bloodstream. reduce theamountofvirusin three typesofanti-retroviral drugscan Combinationsofatleast from replicating. Drugs thatprevent retroviruses like HIV drugs? What areanti-retroviral herpes, meningitis, pneumonia, tuberculosis, including HIV-positive peoplecanget, viraland fungalinfections which Bacterial, infections? What areopportunistic virus whoare nottreated. eventually develop inpeoplewiththe infections that known asopportunistic A collectionofsymptomsandillnesses Acquired Immune DeficiencySyndrome. What isAIDS? system. ofthebody'simmuneare anintegralpart that causes AIDS by destroying cellsthat Human Immunodeficiency virus Virus.The What isHIV? WHAT? a year. thrush andchronic diarrhea. vaginalfluids , WHO? A 19-year-old man before surgery in France. Using a condom properly during sex. WHERE? BASIC QUESTIONS Who gets HIV? Who is in charge of dealing with HIV/AIDS in Anyone. HIV can be transmitted through Where does HIV enter the the blood, semen, pre-ejaculate, vaginal fluid Cambodia? body during sex? or breast milk of an HIV-positive person. The National AIDS Authority, an apex Through the mucous linings of the vagina, Who gets AIDS? body comprising 26 ministries, leads the "multi-sectored" response to HIV/AIDS. vulva, penis and anus. If there are open HIV-positive people whose immune The Ministry of Health's National Center sores, HIV can also enter the body systems have been so damaged over the for HIV/AIDS, Dermatology and Sexually- through the mouth but this is much less years that they become susceptible to a Transmitted Diseases (NCHADS) is likely. wide range of infections. responsible for government surveillance,

SECTION 1 prevention, treatment and care. Where does HIV attack? Who discovered HIV? Who is protected from HIV targets cells known as CD4+ cells, an French doctor Luc Montagnier, who iso- discrimination under integral part of the body's immune lated the virus that causes AIDS in 1983, system. The virus replicates inside these and American doctor Robert Gallo, who Cambodian law? cells, destroying them in the process. did so in 1984. All people known or suspected of being Where are the highest rates Who adopted the infected with HIV/AIDS and their families. of HIV prevalence in Asia? term AIDS? Who can get anti-retroviral drugs in Cambodia? Cambodia (1.9 percent, or about 123,000 The Centers for Disease Control in Atlanta people between 15 and 49 in 2003) in 1982 following an increase in cases of people with various infections linked to The two government requirements are a followed by Thailand (1.5 percent in 2003) immune deficiency. CD4 cell count of less than 200 cells per and Myanmar (1.2 percent in 2003). microliter and compliance with supervised Who was the first record- medical treatment. Where do Cambodians ed Who is bearing the brunt of buy condoms? person to die from AIDS? new HIV infections At pharmacies, service stations, super- A Haitian-born sailor who died of pneu- markets and brothels. monia in New York in 1959 (blood samples in Cambodia today? related to this case were only tested for Wives of infected husbands and children Where are the most people HIV in 1986). of infected mothers.The NCHADS survey with HIV in Asia? in 2003 showed an estimated 6,400 Who was the first women becoming infected with HIV every India (an estimated 5.1 million adults and Cambodian diagnosed with year, primarily from their husbands. New children in 2003) followed by China HIV? infections among men were about 1,700 (840,000 adults and children) and Thailand (570,000 adults and children). Where are the highest rates of HIV infection in the world?

20 and clinics with programs supported by Diseases Center with the National AIDS prohibiting all discrimination with penalties non-government organizations. Program launched five years earlier. of up to six months in jail and fines of up

BASIC QUESTIONS WHEN? to one million riel. When was the National WHY? When did the global AIDS Authority Why are women more HIV/AIDS epidemic start? established? biologically susceptible to In 1979, when doctors began seeing the In 1999, when it was decided to broaden HIV than men? first unexplained cases of bacterial, viral the government's response from the and fungal infections in New York and San Ministry of Health to a "multi-sectored" Women have a greater area of mucous approach involving all ministries. Francisco. By the end of 1981, America membrane exposed than men. In addition, sexually-transmitted diseases, which had an estimated 270 cases of the When did Cambodia set SECTION 1 enhance the ability of HIV to penetrate mysterious illness. targets for reducing HIV the body,are more likely to go undiagnosed When were anti-retroviral prevalence? in women than in men. Even without such infections, UNAIDS says HIV transmission drugs developed to treat In 2001, when it joined other countries in during sex is believed to be about twice people with HIV? adopting a declaration at the United as likely for women than men. Nations General Assembly Special Session In 1986, when American doctors anno- on HIV/AIDS. Commitments include Why are younger women unced that a drug initially developed for reducing HIV prevalence among young more susceptible to HIV cancer seemed to benefit people with HIV. people and infants as well as implementing than older women? More effective drugs emerged in 1996, strategies to support children affected by leading to the combinations of drugs that AIDS by 2005. The genital tracts of women under 20 are are widely used today. less developed and more prone to infection, When did ASEAN leaders increasing the likelihood of HIV transmission When was HIV first address problems of people during sex. detected in Cambodia? with HIV/AIDS? Why don't anti-retroviral In 1991, during screening of donated blood. In 2001, when they adopted a declaration drugs cure HIV/AIDS? promoting the creation of a positive envi- The first recorded people infected were Three classes of drugs inhibit HIV from diagnosed in 1993, the same year the ronment to confront stigma, silence and denial surrounding HIV/AIDS. Leaders also replicating. But the virus still remains inside National AIDS Program was set up. agreed to promote the elimination of dis- the body even if it falls to very low levels crimination. and can rise again to dangerous levels When was the National if treatment is stopped or becomes Center for HIV/AIDS, When was discrimination ineffective due to mutations of the virus. Dermatology and Sexually- against people with Why is it so difficult to Transmitted Diseases HIV/AIDS outlawed in develop a vaccine to (NCHADS) set up? Cambodia? prevent HIV infection? In 1998, when the Ministry of Health In 2002, when the Law on the Prevention HIV incorporates its own genetic material merged the National Sexually-Transmitted and Control of HIV/AIDS was passed, into the immune system itself. The virus also mutates rapidly and has about 10

22 print media allows fraudulent advertisers Under the Millennium Development to claim they had traditional medicines to Goals, the proportion of those getting cure HIV/AIDS. anti-retroviral combination therapy is BASIC QUESTIONS HOW? targeted to reach 25 percent of people with advanced HIV infection by 2005, up How is HIV transmitted? from three percent in 2002. Further targets are 60 percent by 2010 and 75 Through unprotected sex, from mother percent by 2015. Additional targets from HIV/AIDS AND to child including breast feeding, and through UNAIDS indicate that 25 percent of AIDS unsafe medical and other procedures involv- patients will be receiving anti-retroviral ing infected blood ranging from blood treatment in 2006, rising to 44 percent in THE MEDIA transfusions to sharing needles. 2007 and 53 percent in 2008. 2.

SECTION 1 How is HIV most How many orphans due to commonly transmitted in AIDS is Cambodia projected Cambodia? to have in 2010? From infected husbands to their wives. 142,000, according to a joint report by UNAIDS, UNICEF and USAID in 2002. How much do anti-retrovi- ral How much grant aid has drugs cost in Cambodia? HIV/AIDSbeen approved for Usually between 10 dollars and 70 dollars in Cambodia under the a month but sometimes free, depending on the source. Global Fund to Fight AIDS, Tuberculosis and Malaria, How many Cambodians since it was set up in 2002? with HIV are receiving anti- retroviral drugs? More than 25 million dollars as of August Helper T-cells express the CD4 antigen. HIV enters 2004 (11.2 million dollars in the first cells by binding to CD4. Helper T-cells are known More than 8,500 people as of mid 2005, round, 5.4 million dollars in the second colloquially as CD4 cells. A healthy individual according to the National AIDS Authority, round, nothing in the third round and 8.8 normally has between 500 and 1,500 helper T-cells up from 1,700 in 2003 and an estimated million dollars in the fourth round). per cubic millimeter of plasma. 250 in 2002. Picture and text: Boehringer Ingleheim How many Cambodians ingare expected to be receiv- anti-retroviral drugs by 2015?

24 HIV/AIDS AND THE MEDIA HIV/AIDS AND THE MEDIA

n South Africa, which had more than Full and active participation five million people with HIV in 2003, Speaking openly Unique position Ilocal editors see the media as a In 2001, however, Prime Minister Hun Sen "powerful tool" in the fight against AIDS. and nine other ASEAN leaders specifically "We are the new generation and we are The global HIV/AIDS epidemic is a major For the London-based Science and Deve- mentioned the media in their first ever allowed to speak openly about HIV/AIDS international crisis that threatens the lopment Network of journalists and summit on HIV/AIDS. Meeting in Brunei, and our sexual needs. Things are changing" health, security and economic well- being of all nations. We further recognize SECTION 2 scientists, media have a "vital role" in the ASEAN leaders called for the "full and CTN film director and former Rasmei educating people about the epidemic and active participation" of the media and that the world's media are in a unique Kampuchea reporter Poan Phoung reducing stigmatization and discrimination other groups in responding to the epidemic. position to help fight the AIDS epidemic. Bopha against those affected. In Senegal, the They also called for the "elimination of Through its extensive reach, the media African Women's Media Center sees discrimination" against people with HIV/ can be used as a powerful force for journalists as an "essential part" of the AIDS and the "creation of a positive educating and informing the public The sponsors found that the media were solution to the problems caused by the environment in confronting stigma, silence about the HIV/AIDS epidemic. We there- an "often overlooked and under-utilized epidemic in Africa, which had an estimated and denial." Cambodian lawmakers went fore resolve through our companies to resource" in the fight against HIV/AIDS. 25 million people with HIV at the end of even further. The Law on the Prevention expand public knowledge and under- They also estimated that greater access 2003. In these and other countries, and Control of HIV/AIDS passed in 2002 standing about HIV/AIDS. to prevention and education could stem journalists have in recent years developed prohibits "all kinds of discrimination as much as two thirds of the 45 million statement by senior executives of media guides to meet the growing against those persons suspected or known new HIV infections projected to occur in 22 media global organizations demands of reporters covering a very big to be infected or affected by HIV/AIDS", the next decade.The broadcasters agreed meeting with UN Secretary General and increasingly complex story. including family members, and includes that the world's media were in a "unique Kofi Annan in New York on January penalties for violators.The law also mentions position" to help fight the epidemic and 15, 2004 Until this guide was developed, no such the media's role in raising public awareness could be used as a "powerful force" for tool was available in Cambodia, which has of the epidemic. had the highest rate of HIV prevalence in education and information. Broadcasters Asia for many years. In its absence, That role is now recognized by the global that took part in the media summit concern" that levels of understanding of Cambodian reporting on HIV/AIDS has media industry itself. In early 2004, included TVK affiliates such as Japan HIV/AIDS and ways to avoid infection been guided by 11 "primary principles" of top executives of 22 broadcasters met Broadcasting Corp. (NHK) and China were "still woefully low" and called for an ethical standards outlined in the Press with United Nations Secretary General Central Television (CCTV), as well as education strategy for journalists with Law of 1995.These include respect for the Kofi Annan in New York.The meeting -- Gazprom-Media which operates Russia's training and a media guide. The Brussels- truth and individual privacy as well as sponsored by the Joint United Nations popular NTV network, another TVK affiliate. based federation, which had two refraining from publishing information Programme on HIV/AIDS (UNAIDS), the Other media companies included Hong Cambodian journalist associations as which incites discrimination against anyone United Nations Department of Public Kong's Phoenix Satellite Television, the BBC members in 2004, also called for the based on their social status, although there Information and the Kaiser Family Foun- and TV5 from France. introduction of a prize for excellence in is no specific reference to people with dation, with additional support from the HIV/AIDS reporting and the development The International Federation of Journalists HIV/AIDS. Bill and Melinda Gates Foundation -- gave of a forum of media experts. (IFJ) welcomed the initiative at its annual birth to what is now known as the Global congress in Athens in May 2004, offering to Media AIDS Initiative. As part of the UN media initiative, the work in partnership with UNAIDS to World Bank launched in late 2004 an expand the initiative to include print AIDS Media Center (www.aidsmedia.org) media.The congress expressed "profound in partnership with the Kaiser Foundation

26 HIV/AIDS AND THE MEDIA 27 and others including Panos, a non-profit With the highest rate of HIV infection in make HIV/AIDS become a banal issue, Press Law. Among the basic ethical principles media organization with nine offices, mostly Asia, media in Cambodia have played an thus provoking indifference from the that journalists are supposed to follow are in Africa and Asia. The website portal important role in HIV prevention as initial community," the study said. The authors "respect for truth ... good faith ... a sense of includes breaking and embargoed news as sensationalist reports of a frightening urged journalists to show greater respect justice ... (and) fair methods to obtain

HIV/AIDS AND THE MEDIA well as tools and resources for journalists. new virus gave way to more informative for the dignity of people with HIV/AIDS news, photographs and documents." The To ensure exclusive access by credentialed reporting. In 1997, for example, Rasmei and to explain and analyze the key concepts media are also supposed to "retract any media, some parts of the site are password Kampuchea spearheaded a Sunday series of gender bias, stigmatization and ethics. published information that is imprecise protected.Among other initiatives, CCTV of articles on HIV with a special question- But the study also recognized that "those and leads to a misunderstanding."Another and MTV have formed a partnership in and-answer section for readers. concepts are not grasped by the majority principle is to "avoid publishing information China with MTV planning a Chinese- of Cambodians.". which incites discrimination on the basis language version of its Staying Alive website of race, color,sex, language, belief, religion, (www.staying-alive.org), a global youth Number one political opinion or tendency, national or education campaign. Ethics and other aspects of social origin, wealth or other social status". SECTION 2 AIDS is the number one issue on the the Cambodian press law Journalists are also suposed to "strictly During the International AIDS Conference world today ... It's the worst health crisis respect Khmer grammar" and refrain in Bangkok in 2004, UNAIDS executive in at least six, seven centuries. And it isn't The ethical framework for journalists in from publishing "obscene" or "graphically- director Peter Piot said the media com- only a health crisis. The media are finally Cambodia is set out in Article 7 of the violent" material. panies that attended the January summit paying attention to this. made four commitments including devoting Forms of "grave professional abuse" include more space to reporting HIV/AIDS. Piot Richard Holbrooke, president of Sources for new stories "acceptance of a bribe in any form" and said they were also committed to offering the Global Business Coalition on writing that creates an "unjust suspicion both space and time for public announce- HIV/AIDS An excellent source of new stories and among readers about any individual or ments, including HIV/AIDS in popular reports is HIV/AIDS research, a vast and party." In addition to defamatory statements, programs and helping small media outlets important enterprise that strives to Article 10 stipulates that a person has the which don't have the means to produce right to sue a publisher for "humiliation But for the Cambodian media as a whole, improve understanding of HIV/AIDS material themselves. "I frankly don't know which harms his or her honor or dignity", there is clearly scope for more balanced and to create new tools and strategies of any single country that has been and accurate reporting. A three-month for HIV/AIDS prevention, treatment and successful in the fight against AIDS without study of print media published in 2004, for care ... Yet many journalists and other a very big awareness campaign and with a example, found that HIV/AIDS reporting communicators shy away from reporting Good science writers constant engagement of media and other focused on prevention and care. Little about HIV/AIDS research because they information channels," Piot said. A detailed knowledge of science is not space was devoted to stories on infected fear they will not understand its jargon, necessarily the most important requirement. women or discrimination. The study also concepts and processes, or because they Most editors agree that the formula for a found that reporting was often sensationalist are hampered by a lack of accessible infor- Good news, bad news good science writer is 80 per cent good or voyeuristic, with little respect for the mation and resources. As with any form journalism plus 20 percent aptitude to In Cambodia, awareness of HIV prevention dignity of people living with HIV/AIDS of science reporting, the most important learn and communicate science. is relatively high. As part of the Global who were usually depicted as victims or qualities to have for effective HIV/AIDS communication are enthusiasm and Media AIDS Initiative, UNAIDS published objects of sympathy. How to Become a Science curiosity rather than a detailed knowledge a table in early 2004 ranking 29 countries Journalist, Science and The study, commissioned by the POLICY of the subject. according to young women's knowledge Development Network of ways to prevent infection.The good news Project, concluded that the print media was that Cambodia ranked third,well ahead exaggerated the vulnerability of Cambodians HIV/Journalism and Communication with HIV/AIDS and stereotyped them as Skills developed by the London- of many more developed countries. The with penalties of up to five million riel. depressed and despairing people. "By over- based Science Development Network bad news was that half the Cambodian Similar penalties apply to false advertising dramatizing the situation, the print media with TV Padma of Panos India respondents did not know how to avoid and publishing material that either incites the virus.

28 HIV/AIDS AND THE MEDIA 29 people to violence or "affects the good customs of society" (see next Section). Allowances

But good press laws don't necessarily make Journalists should not expect, request, or

HIV/AIDS AND THE MEDIA good journalists. Laurie Garrett, a Pulitzer accept payment for attending meetings, Prize-winning medical and science writer workshops, or conferences; the expecta- for Newsday in the United States, told the tion of an allowance should not be the International AIDS Conference in Durban factor that motivates a journalist to in 2000 that journalists should "grow up'' attend such forums. in their reporting of HIV/AIDS. "It's high LANGUAGE time for all of us, North and South, to Reporting on HIVAIDS in Africa, 3. stop simply saying, 'It's sad. It's pathetic. African Women's Media Center The numbers are huge. It's getting worse.

SECTION 2 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."

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

f the global struggle against HIV/AIDS journalists, especially when expressions English lexicon in recent years. The UN is a "battle," journalists are on the "front like "battle against AIDS" can be found in "Innocent victims" had official French, Spanish and Russian line" in shaping public opinion world- dictionaries. Moreover, the word "surveil- translations for these unwieldy terms as I "I remember talking to a positive person wide.With one of the highest rates of HIV lance" is used by NCHADS when monitoring of 2004. But the is already in one Pacific Island country many years prevalence in Asia, Cambodia is very much the Cambodian groups it considers most littered with too many words borrowed ago who was adamant that he was a on the front line.These military terms are at risk of HIV infection. from English that people don't understand. SECTION 3 victim. He explained that neither his used intentionally to highlight some of the At the same time, some terms have become family, the Ministry of Health, schools This media guide will therefore use sensitive language issues surrounding HIV/ etc provided him with the necessary contemporary terms that are widely used AIDS. almost universally unacceptable such as "innocent victims", suggesting that some information to be able to protect himself. by Cambodian journalists or published in We can't talk about sex, they said. We Cambodian laws. The term "female sex According to the HIV-related language people are "guilty" for contracting HIV. can't talk about many things ... so how worker" (srey roksiplauphet), for example, policy of the United Nations Development Apart from possibly being defamatory, the do they expect us to learn? ‘The negli- has replaced "prostitute" (srey pessya) in Program (UNDP), "the appropriate use of discriminatory notion of innocence and guilt suggests that some people deserve to gence of society and the powers that be recent years. This is the same term used language respects the dignity and rights of be infected with HIV and that others don't. by preventing me (and many others) by NCHADS, which has been surveying all concerned." It also "avoids contributing Such language lacks objectivity, putting from getting accurate non judgmental certain groups of Cambodians and their to the stigmatization and rejection of journalists in the position of expressing an information makes me a victim’ , he told sexual behavior since 1994. While "sex the affected and assists in creating the opinion by judging who is innocent and who me. It made me recall that 'Nothing is worker" is also the preferred term in social changes required to overcome the is guilty rather than reporting the facts. more immoral than allowing our youth some English-speaking countries, media epidemic." Such policies are in keeping with Still,some argue that using the term innocent to die of ignorance'…. With so many of acceptance is by no means universal and the Press Law of 1995, which specifically victim is acceptable in certain circumstances. the positive people in the world being many journalists use the two words denied access to drugs, treatment, love, interchangeably. Even some sex workers mentions upholding people's dignity (sekdey- Cambodian terminology tlaythnou), and the Law on the Prevention a caring and supportive environment, call themselves prostitutes (notably the some of them (like my Pacific Island and Control of HIV/AIDS of 2002 which While these are some of the language Cambodian Prostitutes Union). But the friend) have every right to feel that they devotes an entire chapter to discrimination. issues that journalists writing about HIV/ term "prostitution" (pessyakam) is usually are victims." AIDS have had to deal with internationally used in the pejorative sense, especially in Some experts say that military terms like reference to human trafficking. This is over the past 20 years, the Cambodian unidentified Fijian on the Australian "battle", "fight", "war", "combat", "campaign", print media faces an additional challenge. in keeping with the spirit of Article 46 Federation of AIDS Organizations of the Cambodian constitution which "control" and "surveillance" should not be Under the law of 1995, the press is prohibited website used as they are divisive and prejudicial. from publishing anything that "affects the prohibits "running a business in the field The UNDP policy also says that it's "better" good customs of society" including words of prostitution" (thveu ajivakam pnai without mentioning either if the language used is "drawn from the that are rude (assourous) or explicitly pesseyakam) The authors of this media guide have no prostitutes or sex workers. vocabulary of peace and human development describe sexual acts. Although violations intention of trying to determine what words carry penalties of up to five million riel, rather than from the vocabulary of war." are rude under the law. That's the job To distinguish between the Human some newspapers have openly flouted the But this is not consistently applied, even of Cambodian courts. This media guide Immunodeficiency Virus and the Acquired legal prohibition on rude language with at will also avoid some of the cumbersome among international organizations. More- Immune Deficiency Syndrome, the terms over, it may not be practical for working least one minority group stigmatized for language that has been creeping into many years. used are merok eith ("AIDS virus") for HIV

32 LANGUAGE 33 and chumngeou eith ("AIDS disease") LANGUAGE for AIDS. These are the same terms Appropriate language is constructive, used in the HIV/AIDS law of 2002, which does not fuel stereotypes, and does not also refers to "people with HIV/AIDS" cause prejudice. There are three main (neah min merok eith/neah min chumngeou points to consider about language: eith). These are preferred to the highly- 1. It is essential to use language appro- ambiguous "catch AIDS" (geut eith) which priate to the journalist's audience. should be avoided as it fails to distinguish The use of language is not just the between people who have merely been question of whether to use a local FACTS infected by the virus and those who get sick dialect, but how to phrase concepts, 4. with a related disease such as tuberculosis. and what type of vocabulary to use.

SECTION 3 To find the appropriate language, a To avoid confusion, abbreviations and journalist needs to build her/his acronyms will be used sparingly in this understanding of their audience, guide and mainly confined to medical or and to become "fluent" in HIV/AIDS pharmaceutical terms where necessary. terminology. The responsibility to tell journalists what 2. Language has strong influence on language to use rests with individual attitudes toward HIV/AIDS and people editors. This guide will, however, signal affected by HIV/AIDS. It can be preferred terms and misleading terms to damaging or it can be non- judgmental, be avoided if possible. It will also highlight positive, and constructive. Good any terms that may cause offense as well media coverage of HIV/AIDS uses as other terms that are simply inaccurate. neutral, gender-sensitive language.

3. HIV/AIDS involves highly technical terminology. It is imperative for Shaping attitudes journalists to "translate" this termi- nology into ideas and terms that their In the presence of inadequate therapy, such as monotherapy or Stigma, prejudices, fear, and misconcep- partially suppressive therapy, resistant viral strains (green, purple) tions surrounding HIV/AIDS are only too audiences can readily understand. It is also crucial to ensure that the develop. The rapid replication of HIV and its high mutation rate abundant. The language we use to mean that mutant strains with different attributes, e.g. drug conceptualize and talk about HIV/AIDS language used in stories is accurate. resistance, emerge very quickly. Drug resistance may develop reflects our personal biases and particular Good journalism requires journalists within a few weeks or several months. If a drug resistant viral understanding (or lack of understanding). to understand the facts about HIV/ strain develops in the presence of inadequate therapy, it will At the same time, this language also AIDS, and to get these across to their have a growth advantage over the other strains and quickly helps shape our own and others' attitudes audiences in ways the audiences become one of the dominant strains in the population. Rapid about HIV/AIDS. One cannot overem- can understand. phasize, therefore, the ethical importance ‘outgrowth’ of the resistant strain leads to drug failure. Reporting on HIVAIDS in Africa, of the media using appropriate language Picture and text: Boehringer Ingleheim African Women's Media Center when covering HIV/AIDS.

34 FACTS FACTS

HIV and Vietnam (see HIV strains in glossary of Cambodians with HIV terms). HIV stands for Human Immunodeficiency Estimated number of people aged 15-49 living HIV was first detected in the blood Virus, the virus that causes AIDS by with HIV/AIDS, 1990-2003, Cambodia destroying cells integral to the body's supply in Cambodia in 1991, and doctors diagnosed the first HIV cases in 1993. For 180,000

SECTION 4 immune system. Infection occurs through 158,300 158,900 155,900 147,300 149,900 intimate contact when blood, semen, many years, Cambodia has had the highest 160,000 142,100 132,900 pre-ejaculate, vaginal fluids or breast milk rate of infection in Asia. But with reduced 140,000 Total 120,600 123,100 Men carrying HIV enters the bloodstream of risk behavior and increased numbers of 120,000 101,900 102,500 99,100 deaths in recent years, NCHADS figures Women 95,700 92,700 an uninfected person.Various types of HIV 100,000 85,600 81,100 84,600 tests can confirm infection. The most show that HIV prevalence has fallen from 75,200 80,000 65,600 60,800 common test looks for the presence of an estimated 3.0 percent of all adults in Number 1997 to 1.9 percent in 2003.The estimated 60,000 45,700 antibodies that usually develop within three 56,400 56,400 56,800 57,200 57,500 57,700 57,500 51,600 40,000 33,700 months. number of adults infected dropped from 18,700 39,500 20,000 more than 158,000 to 123,000 in the 1,150 4,300 24,800 12,000 The virus was isolated by French doctors same period, with the number of new 0 in 1983 and American doctors in 1984 infections running at an estimated 8,000 a 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 using blood samples from western Africa. year in 2003. In terms of the number of Ye a r Source: NCHADS 2004 HIV is a type of virus known as a retrovirus infections in Asia, UNAIDS figures for the which means it stores genetic information end of 2003 showed Cambodia ranking differently from common viruses that sixth behind India, China, Myanmar,Thailand Gender distribution cause colds, chicken pox or measles. It is and Vietnam. also a lentivirus which means that it is Gender distribution of people currently living with HIV/AIDS, slow-acting -- like a similar virus that affects 1997-2003, Cambodia monkeys (Simian Immunodeficiency Virus). Transmission 100% For this reason, many people with HIV The ability of HIV to survive outside of can remain healthy for more than 10 years 90% the human body is very limited.As a result, 80% without treatment. In Cambodia, people the virus can only be spread through 70% with HIV usually remain healthy for shorter unprotected sex, from mother to child 60% periods of between four to six years due including breastfeeding and unsafe Men 50% to various factors such as poor nutrition. procedures involving infected blood. Women Viruses that spread through such intimate 40% Different HIV strains are associated with contact are called infectious viruses. In 30% different geographical areas and people. If other words, they are much harder to 20% a person is infected with more than one catch than contagious viruses like colds 10% strain, different parts can recombine into which are airborne. 0% a new form which can then be passed to 1997 1998 1999 2000 2001 2002 2003 others. New combinations of strains have Blood-borne transmission can occur during Source: NCHADS 2004 recently been reported in China,Thailand transfusions or through contaminated

36 FACTS 37 FACTS Transmission routes Myths razor blades or nail clippers is considered extremely unlikely, although sharing such HIV is primarily a blood-borne virus and items is not a good idea due to the possible Route of HIV Transmission over time in Cambodia is not contagious like air-borne viruses transmission of other viruses such as such as influenza or SARS. HIV cannot be Hepatitis C. 100% transmitted by saliva, sweat, tears or urine. So it cannot be spread by shaking hands, Seeds from the slaeng plant (a vine 80% coughing, sneezing or regular kissing. Nor related to strychnine) cannot "cure" AIDS. can it be transmitted by mosquitoes or Extramarital 60% Mother to child Sex worker Female from husband Cambodians with AIDS 40%

SECTION 4 Male from wife Male from sex worker 20% Estimated number of AIDS cases, 1990-2004, Cambodia

25000 0% 22575 22444 21855 1990 1995 2000 21497 Source: NCHADS 2004 Women Ye a r 20000 20087 Men 19814 To t a l 17298 14473 15000 14147 14103 13377 12974 13121 needles and syringes that often contain a 11456 AIDS 11470 10000 small amount of blood after injections. 9023 9096 8344 AIDS stands for Acquired Immune 8103 8342 8522 Needles used for tattoos or acupuncture 6966 7708 5085 6290 can transmit HIV if not sterilized. The Deficiency Syndrome, a collection of 5000 5841 3627 4281 symptoms and illnesses that eventually 2267 virus can also be spread through infected 2732 develop in HIV-positive people who do 1457 blood products, tissue and organs. 0 0 not receive treatment. People who develop 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Source: NCHADS 2004 In Cambodia, however,sexual transmission AIDS often have infections of the lung, has been the main cause of HIV infection. brain, eyes and other organs, and frequently During unprotected sex with an infected suffer debilitating weight loss. People with partner, HIV can enter the body through HIV do not necessarily have AIDS. But all sharing cups, glasses, forks, spoons, linings of the vagina, vulva, penis and anus. people with AIDS have HIV. Nor can lemon juice, although there has chopsticks, toilets or swimming pools. The presence of sexually-transmitted NCHADS has estimated that the number been some inconclusive evidence that a substance found in lemons can help to diseases increases the risk of transmission, of AIDS cases in Cambodia has fallen from Transmission through passionate kissing is especially for women. a peak of almost 23,000 in 2001 to less extremely rare -- the one noted case in prevent transmission of HIV. Grilled than 21,500 cases in 2003, projecting a the United States involved two people pineapple skins, sex with virgins and green Because of husbands infecting their wives, further decline to 19,800 in 2004. But the with severe dental disease which allowed bean porridge cannot cure AIDS either. mother-to-child transmission is a growing AIDS death toll has continued to climb, infected blood to pass from one person In Cambodia, false advertising of such source of HIV infection in Cambodia. An reaching a record of almost 17,900 deaths to the other. "cures" carries a penalty of up to one year infected mother can pass the virus to her in 2003 comprising more than 11,300 child during pregnancy or birth.The other men and more than 6,500 women. Separate As HIV has a limited ability to survive in jail under the HIV/AIDS law. Under route is through breast feeding -- even if estimates for 2001 indicated 55,000 outside the human body. Transmission the Press Law of 1995, false advertising the child is born without the virus. children orphaned by AIDS. through household items like toothbrushes, carries a penalty of up to one million riel.

38 FACTS 39 SECTION 4 FACTS 40 fluids orblood. no exchangeofsemen,pre-ejaculate,vaginal sexcanonly besafe ifthere is unknown, is if theHIVstatusofonepartners But there iszero riskofexposure toHIV. Ifthetwo sion. not exposedtoother in three monthsandwhoare otherwise who have bothtestedHIVnegative twice The safest sexisbetween two people delaying sexualinitiationamongyouth. andthisincludes sexual transmission, safest way toprotect againstHIVfrom Abstaining from sexualactivityisthe Sex andHIV atesremain faithful, partners modes oftransmis- also causecondomstobreak. based lubricantsweaken thelatexand can Oil- Lubricants must bewater-based. prevent breakages ofunlubricatedcondoms. additional lubricantissometimesusedto For maximum safety, before genital contact. completely andfailingtoputcondomson failingtounroll them each ejaculation, include failingtousenew condomsafter Commonproblems safe ifusedproperly. Butcondomsare only positive partner. transmission duringsexwithanHIV- Condoms are theonly way toprevent 5. cerebrospinal fluid. such asnevirapine andzidovudine have beenshown toenterthe include atleastonedrugwhichisable topenetratetheCNS. Drugs specialists believe thatcombinationsofanti-retroviral drugsshould the blood: brainbarrier and enter theCNS, however. Many HIV virus. Notalloftheavailable anti-retroviral drugsare able to cross the brain. The CNShasbeenshown tobeamajorreservoir ofthe HIV isable system(CNS), toinfect thecentralnervous including Picture and text: Boehringer Ingleheim DISCRIMINATION STIGMA AND STIGMA AND DISCRIMINATION STIGMA AND DISCRIMINATION tigma and discrimination strengthen Violating human rights social inequalities and prejudices, patient had died when it realized the Tarred by the same brush Sespecially those related to gender, patient's family had no more money. Discrimination is defined by UNAIDS as sexual orientation, economic status and an infringement of human rights that often "Stigma devalues and discredits people, race. Stigma associated with HIV/AIDS The patient, a father of five who tested leads to people being subjected to various generating shame and insecurity. In the continues to profoundly affect prevention HIV positive in early 2002, was admitted forms of abuse. In Cambodia, any discrim- context of AIDS, it can fuel the urge to to the unidentified hospital when he SECTION 5 efforts, leading people to deny risk, avoid ination in the workplace based on a person's scapegoat, blame or punish certain people testing, delay treatment and suffer needlessly. became seriously ill in 2003. actual, perceived or suspected HIV/AIDS (or groups) in order to detract from the fact that everyone is at risk. Stigma taps Within four days, by which time the status is prohibited under Article 36 of the into existing prejudices and patterns of family had exhausted its entire savings Law on the Prevention and Control of HIV/ Guilt by association exclusion and further marginalizes people of 300 dollars, the hospital said the man AIDS. Termination of employment on the who might already be more vulnerable UNAIDS defines stigma as a "multi-layered had died and had to be removed. same basis is unlawful. process of devaluation that tends to rein- to HIV/AIDS. It stems from the association force negative connotations by associating After arranging to have the body Other articles guarantee freedom of abode, of HIV/AIDS with sex, disease and death, HIV and AIDS with already-marginalized cremated, the family transported the lodging and travel and the right to seek and with behaviors that may be illegal, groups." The agency also notes that stigma body to a pagoda. But when the under- public office for people with HIV/AIDS forbidden or taboo such as pre and "lies at the root of discriminatory actions taker removed the shroud, it was found and prohibit discrimination by educational, extra-marital sex, sex work, sex between that exclude people who need AIDS-related that the man was not dead and could financial and health institutions.While the men and injecting drug use." services." still move his hands and open his eyes. law does not spell out penalties for dis- crimination in the workplace, first-time "Stigma ... prompts people to act in ways In Cambodia, sex workers and men who The family took the man to another violators of the other provisions face a that directly harm others and deny them have sex with men are among the margin- hospital where he received free treatment fine of up to one million riel and up to six services or entitlements -- actions that alized groups most affected by HIV/AIDS. take the form of HIV-related discrimination. before dying four days later. months in jail. Injection drug users are another group on Such unjust treatment can be tantamount the margins of Cambodian society,although The stigma associated with HIV/AIDS is Despite these provisions under Cambodian to a violation of human rights." their numbers are believed to be small one of the greatest obstacles to law, stigma and discrimination persist. and their role in the epidemic has so far UNAIDS Epidemic Update, 2003 Cambodians living with the virus. It is People with HIV/AIDS are often blamed not been significant compared with other also a major barrier to HIV programs -- for getting infected. Many people with HIV/ countries such as Vietnam and Malaysia. people who want to know their HIV AIDS are shunned by their families, ejected Rejection, hardship, status may be afraid to be tested out from homes and villages or abandoned at The case of the moving of embarrassment. It has even been health facilities where they are sometimes bankruptcy and corruption reported that some people are afraid to left to die. Many people running small corpse buy condoms out of fear of being businesses also suffer declines in customers, A report sent to the United Nations labeled as HIV carriers. One of the most striking cases recounted eroding income and sometimes forcing Office of the High Commissioner of Human Rights in 2004 included details of some of by the Cambodian Human Rights and The POLICY Project, HIV/AIDS and parents to withdraw their children from HIV/AIDS Network involved a Phnom Human Rights in Cambodia, 2005 school. Stigma and discrimination can the 80 cases of HIV/AIDS-related violations Penh hospital that falsely claimed a similarly affect families of people with of human rights recorded in Cambodia HIV/AIDS. since 2003.The Cambodian Human Rights

42 STIGMA AND DISCRIMINATION 43 and HIV/AIDS Network (CHRHAN) collected the information from seven Moral judgments provinces and municipalities. In 13 cases, people reported being ostracized or Making moral judgments based on how a person contracted HIV perpetuates rejected by their families or communities, stigma and promotes discrimination STIGMA AND DISCRIMINATION sometimes leading to extreme hardship. against (people living with HIV/AIDS) In 20 cases, people said they were shunned and people who are vulnerable to infection, when they began to show signs of illness and thereby undermines HIV prevention, or when there was a known or suspected treatment, care, and support work. DATA AIDS-related death in the family. A laundry Talking about those infected 'while having 6. and a manicure shop were among small sexual encounters during a drinking spree' and ascribing them guilt for this businesses that collapsed as a result of SECTION 5 doesn't help us understand how to association with HIV/AIDS. prevent HIV infections, nor does it help us care for and about people who are CHRHAN also reported violations of infected. human rights in the health care sector. In some cases, health facilities were refusing ... We should avoid easy conclusions. The to provide services for people with HIV/ phrase 'no human beings in their right AIDS. In others, health facilities charged thinking mind would want to contribute fees that limited access to services -- even to their own infection' makes the very though the HIV/AIDS law of 2002 states complex reasons why we have sex or use that people with the virus are entitled to drugs seem so simple. But we know this free primary care in all public health facilities. is not the case. People smoke, and get lung cancer. Men and women have sex, and have unwanted pregnancies. Sometimes we think about the implica- tions of our actions, and other times not. This picture shows the struture of the Human Andy Quan, Australian Federation Immunodeficiency Virus (HIV). The outer shell of the of AIDS Organizations virus is known as the viral enevlope.

Picture and text: Boehringer Ingleheim

44 DATA DATA

he Ministry of Health has been promotion girls and karaoke hostesses HIV trend in direct sex workers overseeing a national surveillance who sell sex), male military personnel, Tsystem for HIV infection since married women of reproductive age, free- 1994 and for high-risk behavior since 1997. lance sex workers (including massage girls Adjusted HIV prevalence* among direct female sex workers, by age Based on the data collected, national esti- and bar girls), hospital inpatients and group, 1998-2003, Cambodia 50

SECTION 6 mates of HIV prevalence are made, along household males and females. 43.5 40.4 with estimates for the actual number of 40 people with HIV and the number of deaths The number of provinces and municipalities 41.3 34.2 surveyed rose from five in 1994 (Phnom 29.9 from AIDS. 30 32.2 Penh, Banteay Meanchey, Battambang, 24.8 Sihanoukville and Siem Reap) to 22 in 1997. Percent 20 24.1 HIV Sentinel Surveillance Since then, the number has fluctuated 19.7 20 years and older between 19 and 22. 10 NCHADS and its predecessor have been 7.8 <20 years surveying specific groups of people for In 2003, the HSS covered all provinces 0 HIV across Cambodia since 1994. These and municipalities except Kep and 1998 1999 2000 2001 2002 2003 groups are known as sentinel groups, which Mondolkiri. HIV prevalence rates were Ye a r means they are susceptible to an infection estimated at 20.8 percent for direct sex *Adjusted for results of quality assurance testing Source: NCHADS 2004 that is being monitored. Between 1994 workers, 11.7 percent for indirect sex and 2003,nine separate HIV Sentinel Surve- workers, 2.5 percent for policemen and illance (HSS) surveys covered 11 different 2.2 percent for pregnant women attending HIV trend in indirect sex workers groups.There was no survey in 2001 and ante-natal clinics. National prevalence was results of the ninth survey in late 2003 estimated at 1.9 percent.The 2003 survey were released at the end of 2004, showing performed quality controls on samples Adjusted HIV prevalence* among that Cambodia's rate of HIV prevalence going back to 1999. Researchers identified indirect female sex workers, 1996-2003, Cambodia was lower than previously estimated.The false results, both positive and negative, survey system is among the most developed in each group and adjusted the figures 50 in the world and is now in a phase known 42.8 accordingly. For 2002, for example, 39.1 40.0 38.0 as "second-generation surveillance" which Cambodia's national HIV prevalence was 40 could provide a wealth of information on 32.1 adjusted downwards from the previous 30 28.0 the dynamics of the epidemic. estimate of 2.6 percent to a revised 2.1 20.8

percent. Percent 20 Two groups -- direct female sex workers and policemen -- have been included in The number of blood samples taken in 10 every survey. Pregnant women attending the 2003 survey was 20,707 with pregnant 0 ante-natal clinics have been covered in women comprising the biggest sentinel 1996 1997 1998 1999 2000 2001 2002 2003 all but one of the surveys. Other groups group (10,867) followed by policemen Ye a r covered have been tuberculosis patients, (5,796), direct female sex workers (2,411) *Adjusted for results of quality assurance testing Source: NCHADS 2004 indirect female sex workers (beer- and indirect female sex workers (1,633).

46 DATA 47 SECTION 6 DATA 48 HIV trendinpolicemen HIV trendinpregnantwomen

Percent Percent 0 1 2 3 4 5 6 0.0 0.5 1.0 1.5 2.0 2.5 3.0 9619 9819 0020 022003 2002 2001 2000 1999 1998 1997 1996 4.3 9619 9819 0020 022003 2002 2001 2000 1999 1998 1997 1996 1.9 Adjusted, weighted data Adjusted, weighted data Adjusted HIVprevalence* amongpolice, Adjusted HIVprevalence* amongANC 2.3 4.5 women, 1996-2003, Cambodia 1996-2003, Cambodia 2.5 4.4 2.5 4.2 ear a Ye ear a Ye Adjusted, weighted datasmoothedwithEPP 2.5 Adjusted, weighted datasmoothedwithEPP 3.8 2.4 3.5 2.3 3.1 2.1 Source: NCHADS2004 2.7 Source: NCHADS2004 behavior. Cambodia are theseparatesurveys of changes intheriskofmaleinfection in has alsonotedthattheonly datatracking NCHADS on datafor pregnant women. large istomake indirect estimatesbased at HIV infection amongthemalepopulation of theonly way toestimatetherate result, Asa which itisdifficulttodraw conclusions. policeare anagingpopulationfrom 1993, of new policemore orlesssuspended recruitment group surveyed.Moreover,with was limitedaspolicewere theonly male estimating HIVprevalence amongmen NCHADS hadpreviously admittedthat be carried outbefore thenextsurvey. mended thatpilotsurveys ofthesegroups Italsorecom- and migrantpopulations. menwhohave sexwithmen drug users, the needfor dataonHIVprevalence among NCHADShighlighted For future surveys, however, itcovered five additional provinces In2003, Siem Reap andSihanoukville. PhnomPenh, KampongCham, Battambang, -- limited tofive provinces andmunicipalities the survey was Between 1997and2001, and householdmales. women whowork vocational students, surveyed over theyears have included Othergroups leaving four sentinelgroups. into onegroup withequal numbers, andpolicewere military merged in 2003, Inthesixthsurvey motorcycle taxidrivers. policemenand inthemilitary, serving men beerandkaraoke girls, sex workers, direct has covered five distinctgroups -- theBSS Since2001, carried outevery year. surveys have been exception of2002, Withthe of sentinelgroups in1997. surveying thebehaviorNCHADS started Survey Behavioral Surveillance since that knowledge ofHIV/AIDSwas"very found most comprehensive of itstype, the The survey, the agesof15and49. covered 15,351women between 2000, ofHealthin Planning andtheMinistry of conductedby theMinistry Survey, The CambodiaDemographic andHealth Survey Demographic Health girlfriends. the sexualriskswithboyfriends and for "innovative approaches" toaddress use ofcondomsincommercial sexand wereefforts neededtosustain thehigh NCHADSsaid included infuture surveys, In addition tocallingfor young mentobe girlfriends allthetime. policemen usedcondomswiththeir taxi drivers and26.4percent ofthe 30.7percent ofthemotorcycle military, only 37.6percent ofthe with girlfriends, Butamongthose motorcycle taxidrivers. personneland88.9percent formilitary 90.8percent for percent for policemen, condom usewithsexworkers was95.5 consistent Among themensurveyed, all thetime. girls usedcondomswiththeirboyfriends of beergirlsand41.7percent ofkaraoke 65.8percent percent ofthesexworkers, only 55.6 among thosewithboyfriends, But girls and81percent for karaoke girls. 81.7percent for beer female sexworkers, with clientswas95.1percent for direct showed thatconsistentcondomuse 2004, released inearly The results ofthesurvey, workers and947motorcycle taxidrivers). 1,308 direct sexworkers, andpolice, 2003 was4,858(1,351military in Takeo.The number ofpeoplesurveyed and Pursat Kratie, Kong, Koh -- Kampot, 1,252 indirect sex DATA 49 SECTION 6 DATA 50 Sex workersusingcondomswithclients o ei orpr bu I/IS A for aboutHIV/AIDS. mediatoreport At least90percent saiditwasacceptable AIDS orifitcouldbeavoided. percent eitherdidnotknow aboutHIV/ But24 someone whohaddiedof AIDS. Almost halfknew someonewithHIVor could betransmittedwhilegivingbirth. person couldhave HIVandthatthevirus 60 percent knew thatahealthy-looking More than pregnancy andbreast feeding. and thatHIVcouldbespread during condoms couldprevent HIVtransmission About 70percent ofallwomen knew that Kratie andBanteay Meanchey.Treng, Steung Preah Vihear, Ratanakiri, remote provinces suchasMondolkiri, But awareness was"significantly lower" in five percent hadheard aboutHIV/AIDS. Ninety- high" amongCambodianwomen. 100% 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% 9719 9920 2003 2001 1999 1998 1997 14.8 42 female groups,1997-2003,Cambodia Consistent condomusewithclients: 29.7 53.4 38.2 78.1 55.2 91.7 had heard aboutsuchinfections. than 40percent ofCambodianwomen ually-transmitted infections waslow -- less ofothersex- Speu andPursat.Awareness Kampong high inKampongChhnang, demand" for HIVtestingwasparticularly Such"unmet but hadnotyet beentested. respondents saidthey wantedanHIVtest and25percent ofall where togetatest, 84percent didnotknow been tested, Amongthosewhohadnot tested for HIV. Only three percent ofwomen hadbeen with HIVshouldbeallowed tokeep working. with AIDS butonly athird saidpeople sick they were willingtocare for arelative More thanhalfsaid schools. in primary with 80percent approving suchdiscussion schoolstodiscusstheissue, for secondary similar proportion saiditwasacceptable DSW 84.4 96 BEER Source: NCHADS2003 Beer promotiongirlsusingcondoms Clients usingcondomswithsexworkers *Comdom usewithclientamongthoseclients; condomusewithsweetheartsamongthose 100% 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% 100% 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% 53.8 9719 9920 2003 2001 1999 1998 1997 65.6 43.3 8.2 14.8 1997 worker inpast3months,1997-2003,Cambodia Moto-taxi Sweethearts by typeofpartner*,1997-2003,Cambodia Consistent condomusewithsex 68.8 55.1 Beer girls:consistentcondomuse 9819 012003 2001 1999 1998 29.7 61.8 Military Military 19.3 Client 69.7 80.3 69.8 38.2 Police 26.1 55.2 88.8 83.9 37.4 87.0 89.4 94.2 86.9 49.0 84.4 Source: NCHADS2003 Source: NCHADS2003 DATA 51 SECTION 6 DATA 52 Men usingcondomswithgirlfriends 10% 15% 20% 25% 30% 35% 40% 45% 50% 0% 5% 14.5 11.4 sweethearts: bymalegroups,1997-2003,Cambodia 1997 0 Moto-taxi 10.3 Consistent condomusewith 1998 5.0 iiayPolice Military 10.6 32.4 9920 2003 2001 1999 12.8 27.8 29.8 44.4 26.5 41.2 27.3 25.0 Source: NCHADS2003 7. children worldwide. baby isthemajorcauseofHIVinfection in Perinatal transmissionofHIVfrom motherto Picture and text: Boehringer Ingleheim WOMEN

WOMEN WOMEN

CHADS estimates that women of new HIV infections in Cambodia, Biological susceptibility Social vulnerability account for almost half of the HIV NCHADS estimated the number of new Ncases in Cambodia and more than infections in women at 6,350 in 2003, Women are more physically susceptible In Cambodia, many decisions relating to a third of the AIDS deaths. almost four times higher than the 1,694 to HIV infection than men, and younger reproductive practices as well as sexual new infections in men and virtually women are more susceptible than older and "health-seeking" behavior are deter- Worldwide, women are more biologically SECTION 7 unchanged from 6,393 in 2002. women. Under a policy adopted in 2003, the mined by men.This limits women's ability susceptible to HIV than men because of to control their own bodies, increasing their physical makeup. In Cambodia and The survey estimated 6,544 new AIDS Ministry of Women's and Veterans Affairs recognized that women were up to four their vulnerability to HIV, sexually-trans- several other countries, women are also deaths among women in 2003, amounting mitted diseases and unwanted pregnancies. socially vulnerable to HIV because of the to 37 percent of all adult deaths from times more vulnerable to HIV infection than In its 2003 policy, the Ministry of Women's large numbers of husbands and boyfriends AIDS the same year. But the proportion men during unprotected sex. This is because and Veterans Affairs recognized that who infect their wives and girlfriends. of women developing AIDS was higher -- 40 of the larger surface areas exposed and domestic violence made women more vulnerable percent of all new cases among adults, retention of infected body fluids. HIV Sentinel Surveillance in 2003 indicated amounting to 8,522 women. Even though to HIV/AIDS. The policy also recognized that UNAIDS reckons transmission is about that about 57,500 women were HIV the number was projected to decline to Cambodian customs made it "inappropriate positive, amounting to 47 percent of all 8,344 in 2004, women's share of the total twice as likely in an uninfected woman for women to be knowledgeable about sexuality adults infected. With husband-to-wife was expected to climb even higher to reach having vaginal sex with an HIV-positive or to negotiate safe sex or condom use." man than an uninfected man having vaginal transmission emerging as the main source 42 percent of all adults developing AIDS. The National AIDS Authority has also noted that sex with an HIV-positive woman. the traditional code of conduct says women Women with HIV, new infections and AIDS deaths The chances of HIV infection are even are supposed to be "demure and obedient" higher if an uninfected woman has sores and "not too intelligent to argue with their or cuts in her vaginal wall, which are mostly husbands." This presents obstacles for HIV Estimated number of women aged 15-49 living with HIV, caused by sexually-transmitted diseases. prevention efforts. newly infected with HIV, and who died from AIDS, 1990-2003 Cambodia The National AIDS Authority (NAA) In its policy for HIV/AIDS and STI prevention reckons the presence of sexually-trans- and care adopted in 2001, the Ministry of Living with HIV (Prevalence) mitted diseases makes transmission up to Health noted that the risk of HIV trans- Deaths (Mortality) 10 times more likely. In addition to causing mission in Cambodia was fueled by "large 70,000 New HIV Infections (Incidence) open sores, such diseases bring immune numbers of both married and single men 60,000 cells to the site of the infection, enhancing who continued to buy large amounts of 50,000 the ability of HIV to enter the body. Due commercial sex." The ministry warned 40,000 to an absence of symptoms, women are that HIV infection among men throughout 30,000

Number unaware they have such diseases about Cambodia was already so high that the 20,000 half of the time. As a result, they are fre- virus was spreading to wives, girlfriends 10,000 quently left untreated. Teenage girls are and children, creating a "significant burden" 0 in terms of increased sickness and death. 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 particularly susceptible to HIV exposure The NAA has estimated that up to 20,000 Ye a r Source: NCHADS 2004 as their genital tracts are not fully developed and therefore more prone to infection. men buy sex every day in Cambodia.

54 WOMEN 55 WOMEN Mother-to-child mothers, a single dose of 200 milligrams is transmission recommended at the onset of labor or before a Caesarean. For new-born babies, HIV-positive mothers can pass the virus a single dose of oral nevirapine (two to infants during pregnancy or at birth, milligrams per kilogram) is recommended known as perinatal infection, as well as within 72 hours of birth. The consent of during breast feeding. Such mother to child the mother is required in both cases. transmission, also known as vertical CHILDREN AND transmission, can also occur if the mother The policy also requires HIV-positive is infected while breast feeding. In women to be informed about breast feeding low-income countries like Cambodia, and other feeding methods. Women YOUNG PEOPLE who are HIV-negative are supposed to be 8. UNAIDS estimates that the likelihood of SECTION 7 an infected mother passing the virus to informed about the importance of avoiding her newborn child is at least 30 percent. infection during pregnancy and breast In rich countries, however, HIV-positive feeding.The policy also recommends that mothers rarely transmit the virus to their infants born to HIV-positive mothers be children due to alternatives to breast tested at 18 months and that immunization feeding and the availability of Caesarian and preventive treatment for opportunistic deliveries as well as access to anti-retroviral infections be provided to the newborn. drugs. In addition, HIV-positive women and children are supposed to be "protected Under Cambodia's national policy on from stigmatization and discrimination." preventing mother-to-child transmission adopted in 2001, the Ministry of Health Under the Cambodian Millennium Devel- projected 1,000 new cases of children with opment Goals, 10 percent of HIV-infected HIV every year by 2000. pregnant women attending ante-natal clinics are targeted to receive a complete The policy recommends preventive course of anti-retroviral drugs by 2005, up treatment with the anti-retroviral drug from 2.7 percent in 2002.The target is 35 nevirapine where the full range of support percent for 2010, rising to 50 percent in The battle between the viral infection and services is available. For HIV-positive 2015. 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 NAIDS has estimated that benefit from such treatment are different vulnerable to sexual exploitation and drugs. be sent away from home. All of the children Cambodia had 7,300 children from those in adults, so different criteria Orphans can also be a burden on grand- surveyed had been exposed to high levels U under the age of 15 with HIV at are needed to determine if children are parents and other family members. In of stigma and psycho-social stress, with the end of 2003, up from 6,400 two years eligible for the drugs.The agency has also other cases, orphans can end up being girls being more vulnerable than boys. earlier. And the Ministry of Health has noted that treating children may be a low street children or heading households to forecast that about 1,000 children will go priority in families where several members avoid being separated from their siblings. Young people SECTION 8 on to develop AIDS every year by 2005. are HIV positive. Moreover, many HIV- The UN defines orphans as children who The number of children who have lost positive children have also lost their With young people under the age of 24 parents to AIDS was meanwhile estimated mothers to AIDS, making it difficult to have lost either one or both parents, the same definition used by the Chuon Nath accounting for half of the new HIV at 55,000 in 2001. Projections by UNAIDS, supervise treatment. infections in Cambodia, the focus of HIV UNICEF and USAID show the number of dictionary. The UN definition covers Even if they are not born with HIV,children children below the age of 18. prevention is moving towards adolescents orphans due to AIDS skyrocketing to and youth. To reduce the rate of new 142,000 by 2010 with HIV/AIDS accounting are still vulnerable to infection, especially The NAA says discrimination against infections among young Cambodians, the for one out of every four orphans. street children who are highly mobile and often separated from their families. children affected by AIDS is a "prime Ministry of Education, Youth and Sport A study cited by the National AIDS factor" that hinders their access to schools, developed a strategic plan for 2001 to 2005. Children with HIV Authority (NAA) found that due to their playgrounds and medical services resulting But while HIV/AIDS is addressed to some circumstances, street children were more in trauma exacerbated by the loss of parents. extent between Grades 5 and 12, the Newborn infants and children are mainly likely to sell sex and inject drugs than other Other problems include loss of identity, NAA has noted that there is "no link" infected by HIV during pregnancy, birth children. It also noted that street boys psychological stress, malnutrition, increased between lessons and that the capacity of or breast feeding. Without anti-retroviral tended to have both male and female demand for labor,loss of inheritance,forced teachers is limited. It says the lack of any drug treatment, children are especially sexual partners, increasing their risk of migration, homelessness, starvation and policy on sexual education is an "important vulnerable to HIV as their immune systems both contracting and transmitting the virus. crime. Children affected by HIV/AIDS also determinant" of young people's vulnera- break down much faster than adults with Sexually-exploited children, especially girls, risk being infected by the virus.The NAA bility. The NAA has also noted that the virus. Figures quoted by UNAIDS in are particularly vulnerable to HIV if they says the government is unable to help teenagers who start having sex at an early 2004 showed that at least 25 percent of are forced into sex work. children without extended families but age are more likely to have sex with high- newborns infected with HIV die before notes that some orphanages are receiving risk or multiple partners and less likely to turning one and that up to 60 percent die support from non-government organizations use condoms. before reaching their second birthday, Orphans and other to accept them. with most dead before they turn five. children affected by AIDS At the same time, the use of amphetamines Such deaths are expected to hamper One study found that about one in five appears to be growing among young people efforts to reduce Cambodia's under-five In addition to the tens of thousands of Cambodian children in AIDS-affected in Cambodia.The NAA has noted that the mortality rate, which at more than one in children orphaned by AIDS, many other families had to start working in the previous use of such drugs as well as alcohol have every 10 live births is already one of the children are living with family members six months. The study, by the Khmer been linked to risky behaviour. It has also highest in Asia. with HIV/AIDS. For orphans, which account HIV/AIDS NGO Alliance (KHANA) and noted that the movement of young people for about nine percent of all children in Family Health International, found that from rural to urban areas to find jobs or UNAIDS has noted that few anti-retroviral Cambodia, the NAA has noted that safety one in three had to provide care and take study can lead to risky sexual behavior, drug treatments are formulated for children. nets are poorly developed in Cambodia on major housework. Many had to leave and that single young migrant workers are Moreover, indications that a child might and that such children can be particularly school, go without food and clothing or more likely to have casual sex and less likely to use condoms.

58 CHILDREN AND YOUNG PEOPLE 59 PLE

Under the Cambodian Millennium Devel- sexually active boys and two percent of opment Goals, 85 percent of 15 to 24- the girls said they had been involved in year-olds are targeted to be reporting the forcing someone else to have sex. use of condoms during sex with a non- regular partner in 2005, up from 82 Twenty-four percent of young Cambodians were not aware of sexually-transmitted CHILDREN AND YOUNG PEO- percent in 2002. infections. Although 98 percent were aware of HIV/AIDS, only 67 percent had MEN AND Youth risk behavior heard of syphilis and only 38 percent had heard of chancroid. Less than five percent OLDER PEOPLE The Ministry of Education's National of all respondents had heard about genital 9. Youth Risk Behavior Survey completed in warts, gonorrhea or herpes. 2004 found that less than two percent of SECTION 8 11 to 18 year olds admitted to having sex Only 57 percent had been educated about although one in three personally knew AIDS by their parents or other guardians. young men who had been involved in bauk Asked about how to avoid HIV infection, (See definition on page 142). 84 percent suggested always using a condom when having sex and 36 percent Among those who admitted to having sex, mentioned not sharing needles. Thirteen only 34 percent always used condoms.The percent of Cambodian young people said survey, covering 9,388 young people in they believed HIV infection could be school and out of school in all 24 provinces avoided by not having sex at all. Almost and municipalities, also found that 52 two percent suggested touching or being percent of sexually-active girls and two near people with AIDS could result in HIV percent of sexually-active boys had been infection. forced to have sex. Eight percent of the

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 Men oping AIDS was lower at 60 percent of all survey, NCHADS highlighted the need for relates to "rituals of masculinity" as well new cases among adults, amounting to data on HIV prevalence among men who as peer pressure. Predominantly mobile NCHADS estimates that men account for 12,974 men. With a sharp decline to have sex with men as well as injection occupations in the transport, fisheries and slightly more than half of the HIV cases in 11,470 projected for 2004, men's share of drug users and migrant populations, calling military sectors meanwhile increase the Cambodia and almost two thirds of the the total was expected to fall even further for pilot surveys of these groups before likelihood of commercial sex.The authority AIDS deaths. NCHADS nevertheless esti- to 58 percent of all adults developing the next survey is carried out. NCHADS has also noted that while the police and mated in 2003 that the number of new AIDS. had previously acknowledged that men military have been monitored by SECTION 9 infections in men had plunged to 1,694, who have sex with men had been identified NCHADS surveys, programs have not down from a peak of 27,464 in 1994 and NCHADS has admitted that one of the as a "highly vulnerable population" through been extended to the navy, airforce and only a quarter of the rate of new infections limitations of the surveys is that policemen ad hoc studies in Phnom Penh and that some groups of police which may be even in women. have been the only male group included in "more information is needed on the size more vulnerable. As for men who have every survey (see page 49).As a result, the of this population." sex with men, the NAA says this group The HSS estimated 11,335 new AIDS deaths only way to estimate the rate of HIV is "difficult to address" and that more among men in 2003, amounting to 63 infection among the male population at In the 2003 survey, NCHADS estimated qualitative research is required to explore percent of all adult deaths from AIDS the large is to make indirect estimates based that 2.7 percent of Cambodian policemen their sexual behavior,culture and identities. same year.But the proportion of men devel- on data for pregnant women. In the 2003 were HIV positive nationwide. A separate Behavioral Surveillance Survey earlier found that 25 percent of men between 20 and Men who have sex Men with HIV, new infections and AIDS deaths 25 years of age had visited a sex worker with men over the previous year. Within this group, Estimated number of men aged 15-49 living with HIV, 20 percent did not use a condom. The In the world of HIV/AIDS, the term used survey, covering male members of house- internationally and by NCHADS is "men newly infected with HIV, and who died from AIDS, 1990-2003, Cambodia holds in five provinces, also found that 40 who have sex with men" (proh delrourm percent of men in their early thirties did phet jimoi proh dôchknir). This term recog- Living with HIV (Prevalence) not use condoms with sex workers. nizes that many biological men who have Deaths (Mortality) sex with other men also have sex with 120,000 New HIV Infections (Incidence) The National Aids Authority (NAA), women and that they may not "identify" 100,000 which estimates that up to 20,000 men with being homosexual (nea rourm rea 80,000 buy sex every day in Cambodia, has noted phet dôchknir). A study of more than 200 that traditional expectations of male 60,000 such men in Phnom Penh by Family Health behavior play a role in men's vulnerability International in 2000, for example, found Number 40,000 to HIV infection. Cambodian men, for that only 23 percent reported their "sex- 20,000 example, are usually expected to drink ual identity" as being homosexual. More 0 large quantities of alcohol when socializing. than 30 percent considered themselves 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Peer pressure is a major factor. But the men, 27 percent reported a bisexual Source: NCHADS 2004 Ye a r NAA has also noted that alcohol identity and 19 percent identified them- consumption among Cambodian police selves as being a woman.

62 MEN AND OLDER PEOPLE 63 Older people poor physical and mental health, and are commonly subjected to discrimination In the absence of reliable information from other community members." The about the impact of HIV/AIDS on older study noted that grandparents who look people in Cambodia, Help Age International after grandchildren orphaned by AIDS carried out an indicative study in 15 rural have a deep sense of responsibility to MEN AND OLDER PEOPLE villages in Battambang in 2003. The study keep families together. "At a time when found that HIV/AIDS was changing family physical and mental ability is often waning, VACCINES AND and community structures. In a reversal of the need to start again as would a young roles, older people were looking after their mother or father is the ultimate sacrifice." sick adult children as well as orphans. MICROBICIDES Despite their growing responsibilities, 10. The study found that the epidemic had older people are typically excluded from led to "significant changes in the responsi- most HIV/AIDS programs. "Prevention and SECTION 9 bilities and needs of older people," awareness activities are almost exclusively especially in terms of increased workload targeted at young people, and rarely reach for those taking care of sick relatives or out to older age groups," the study said. orphans. "Older people in HIV/AIDS- "As a result, older people seldom have affected households are vulnerable to access to information about HIV/AIDS, extreme poverty and,at times,destitution," which compromises their ability to the study found. "Many older people in protect themselves and those in their care." HIV-affected households also suffer from

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 Vaccines way to prevent HIV infection may require Microbicides Members of the International Partnership different vaccines for the different strains. for Microbicides committed almost 79 Infectious organisms have proteins called Microbicides are chemical or antibiotic million dollars to research in 2003, with antigens that cause the immune system But even if a potential preventive HIV foams or gels that can be applied to the more than half of the commitments to produce antibodies. With vaccines, vaccine began clinical trials today and lining of the vagina or anus to protect against coming from the United States. The rest antigens are used to stimulate an immune proved to be safe and effective, it has been infections from micro-organisms. Most of came from philanthropic organizations, estimated that it would not be available to SECTION 10 response -- but not the disease itself -- and the product developers are small biotech- other bilateral donors and multilateral protect against infection by the organism. the public for at least five years. One nology companies, non-profit companies agencies. Of the 40 potential microbicides Preventive vaccines are not a cure. But complication is that most international and academic institutions. being developed in 2004, only one was they can prevent people getting sick from vaccine research has targeted the strain sponsored by a major pharmaceutical manu- viruses such as measles or mumps.Thera- most common in developed countries. facturer. peutic vaccines, also known as treatment Another focuses on the ethical issues vaccines, are being used in people with surrounding clinical research trials in HIV to maintain, stimulate or repair the developing countries including Cambodia. immune system. For HIV, the most exten- sive trials have involved Interleukin-2, a The International AIDS Vaccine Initiative natural protein produced by the body that (see page 158) spent about 570 million can dramatically raise the number of CD4 dollars on research and development in cells. 2002, about 100 million dollars more than 2001. The private sector accounted for Developing a preventive vaccine against less than 25 percent of the spending, with HIV is difficult as the virus incorporates about 14 percent coming from pharma- its genetic material into the very immune ceutical manufacturers and about seven system that is designed to fight viruses. percent coming from biotechnology The main challenge for medical researchers companies. In 2004, the principal is to find a way to eliminate or neutralize government institutions funding clinical the virus without destroying the immune research were the National Institutes for system itself. Another challenge is the Health in the United States, the Medical rapid mutation of the virus and the growing Research Council in Britain, the Agence number of HIV strains (see page 154). Just Nationale de Recherches sur le Sida in like different vaccines are developed for France and the European and Developing various strains of influenza, developing a Countries Clinical Trials Partnership.

66 VACCINES AND MICROBICIDES 67 SECTION 10 VACCINES AND MICROBICIDES 68 11. virus intothebloodstream. apart. Thisreleases increasing amountsofthe follicular dendriticcellnetwork beginstobreak During thelaterstages ofHIVdisease, the Picture and text: Boehringer Ingleheim TESTING AND COUNSELING TESTING AND COUNSELING TESTING AND COUNSELING

n 1995, the Institut Pasteur established Another test known as polymerase chain It is not clear why government monitoring Counseling the first HIV testing and counseling reaction (PCR) tests for the virus itself of the epidemic needs to be exempted Under the Ministry of Health policy, center in Cambodia. Over the next four and can detect HIV within two weeks of from confidentiality as Article 22 states I strategy and guidelines adopted in 2002, years, another five were set up -- two at infection. A special blood test involving a that "all" testing should be anonymous. counseling is supposed to take place both the National STI Clinic and the Preah process called nucleic acid amplification Moreover, Article 32 states that informa- before and after every HIV test. Before Bat Norodom Sihanouk Hospital in can detect HIV infection during the tion gathered through "health intelligence

SECTION 11 the test, counselors have to discuss why Phnom Penh and one each in Battambang, "window period" of up to three months. activities" should remain confidential and the test is being sought and assess the Kampong Cham and Siem Reap. A seventh classified. client's understanding of HIV/AIDS and was established in Sihanoukville in 1999. The guidelines for testing in Cambodia his or her risk of getting infected. Pre-test By 2005, the Ministry of Health was aiming are spelt out in Chapter IV of the Law on NCHADS reviewed the policy and counseling is also supposed to cover the to have testing and counseling centers in the Prevention and Control of HIV/AIDS strategy for testing and counseling in client's plans to reduce high-risk activities all 24 provinces and municipalities. Toge- adopted in 2002 and provisions for confi- 2001. The new policy, strategy and and the meaning of positive and negative ther with all national hospitals and some dentiality are contained in Chapter VII. guidelines adopted by the Ministry of results including the "window period" of referral hospitals, some non-government All testing is supposed to be voluntary Health state that compulsory testing with up to three months. Counseling after the organization (NGO) centers offer testing with the informed consent of the individual, no option to refuse is prohibited under all test is supposed to take place when the and counseling services in Phnom Penh as and there are provisions for testing minors circumstances in Cambodia. Anonymous client returns to get the results. Informing well as the provinces. By mid 2004, the who cannot get the written consent of testing for research and surveys must be clients of the results by telephone or letter number of government and NGO centers their legal guardians. Under guidelines for approved by the Ministry of Health and is strictly prohibited. amounted to 58 and by 2005 this had implementing the law, a minor is defined its ethics committee, and also must increased to around 90.A large number of as anyone less than 18 years of age. Com- conform with the ministry's ethical guide- In the case of HIV-positive results, unregulated private testing centers also pulsory testing is allowed only if requested lines for HIV/AIDS-related research. All counselors have to explain the result and operate in most major towns. These are by a court. Any testing for employment, public and private institutions doing HIV reassure clients that they can learn to linked to private hospitals and clinics and education, housing, travel, medical and tests have to be licensed and super cope with the situation. In addition to operate independently. other services is "strictly prohibited" vised by the ministry, strictly follow offering emotional and psychological under Article 20 of the law. ministry guidelines and be run by staff support, counselors have to discuss the trained under approved courses. In implications of the result, any worries, Testing Anonymity and confidentiality for all HIV addition, all have to report regularly to fears or immediate problems and how to testing is guaranteed by the Ministry of The most common test for HIV involves NCHADS using standardized formats. live with HIV and stay healthy. Counselors Health under Article 22. Under Article 31, taking a blood sample and testing it for Test results in both public and private must also inform the client about medical, the government's program for monitoring the presence of antibodies to the virus. health-care facilities must be "confined to counseling, support and other services for HIV/AIDS has to use a coding system that But seroconversion, the development of a staff directly responsible for the patient's people with HIV. promotes anonymity. Under Articles 33 detectable level of antibodies following medical care" and no relatives should be and 34, the confidentiality of all people exposure to a virus, can take up to three notified unless the patient has given With negative results, counselors have to with HIV/AIDS has to be maintained months with HIV. So the results of such explicit permission. explain the result and discuss the client's except in cases involving government tests, known as the enzyme-linked plan to reduce his or her high-risk behavior. monitoring, health workers and court immunosorbent assay (ELISA), can be Counselors also have to offer psychological orders. First-time violators face a fine of negative even if the person is infected by support and plan for further tests if up to 200,000 riel and up to six months in HIV within the previous three months. appropriate. jail.

70 TESTING AND COUNSELING 71 SECTION 11 TESTING AND COUNSELING 72 12. Picture vulnerable toHIVinfection. helper T-cells, express CD4andsoare and subset oflymphocytes (T-cells), known as as theCD4antigen. Macrophages anda HIV bindstocellsviaamoleculeknown text: Boehringer Ingleheim AND TREATMENTCARE TREATMENT AND CARE TREATMENT AND CARE

Anti-retroviral drugs Treatment with anti-retroviral drugs goes simpler. Two are produced by Indian patients. But it has also noted that many back to 1986 when American doctors manufacturers of generic drugs, Cipla and Cambodians have yet to accept the idea Anti-retroviral drugs kill or prevent the announced that a drug originally developed Rambaxy, and a third is being made by of caring for people as many believed that replication of retroviruses like HIV. By to treat cancer seemed to help people British pharmaceutical company Glaxo- HIV/AIDS is a "well-deserved punishment 2004, three classes of anti-retroviral drugs with HIV. These drugs, which target a SmithKline. Patients taking the most widely for those who have had socially-unaccept- had been developed. Using a combination protein known as reverse transcriptase, available fixed-dose combinations of d4t, able sex." As a result, the authority said of drugs from these three classes is were only moderately effective. Since 3tc and nevirapine -- marketed as GPOvir "all efforts to encourage people to take SECTION 12 referred to by doctors as Highly-Active 1996, however, a new class of drugs called in Thailand where it also being produced -- good care of AIDS patients should be Anti-Retroviral Therapy. Such treatment is protease inhibitors has been developed can take one pill twice a day instead of six actively encouraged." also known as combination or cocktail and proven effective when combined with pills a day if the three drugs are taken sep- therapy. Although such treatment reduces other drugs. These drugs target the arately. Medecins sans Frontieres strongly The Ministry of Health has identified care the amount of HIV in the bloodstream, protease enzyme, which the virus needs advocates such combinations, saying it and support as one of 12 strategic areas the virus is still present and can rise again to replicate. A third class of drugs also pays only 270 dollars a year for each under its strategic plan for 2001 to 2005. to dangerous levels. The drugs can have targets the reverse transcriptase protein. patient for such treatment compared with Under the plan, the home-based care serious and even potentially life-threaten- 562 dollars if the drugs are bought sepa- system is being expanded nationwide, ing side effects including diarrhea, liver People who receive anti-retroviral rately from the originators. with team members being trained in problems, rashes, nerve damage and treatment must strictly adhere to their collaboration with non-government neurological problems. doctor's instructions and have to be organizations, nursing schools and the monitored regularly with tests to determine Opportunistic infections National Center for HIV/AIDS Dermatology More than 8,500 people in Cambodia whether the combination is effective. and caring for people with and Sexually-Transmitted Diseases. One were receiving such drugs as of mid 2005, Adhering to the therapy is important to AIDS of the goals of the plan is to ensure that up from 1,700 in 2003, according to the avoid resistance.This is difficult due to the programs receive drug kits and other National AIDS Authority.Treatment ranges side affects and, until recently, the large Under the Ministry of Health's strategic supplies. from 10 dollars to 70 dollars a month but is number of tablets that have to be taken plan for HIV/AIDS prevention and care Home-based care is designed to provide sometimes free, depending on the source and the frequency of doses. People taking for 2001 to 2005, drugs for opportunistic symptomatic relief to comfort and of the drugs. In terms of the proportion of these drugs still have HIV, even if the infections are supposed to be on the support patients with life threatening people with access to the drugs, only three presence of the virus falls to levels that essential drugs list. These drugs are illnesses such as the advanced stages of percent of people with advanced HIV cannot be detected using standard testing supposed to be available at all national AIDS.The World Health Organization has infection were receiving anti-retroviral procedures. hospitals and 12 referral hospitals in the recently produced guidelines indicating combination therapy in 2002. But under provinces. the Cambodian Millennium Development that drugs derived from opium, including Goals, the proportion is targeted to reach Fixed-dose combinations The National AIDS Authority has stated morphine take orally, are necessary for such "palliative" care. In Cambodia, 25 percent by 2005, 60 percent by 2010 As of mid-2004, the World Health Organ- that home-based and community care and 75 percent by 2015. needs to be expanded in Cambodia as morphine is illegal unless prescribed by ization had approved three fixed-dose a doctor. combinations that made treatment a lot institutions are unable to cope with the rapid increase in the number of AIDS

74 TREATMENT AND CARE 75 SECTION 12 TREATMENT AND CARE 76 13. using theviralRNAasatemplate. A DNAcopy ofHIVRNAissynthesized Picture production ofaRNA-DNA double helix. Reverse transcriptase isinvolved inthe and text: Boehringer Ingleheim TEN YEARS THE NEXT THE NEXT TEN YEARS THE NEXT TEN YEARS

nder the Millennium Declaration percent for adults and 1.5 percent for signed by all 189 members of the young pregnant women attending antenatal GOVERNMENT UUnited Nations General Assembly clinics.With the NCHADS survey of 2003 in 2000 including Cambodia, decreasing showing declines in both rates to 1.9 INSTITUTIONS the spread of HIV/AIDS. is one of 25 percent, the targets for 2005 and 2010 14. targets to be met by 2015. Following talks have already been met ahead of schedule. SECTION 13 between ministries, donors and non- Condom use is meanwhile targeted to government organizations, the Council of rise to 98 percent for sex workers, 95 Ministers approved specific indicators and percent for young people between the ages targets for Cambodia including seven in of 15 and 24 and 10 percent for married the area of HIV/AIDS. A progress report women who identify themselves at risk. released in 2004 showed that meeting the Another target for 2015 is for 50 percent overall target of reducing the spread of of all pregnant women with HIV to be HIV/AIDS was one of only three out of receiving a complete course of anti-retro- the 25 overall targets that would "proba- viral drugs to reduce the risk of transmitting bly" be met and one of only five that had the virus to the child. The seventh target "strong" support. is for 75 percent of people with advanced HIV infection to be receiving advanced The seven HIV/AIDS targets for 2015 anti-retroviral combination therapy by include reducing in HIV prevalence to 1.8 2015. Targets for reducing HIV (%) Benchmark 2005 2010 2015 Antibodies directed against antigens on HIV among adults 3.3 2.3 2.0 1.8 pathogens, such as HIV, are released from HIV among pregnant women 2.8 2.4 2.0 1.5 plasma cells. Each plasma cell synthesizes Sex workers using condoms 91 98 98 98 antibodies which recognize a specific Young people using condoms 82 85 90 95 antigen on the pathogen, e.g. the HIV GP 120 protein. Married women using condoms 1 2 5 10 Picture and text: Boehringer Ingleheim

Targets for getting ARV treatment (%) Benchmark 2005 2010 2015 Pregnant women with HIV 2.7 10 35 50 People with advanced HIV infection 3.0 25 60 75

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 GOVERNMENT INSTITUTIONS GOVERNMENT INSTITUTIONS Under the Council of centered with a focus on empowering Chief of Information: 1994 and 2003. During this period, the individuals, communities and society." Dr. Sim Kim San (012-940-854) number of provinces surveyed rose from Ministers: Based on this framework, seven strategies Email: [email protected] five to 20. In the 2002 survey, NCHADS National AIDS Authority (NAA) were designed. Website: www.naa.org.kh was responsible for coordination, training Tel:023-885-129 and supervision as well as data management The authority was set up in 1999 to The National Strategic Plan for 2006 to and analysis. Provincial AIDS committees broaden the government's response to 2010 was being reviewed by the Policy SECTION 14 Under the Ministry of provided management and administrative HIV/AIDS which had until then been Board of the NAA as this guide went to support while provincial health departments almost entirely confined to the Ministry press. Health: and provincial AIDS offices collected and of Health. As the apex body in charge of transported the data. The United States National Center for HIV/AIDS, developing a multisectoral approach to As well as coordinating the multisectoral Agency for International Development, Dermatology and Sexually HIV/AIDS, the authority has a policy approach to HIV/AIDS, the NAA is respon- through Family Health International, Transmitted Diseases (NCHADS) board comprising secretaries of state sible for policy development, strengthening provided technical assistance along with from 26 ministries and third deputy relations with all stakeholders and mobi- The Ministry of Health established the the University of California in Los governors from all 24 provinces and lizing resources from national and interna- center in 1998 as part of an upgrading of Angeles, the University of New South municipalities.The authority is chaired by tional institutions and agencies. It also its national AIDS program launched in Wales in Sydney, the World Health the prime minister or someone assigned advocates for legislative support and 1993. The center is responsible for Organization and the East West Center by the prime minister. In addition to four research on the socio-economic impact surveying sentinel groups and implementing in Honolulu. The Centers for Disease vice chairmen, the NAA has a secretary of HIV/AIDS, coordinates the research programs for those infected and affected Control - Global AIDS program in general responsible for its day-to-day agenda and approves information, education by HIV/AIDS. Cambodia supported the ninth round of operation. and communication programs in all sectors. HIV surveillance at the end of 2003. This NCHADS and the Ministry of Health have included several important changes to Under its National Strategic Plan for a The authority aims to reduce the vulner- also developed the Strategic Plan for confidentiality safeguards, decentralization Comprehensive and Multi-Sectoral Response ability of women and girls to HIV/AIDS by HIV/AIDS and STI Prevention and Care of testing, a switch to rapid testing and to HIV/AIDS for 2001 to 2005, the NAA seeking to offset discriminatory attitudes, for the period 2001 to 2005.The goals of a quality assurance protocol.The changes outlined two approaches to reduce especially among men. Under the National the plan are to reduce new infections of were expected to ensure better and more vulnerability to HIV/AIDS. The first con- Poverty Reduction Strategy, the NAA is HIV,to provide care and support for people reliable results than previous surveys. centrated on influencing individuals that also responsible for the HIV/AIDS pre- living with and affected by HIV/AIDS, and safer behavior was a more attractive vention and elimination strategy. The to alleviate the socio-economic impact Director: option, while the second focused on strategy includes promoting public infor- on individuals, families, communities and HE Dr. Mean Chhi Vun supporting individuals to protect themselves mation and education about HIV/AIDS, society. NCHADS also plays a role in Deputy Directors: from infection and cope with the creating specific programs for different providing care across a "continuum" ranging Dr. Ly Penh Sun consequences of HIV/AIDS.The plan also sub-populations, and strengthening and from homes and communities to health Surveillance Chief: called for a shift from a segmented and expanding preventive programs. centers and hospitals. Dr. Heng Sopheab health-centered top-down approach, to a Information Chief: Deputy Secretary General: "more holistic development approach, Dr. Lan Van Seng Dr.Teng Kunthy (023-885-129) The system of HIV Sentinel Surveillance that is gender sensitive and people began in 1994. With the exception of Email: [email protected], 2001, surveys of different sentinel groups [email protected] were carried out every year between Website: www.moh.gov.kh Tel:023-216-515

80 GOVERNMENT INSTITUTIONS 81 Ethics Committee National Institute for Public Other Ministries: Contacts: Health (NIPH) Hoy Chan Vireak (012-830-399), Approves anonymous HIV testing for Ministry of Cults and Religion Dr. Ken Phun (023-212-707) research and surveys. Ministry of Health research and training Email: [email protected] Involved in HIV/AIDS prevention and care institute. Also runs a laboratory. Website: www.interior.gov.kh Director: with support from UNICEF, the POLICY GOVERNMENT INSTITUTIONS Professor Eng Hout Director: Project and monks. Ministry of Justice Other contacts: Dr. Sam An Ung (023-880-345, Dr. Ung Sam An, Dr. Saphorn Vothorn 023-881-345, 023-882-941) HIV/AIDS contact: Develops laws and policies to reduce the Tel:012-836-781, 012-890-889 Other contact: Uong Sophearin spread of HIV/AIDS and ensure the rights Dr. Sophorn Vuthanak (012-866-608) (023-725-699, 012-850-192) of people infected and affected by the National Blood Transfusion Email: [email protected] Email: [email protected], virus. Center (NBTC) [email protected] HIV/AIDS contact: SECTION 14 National Maternal and Child Ministry of Health center promoting Health Center (NMCHC) Ministry of Education,Youth and Dr. Neangsina Vatanak voluntary blood donations from people Sport (023-360-327, 012-683-329, with a low risk of HIV infection. Also Ministry of Health center responsible 023-212-693, 011-893-417) screens blood for HIV and offers counseling for research, policies, guidelines and Supports development of HIV/AIDS policies before and after donations. training for the prevention of mother to and education for young people in and Ministry of National Defense child transmission of HIV. Also operates out of school. Under a five-year plan, Director: Cambodia's leading maternity teaching HIV/AIDS activities are being strengthened Runs an education program for the military Dr. Nhem Tourk (023-215-949) hospital which includes screening for at provincial and district levels. Carried in 21 provinces. Also has a five-year Other contacts: HIV, treatment with nevirapine and out a youth risk behavior survey with strategic plan for HIV/AIDS running until Dr. Hok Kim Chaeng (016-849-966), counseling on infant feeding. support from UNICEF and UNESCO 2006. The ministry has received support Dr. Chhorn Samnang (016-865-565) in 2003 and 2004. Implements a program from Family Health International since Email: [email protected] Director: funded by DFID, focusing on student values 1999. Prof Koum Kanal and behavior. National Center for Tuberculosis (023-724-257, 012-943-785) Health Department Director: and Leprosy Control (CENAT) Other contacts: Shoool and Health Department Director: General Dr.Thou Tharith Prof Sann Chan Soeung Pen Saroeun (012-819-610) Ministry of Health center working with (012-933-344), Youth Department Director: HIV/AIDS Unit: NCHADS to develop strategies addressing Dr.Tan Vuoch Chheng Chhim Samanh Lietenant-Colonel Tan Sokhey tuberculosis. Runs afternoon tuberculosis (011-951-002) Tel:023-217-253, 428-084, 219-284-5 (011-810-610) screening for people at risk of infection. Reproductive health contact: Email: [email protected] Email: [email protected], Services include referrals for voluntary Dr.Tung Rathavy Website: www.moeys.gov.kh [email protected], counseling and testing. (016-834-700, 023-427-300) [email protected] Ministry of Interior Nutrition contact: Website: www.mond.gov.kh Director: Dr. Ou Ke Vanna (012-855-319) Dr. Mao Tan Eang (023-219-274, The Ministry's health department has a Ministry of Planning 012-916-503) JICA contact: prevention and care plan for police officers Dr. Kazuhiro Kakimoto HIV/AIDS contact: and those infected or affected by HIV/ Works with other ministries and agencies (012-983-091) Dr. Chay Solun (012-925-571) AIDS. Strategies include integrating HIV/ on socio-economic sectors such as the Email: [email protected], Email: [email protected], AIDS education into training. Partners Millennium Development Goals which [email protected] [email protected] include the Cambodian Red Cross, include specific targets for reducing NCHADS and the NAA as well as Family HIV/AIDS and increasing anti-retroviral Health International, USAID, UNDP and treatment.Also involved in the population UNAIDS.

82 GOVERNMENT INSTITUTIONS 83 census and other national surveys relevant educates workers at six garment factories to HIV/AIDS such as the demographic around Phnom Penh and also helps vul- health survey with the Ministry of Health nerable children and widows affected by and a youth risk behaviour survey with HIV/AIDS in a separate project with the Ministry of Education, Youth and Nyemo. Sports. GOVERNMENT INSTITUTIONS Social Affairs Director General: Census Survey Department HE Keo Boren MULTILATERAL Deputy Director: (023-724-091, 365-469, Long Chindtha 012-417-399) AGENCIES (023-720-901-4, 212-049, 15. 212-055, 210-549, 012-810-810) HIV/AIDS contact: Em Sophon (012-886-748) SECTION 14 National Institute of Statistics Researchers: Deputy Director General: Sat Sithy (012-271-288), Hang Lina (023- 210-719, 213 650, Phauk Sotheara (012-642-907), 012-723-107, 016-832-762) Ban Ravuth (012-823-399) Email: [email protected], Email: [email protected] [email protected] Website:www.mop.gov.kh Ministry of Women's Affairs

Ministry of Rural Development Educates women, young people and their families about HIV/AIDS, especially in The Department of Rural Health works rural areas. Has projects with UNFPA in with local communities to combat the eight provinces (Kandal, Kampot, Prey spread of HIV/AIDS under a strategic plan Veng, Svay Rieng, Kampong Chhnang, from 2000 to 2005.Works with UNICEF Kampong Cham, Battambang and Siem and youth volunteers in Kampong Chhnang, Reap). Also works with UNAIDS and the Kampong Speu, Svay Rieng, Koh Kong, POLICY Project. Encourages "gender- Oddar Meanchey and Stueng Treng. responsive" HIV prevention in Battambang, Nevirapine (green) is a potent inhibitor of viral Banteay Meanchey, Koh Kong, Siem Reap replication. Rural Health Care Department Director: and Phnom Penh. Picture and text: Boehringer Ingleheim Dr. Chea Samnang (023-366-627, 012-873-671) Minister: HIV/AIDS contact: HE Dr. Ing Kantha Pavi Dr. Ouk Rim (012-973-738) (023-216-573) Email: [email protected], Secretary of State: [email protected] HE Chann Serey (012-985-052) Director General: Ministry of Social Affairs,Veterans HE Chou Bun Eng (012-872-639) and Youth Rehabilitation HIV/AIDS contact: Dr. Kou Sothea (012-707-705) Trains officials at the national, provincial Email: [email protected], and district levels and also educates [email protected] migrant workers recruited to work in Website: www.mwva.gov.kh countries such as Korea and Malaysia. With support from the Global Fund,

84 MULTILATERAL AGENCIES MULTILATERAL AGENCIES

Asian Development and the World Food Program). The UN HIV/AIDS team: Dr. Seng Sutwantha Theme Group on HIV/AIDS comprises Haritiana Rakotomamonjy, Email: [email protected], Bank (ADB) the heads of all agencies in Cambodia, Sedtha Chin, Fabrice Laurentin, [email protected]. A multilateral financial institution chaired in 2005 by UNICEF representative Bunthy Chea, Udom Kong [email protected] established in Manila in 1966 with Rodney Hatfield. A separate group (023-426-214/5) Website: www.un.org.kh/undp/ Cambodia as one of the founding known as the Technical Working Group Email: [email protected],

SECTION 15 United Nations shareholders. Following the civil war, the comprises various UN experts working in [email protected], ADB resumed operating in Cambodia in the field of HIV/AIDS. The UN Country [email protected], Educational, Scientific and 1992 with a resident mission established Team developed a "common strategy" to [email protected] support Cambodia's response to the HIV [email protected], Cultural Organization in Phnom Penh in 1996. Funding for (UNESCO) HIV/AIDS has included a project to prevent epidemic from 2001 to 2005.Top priorities [email protected] transmission among vulnerable groups in were advocacy and building capacity to Website: www.unicef.org/ coordinate aid. infobycountry/cambodia.html Focuses on preventive education and Battambang, Koh Kong, Prey Veng and Svay culture.Activities have included traditional Rieng.Cambodia has also received technical Country Coordinator: United Nations Cambodian theatre and graphic arts, and assistance from the ADB's Japan Special Tony Lisle (023-219-340) have involved different partners including Fund for capacity building in the areas of Development Program E-mail: [email protected] the Ministry of Culture and Fine Arts, prevention and control. In 2001, the ADB http://www.unaids.org/en/ (UNDP) NGOs and students. Supports Ministry of and UNAIDS helped finance a study called geographical+area/by+country/ Education, Youth and Sport in producing Supports local leaders and communities in Health, Wealth, AIDS and Poverty -- the case cambodia.asp materials, developing curricula, training of Cambodia. A separate series of ADB/ dealing with HIV/AIDS and has developed teachers and conducting surveys. Also UNAIDS studies has compared the impacts United Nations Children's booklets and films for speakers and supports communications initiatives, commune counselors. Working with the of HIV/AIDS in Cambodia with the impacts Fund (UNICEF) television commercials and the Inthanou on India,Thailand and Vietnam. NAA, it launched a media campaign hotline. UNESCO wants to expand its against HIV/AIDS endorsed by Prime Prevention and care activities include "edutainment" activities to develop self- Country Director: Minister Hun Sen in 2003.The UNDP also raising awareness of HIV/AIDS through esteem and confidence among young Shyam Bajpai (023-215-805) sponsored the first arts and media forum radio, television and hotlines, support for people living with HIV/AIDS and reduce Project Officer: (023-214-556) on HIV/AIDS with the NAA and TVK voluntary counseling and testing, strategies HIV-related discrimination. Email: [email protected] in 2004. The UNDP is also in charge to prevent mother-to-child transmission Website: www.adb.org of helping countries meet targets under of HIV and pagoda-based support groups. Education Section Head: the Millennium Development Goals, UNICEF works closely with the Ministry Dr. Supote Prasetsri Joint United Nations such as reducing the spread of HIV/AIDS of Health, the Ministry of Rural HIV/AIDS focal point: and expanding access to anti-retroviral Programme on HIV/AIDS Development, the Ministry of Education, Julie David treatment. (UNAIDS) Youth and Sport, the Ministry of Cults and Email: phnompenh@.org.kh, Religion, the Ministry of Social Affairs, [email protected] Pools experience, efforts and resources of Resident Representative: [email protected] Veterans and Youth Rehabilitation as well Douglas Gardner (023-216-167) 10 co-sponsoring agencies working in the as the NAA. Website: www.unesco.org field of HIV/AIDS as of 2004 (UNICEF, HIV/AIDS contacts: Renato Pinto (023-216-167) UNDP, UNFPA, UNHCR, UNODC, the Representative: ILO, UNESCO, the WHO, the World Bank Rodney Hatfield (023-426-214/5)

86 MULTILATERAL AGENCIES 87 United Nations High HIV/AIDS contact: Committee and the Condom Use Working World Health Dr.Tea Phauly (023-222-349) Group of NCHADS.The World Bank has Commissioner for Email: [email protected], a five-year health sector support project. Organization (WHO) Refugees (UNHCR) [email protected] Approved in 2002, this project aims to Key partner of the Ministry of Health

MULTILATERAL AGENCIES Website: www.unodc.org.kh integrate HIV/AIDS into all services. Became a UNAIDS cosponsor in 2004. supporting NCHADS in such areas as HIV/AIDS Sentinel Surveillance, diagnosis Has HIV unit at its headquarters in Country Director: United Nations Population and treatment of sexually transmitted Geneva with two technical experts and Nisha Agrawal (023-213-639) Fund (UNFPA) infections and home-based care. Also four regional coordinators for Africa. A HIV/AIDS contact: supports the "continuum of care" frame- regional coordinator for Asia is planned Simeth Beng (012-772-226) Integrates HIV/AIDS into community work as well as the National Blood for 2005. Email: [email protected], activities though a network of more Transfusion Center,the National Maternal [email protected] than 900 volunteers in eight provinces. and Child Health Center, the National Tel:023-216-005 Website: www.worldbank.org/kh Promotes reproductive health through Tuberculosis Control Program and the SECTION 15 Email: [email protected] community networks and trains midwives Website: www.un.org.kh/unhcr/ World Food Program National Nutrition Program. In addition, at regional centers. HIV prevention is a the WHO also works on HIV prevention United Nations Office on priority in an initiative involving the (WFP) with the Ministry of National Defense. European Union and UNFPA. In collabo- Drugs and Crime ration with UNESCO and the Ministry of Provides food and basic medicine to Representative: (UNODC) Health, UNFPA has also developed a households affected by HIV/AIDS in Dr. Michael O’Leary manual for training teachers about HIV partnership with the Ministry of Health HIV/AIDS contact: Given what seems to be "relatively limited" transmission and prevention. and non-government organizations. Dr. Massimo Ghidinelli use of needles among illicit drug users in Assistance also covers orphans and Tel:023-216-005, 023-212-228 Cambodia, UNODC sees an opportunity Representative: vulnerable children and is provided up to Email: [email protected]. to prevent the scale of drug-related HIV Bettina Maas (023-215-519) eight months when a parent is unable to who.int, transmission seen in countries like Deputy Representative: work and up to five months after a parent [email protected]. Thailand and Vietnam. In 2004, it helped Alice Levisay (023-215-519) has died. Monthly food rations involved who.int set up the Drug-related HIV/AIDS HIV/AIDS contacts: about 4,000 households in 2004.The WFP Website: www.who.int/countries/ Technical Working Group, jointly chaired May Tum, Dr. Chong Vandara has agreements with World Vision, khm/en/ by the NAA and the National Authority (023-215-519) KHANA and Caritas in 10 provinces for Combating Drugs (NACD). Comprising Email: [email protected], (Kampong Thom, Kampong Speu,Takeo, government and non-government agencies [email protected], [email protected], Kandal, Banteay Meanchey, Kampong as well as bilateral and multilateral donors, [email protected] Cham, Kampot, Prey Veng, Siem Reap and the group endorses activities to counter Website: www.un.org.kh/unfpa/ Svay Rieng). drug-related HIV transmission. But the legal authority to approve activities rests World Bank HIV/AIDS contact: with the government's Drug and HIV/AIDS Heng Mory (023-212-137/8) Committee, which includes various Supporting anti-retroviral treatment, 100 Email: [email protected], ministries and agencies such as the NAA, percent condom use and other activities [email protected] the NACD and the Ministry of Interior. in 12 provinces and municipalities (Pailin, Website: www.wfp.org/kh With its human rights-based approach, Kampot, Banteay Meanchey, Steung Treng, UNODC reckons Cambodia is in a unique Preah Vihear, Battambang, Kampong Speu, position to prevent drug-related HIV Pursat, Kampong Thom, Kratie, Kep, transmission "before a significant onset of Oddar Meanchey). Also supports the injecting drug use becomes clearly evident." Condom Use Monitoring and Evaluation

88 MULTILATERAL AGENCIES 89 SECTION 15 MULTILATERAL AGENCIES 90 16. Picture andtext: Boehringer Ingleheim cell. Theinfectious cycleofHIVbegins. molecules, tofusewiththetarget HIVstarts to bindCD4andotherhostcellsurface After theGP120protein hasenabled thevirus BILATERAL SELECTED DONORS SELECTED BILATERAL DONORS SELECTED BILATERAL DONORS Australian Agency for Email: dominique.dordain@diplo Senior Project Officer: United States Agency matie.fr, Elizabeth Pirnay (012-806-937) International [email protected] Email: [email protected] for International Development (AusAID) Website: www.cooperation.gouv.fr/ Website: www.delkhm.cec.eu.int Development (USAID) actu/actu.asp?DOS=12544 Australian government agency assisting Japan International USAID-administered funding for Cambodia the Ministry of Health to develop a research is expected to exceed 50 million dollars SETION 16 Department for Cooperation Agency capacity and information database to International Development in 2006. Of the total US funding for determine the optimal way to use anti- (JICA) Cambodia in the year to September 2006, retroviral treatment. The results of the (DFID) 28.7 million dollars is earmarked for three-year project, carried out by a Supports the National Prevention of health and 14.3 million dollars is earmarked University of New South Wales research British government agency working with Mother To Child Transmission Program for HIV/AIDS. Agencies cooperating with center, are expected to have wider the Cambodian government, the Asian including technical assistance to two pilot USAID in the field of HIV/AIDS include the applications given the little research on Development Bank and the World Bank projects in Phnom Penh and Battambang. Centers for Disease Control's Global AIDS anti-retroviral treatment in poor countries. on a 77 million dollar health sector support Financial support has included workshops, Program, Family Health International, AusAID also has HIV/AIDS activities in a project which includes HIV/AIDS activities. HIV testing kits, antiretroviral drugs and CARE, the POLICY Project, Population regional program. Also supports Population Services Interna- education materials. Also supports the Services International, Reproductive tional, BBC World Trust and the NAA. National Tuberculosis Control project Health Association of Cambodia, Khmer Country Representative: which started referrals between TB and HIV/AIDS NGO Alliance, Reproductive Health and Population Advisor: Fleur Davies (023-213-470) HIV medical facilities in Phnom Penh in and Child Health Care Alliance, University Elizabeth Smith (023-430-240) Email: [email protected] 2003. Research Company, Helen Keller Interna- Program Support Officer: Website: www.ausaid.gov.au/ tional, Partners for Development and David Quinn (023-430-240) Country Representative: country/country.cfm?CountryId=34 World Vision. Email: [email protected] Juro Chikaraishi (023-211-673) Cooperation Française Website: www.dfid.gov.uk/ Assistant Country Representative: Team Leader for Family Health: countries/asia/cambodia.asp Tsuyoshi Yusa (012-909-609) Dr. Chak Chantha, Supports efforts to prevent HIV being HIV/AIDS contacts: European Union (EU) E-mail: [email protected] transmitted from mother to child and Dr. Kosuke Okada (023-211673) Development Assistance Specialist: also supports follow ups for babies born Dr. Kazuhiro Kakimoto The European Commission Delegation Dr. Sok Bunna, with the virus. Partners include the (012-938-091) E-mail: [email protected] Ministry of Health, NCHADS and referral to Cambodia has funded various bodies Email: [email protected], working on HIV/AIDS in Cambodia ranging (023-216-438) hospitals as well as Calmette Hospital, the [email protected], Website:www.usaid.gov/locations/ National Pediatric Hospital and French from Medecins du Monde and Medecins [email protected] Sans Frontieres to Marie Stopes Interna- asia_near_east/ organization Esther which has partner- Website: www.jica.org.kh countries/cambodia/cambodia.html ships with three French hospitals. tional, the Institute of Tropical Medicine, Healthnet International and NCHADS. Country Director: The European Commission is also funding Dominique Dordain (023-430-032) the second phase of a reproductive health Health Advisor: initiative with UNFPA from 2004 to 2007. Dr. Regine Lefait-Robin

92 SELECTED BILATERAL DONORS 93 Centers for Disease Control and Prevention (CDC) Global AIDS Program

SELECTED BILATERAL DONORS Established by the Centers for Disease Control in Atlanta in 2002, the CDC Global AIDS Program in Cambodia is NON-GOVERNMENT strengthening capacity at the National Institute of Public Health and NCHADS laboratories. It also provides technical ORGANIZATIONS assistance and has a cooperative agreement 17. with the Ministry of Health to support SETION 16 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/ Following the establishment of a stable contact, gap/countries/cambodia.htm the viral membrane fuses with the membrane of the CD4 cell. Picture and text: Boehringer Ingleheim

94 NON-GOVERNMENT ORGANIZA- NON-GOVERNMENT ORGANIZATIONS he following section includes Aphiwat Srei Director: with union federations spanning the garment, members of the HIV/AIDS Coordi- Srey Keo Pisei (012-713-960, footwear, maritime, hospitality, tobacco, Tnation Committee (HACC), those Battambang 012-954-894) cleaning and rubber industries. that appear in University Research Other contacts: Provides psychological and social support Country Director: Companys’ (URC) HIV/AIDS agency list, Sak Sokim,Van Chamran through home visits. Supported by Barbara Fitzgerald and a selection of other non-government (012-439-750) KHANA and Frontiers Prevention Project. (023-216-034) organizations and agencies with related SECTION 17 HIV/AIDS contacts: activities in Cambodia. Director: Association of Medical Thong Thavrin (012-694-390) Doctors of Asia (AMDA) Ly Kim Song, Ms Lim Lok San Action IEC Email: [email protected] (011-918-810) Phnom Penh Email: [email protected] Phnom Penh Asian Outreach Cambodia Japanese organization working with four Website: www.apheda.org.au Local organization producing communication (ASC) heath centers in Kampong Speu, training Australian Red Cross materials to change behavior. Kandal health volunteers on HIV/AIDS. (ARC) Country Director: Faith-based organization founded in Hong Country Director: Phnom Penh Chheng Kossal (012-212-944) Kong. Offers home care and support in Dr. Sieng Rithy (023-218-820, Email: [email protected] Lvea Em district. 012-805-034) Provides HIV/AIDS technical support and Website: www.actioniec.org HIV/AIDS contact: funds to the Cambodian Red Cross for Country Director: Dr. Peas Muslim (011-875-404) community projects in Kampot and Adventist Development Mike Robb (023-217-706, Email: [email protected], Battambang and youth education projects and Relief Agency (ADRA) 012-798-136) [email protected] at universities in Phnom Penh and schools HIV/AIDS contact: Website: www.amda.or.jp in Siem Reap, Pailin and Kampot. Phnom Penh Lorraine Hudson (012-415-749) Faith-based organization with projects in Email: [email protected]. Australian People for Email: [email protected] Pursat and Kampong Thom, which aim to [email protected], lorraine_hud Health, Education and Tel:023-990-030 restore dignity and educate young people [email protected] Development Abroad www.redcross.org.au about reproductive health. Training Website: www.aocam.org (APHEDA) BBC World Service Trust Buddhist leaders and local authorities. Association for Farmer Phnom Penh Phnom Penh Country Director: Development (AFD) Mark Schwisow Also known as Union Aid Abroad, Promotes changes in behavior through (023-880-693, 012-813-213) Takeo the overseas aid agency of the Australian the production of radio and television Council of Trade Unions has integrated HIV/AIDS contact: Supports PLHA, orphans and vulnerable commercials including Jackie Chan with Sieng Bunthoeun (011-957-741) STD/HIV/AIDS awareness into all AusAID- Louk Chouy. Also produces a television children in Kirivong operational district assisted vocational education and agricultural Email: [email protected], including home visits and food support drama called "Taste of Life" on TV5 and [email protected] training programs.Working with the ILO, radio phone-in shows. in partnership with the World Food it has also carried out an HIV/AIDS project Website: www.adracambodia.org Programme.

96 NON-GOVERNMENT ORGANIZATIONS 97 Country Director: Other contacts: Cambodia HIV/AIDS children in schools and provides food David Wood (023-430-555) Prak Chea (012-736-042), Education and Care in partnership with the World Food Email: [email protected] Mok Chantha (012-571-543), (CHEC) Programme. Also provides education and Website: www.bbc.co.uk/ Khem Bounnath (012-566-253), referrals in Kampong Trach and Dangtong worldservice/trust Venerable Toeuch Yun (012-996-455), Phnom Penh districts. Kong Sokunthea (012-592-497) Works with provincial HIV/AIDS offices NON-GOVERNMENT ORGANIZATIONS Banteay Srei Care and Email: [email protected] Director: Support and about 200 volunteers in each district Leng Sothea (012-651-123) Cambodia Family to provide training, counseling, care and Email: [email protected] Phnom Penh support. Development Services Cambodian Health and Tel:023-216-992 (CFDS) Program Manager: Human Rights Alliance Email: [email protected] Kasem Kolnary (023-884-473) Banteay Meanchey HIV/AIDS contacts: (CHHRA) BattambangWomen's SECTION 17 Targets sex workers in Sisophon and Dr. Pen Leakhena (092-294-218), Phnom Penh AIDS Project (BWAP) Poipet. Offers education and vocational Kim Ton (012-486-940) Works on research and action to increase training. Funded by USAID through Family Email: [email protected] Battambang the human rights of especially vulnerable Health International. Website: www.chec-cambodia.org Provides home-based care and supports people. orphans and vulnerable children in Thmor Director: Cambodian Children John Phay (012-847-720) Director: Kol operational district including referrals Against Starvation and Sim Kim Horn (023-212-941) Project Manager: to key health services and support for Violence Association Email: [email protected] self-help groups. Meas Yen (054-710-022) (CCASVA) Email: [email protected], Cambodian Health Operations Manager: [email protected] Prey Veng Em Siv Heng (053-952-150, Education Development Educates young people and sex workers 016-777-199, 016-530-236) Cambodia Health (CHED) and supports PLHA and affected children Consultants: Committee (CHC) in 16 villages in Takor and Kampong Leav Phnom Penh, Battambang, Pailin Kim Lon (016-934-241), Phnom Penh communes in Kampong Leav district. Grik Pouv (016-946-174) Provides home based care in Pailin. In collaboration with CHEMS (see below), Email: [email protected] Provides home care in Svay Rieng and Country Director: broadcasts radio programs on two stations Kampot. Also provides anti-retroviral Bunrouen Phok (023-993-615, in Battambang and one in Pailin. Has also Buddhism for Development treatment in Svay Rieng in cooperation 012-888-613) been working in five garment factories in (BFD) with NCHADS and the Svay Rieng Email: [email protected] Phnom Penh. Battambang Referral Hospital. In Kampot, patients are referred to Takeo where Medecins Sans Cambodian Development Executive Director: Trains monks in HIV/AIDS and uses Frontieres Belgium operates a clinic. and Relief Center for Lok Vichet (023-884-842, the Anlongville Wat as a home for the Poor (CDRCP) Country Director: 053-952-771, 012-820-883) children orphaned by AIDS. Provides Pailin Coordinator: home-based care in Anlongville and O Dr. Chiv Bunthy (023-885-169, Kampot 012-952-508) Khy Nearyroth (012-708-301) Dambang 1 and 2 communes. Refers Provides home care with counseling HIV/AIDS contact: Email: [email protected] suspected tuberculosis cases to health and welfare support. Also supports the Dr. Sok Thim (012-952-858) centers for screening and treatment. enrolment of orphans and vulnerable Email: [email protected], Branch Manager: [email protected], Pok Socheat (063-370-041, [email protected] 012-725-191)

98 NON-GOVERNMENT ORGANIZATIONS 99 Cambodian Health Cambodian Network of Cambodian Organization Cambodian Social Education Media Service People Living With HIV/ for Human Rights and Economic Development (CHEMS) AIDS (CPN+) Development (COHD) Association (CSEDA) Phnom Penh Phnom Penh Pursat Bantey Meanchey A project of UK based organization Health Provides home care for PLHA as well Provides home care to PLHA as well as NON-GOVERNMENT ORGANIZATIONS Lobbies for human rights, reducing stigma Unlimited, CHEMS produces radio and and discrimination, and access to anti- as orphans and vulnerable children in orphans and vulnerable children in O television commercials mainly targeting retroviral treatment. Meets with hospital Sompov Meas district. Also provides Chrov and Thmar Pouk operational districts. young people from 12 to 25.It also produces doctors and school teachers, and has education and referrals. Food is provided through the World Food a twice-weekly 15-minute radio soap opera Programme. strong government links. In 2004 it Director: called "Lotus on a Muddy Lake" as well as covered over 10,000 PLHA in 275 self-help Mr. Kim San (052-951-752, Director: a live one-hour radio show called "Especially groups in 12 provinces and municipalities 012-723-853, 012-652-271) Yim Bun Son (054-710-056, for You,Young People." SECTION 17 (Phnom Penh, Battambang, Kampong Email: [email protected] 012-835-931) Executive Director: Cham, Siem Reap, Prey Veng, Svay Rieng Deputy Director: Kim Sokuntheary Kampong Thom, Sihanoukville, Kandal, Cambodian Red Cross Sok Sarun (012-863-415) Takeo, Pursat and Kampong Speu). (CRC) Email: [email protected] Other contacts: Yvette Height (023-219-305, Director: Phnom Penh Cambodian Vision for Heng Sokrithy 023-218-410, 012-214-973) Started with community education in five (023-216-399, 012-934-777) Development (CVD) Nou Sovann (012-848-785), provinces in 1995. By 2004, it was working Email: [email protected] Battambang Sour Leng (016-830-447) in 11 provinces and municipalities providing Email: [email protected], Cambodian Organization education for young people and police, HIV prevention for indirect sex workers [email protected] community support for PLHA and their and workers clearing landmines. Website: www.healthunlimited.org of People Living with HIV/AIDS (COPHA) families and effort to prevent stigma and discrimination. In addition to Phnom Penh, Country Director: Cambodian Human Rights Mounh Sarath (012-565-699) Phnom Penh HIV/AIDS activities are also located in Email: [email protected] and HIV/AIDS Network Siem Reap, Kampot, Pailin, Kampong Cham, Provides traditional medicine, counseling, (CHRHAN) Banteay Meanchey, Battambang, Koh Kong, home care and referrals. Works with Cambodian Women for Sihanoukville, Prey Veng and Svay Rieng. Phnom Penh Italian organization Don Bosco in caring Peace and Development Network of more than 30 local human for children with HIV/AIDS. HIV/AIDS Program Manager: (CWPD) Dr. Sok Long (023-990-030, rights and HIV/AIDS related non- Country Director: Phnom Penh 012-688-081) government organizations. Investigates, Bunthy Sok (012-803-040) Project Team Leader: Provides education for sex workers, documents and monitors human-rights HIV/AIDS contact: Mom Chanthy (012-928-579) migrants, community leaders and indige- violations against PLHA and others Billy Barnaart (016-890-891) Email: [email protected], nous people in Kandal, Kampong Chhnang, affected, and advocates for the elimination Email: [email protected] of stigma and discrimination. Funded by [email protected] Kampong Thom, Kampong Speu, Batta- USAID through the POLICY Project. mbang, Siem Reap, Pailin, Prey Veng and Kampong Cham as well as Phnom Penh. Director: Dr. Kang Serei (023-993-295, Country Director: 012-588-299) Men Sam An (023-724-274, Email: [email protected] 012-912-042)

100 NON-GOVERNMENT ORGANIZATIONS 101 Other contact: Catholic Office for Director: Church World Service San Arun (012-807-704) Emergency Relief and Dr. Hean Sokhom (016-813-511) (CWS) Email: [email protected] Refugees (COERR) Email: [email protected] Website: www.cascambodia.org Phnom Penh Cambodian Women's Phnom Penh Tel:023-214-494 American faith-based organization providing Development Association Faith based organization from Thailand. education on prevention, transmission NON-GOVERNMENT ORGANIZATIONS (CWDA) Centre Canadien d'Etude Conducts seminars on HIV/AIDS prevention et de Cooperation and care in Kampong Thom, Battambang, Phnom Penh and care for monks in Kampong Speu and Banteay Meanchey and Svay Rieng.Targets helps operate the Wat Opod Health International (CECI) include traditional birth attendants and Provides education on human rights in Center in Takeo province which cares for Takeo volunteers. relation to HIV/AIDS among sex workers, PLHA. police, military and teachers including Operating in Kvao and Roneam communes, Country Director: training in brothels. Director: CECI seeks to mitigate the spread of Josephine Barbour (023-217-786)

SECTION 17 San Vandin (023-364-306) HIV/AIDS among women and vulnerable Deputy Director: Director: Email: [email protected] people in rural areas. Olivet Visda (023-213-438) Kien Serey Phal (023-210-449, Email: [email protected], 023-210-487, 012-999-995) Catholic Relief Services Country Director: [email protected] HIV/AIDS contact: (CRS) Monique Larose (023-217-561) Website: www.churchworldservice.org Keo Sichan (016-904-915) Health Coordinator: Email: [email protected] Battambang Muriel Mac-Seing (012-449-367) Community of Cambodian Website: www.bigpond.com.kh/ American faith-based organization Email: [email protected], Women for Development users/cwda conducting HIV/AIDS awareness and [email protected] (CCWD) education activities in five districts. Website: www.ceciasia.org Caritas Kandal Country Director: Christian Care for Siem Reap Educates young people and garment Richard Balmadier (012-907-806) Cambodia (CCFC) factory workers. Makes referrals and Faith-based organization providing home- HIV/AIDS contact: Phnom Penh home visits. care services to PLHA including anti- Heng Bunsieth (012-907-802) retroviral treatment, food and loans to Email: [email protected], Operates a center in Kampong Speu Director: start businesses. Also builds homes and [email protected] for desperate families with HIV/AIDS. Sorn Dedynin (011-667-727) provides transport from villages to hospitals Website: www.catholicrelief.org Families also come from outside the Other contacts: and clinics. province, referred by organizations such Mo Rein (011-621-376) Center for Advanced as Maryknoll, Servants to Asia's Urban Ing Sengkim (012-833-584) Country Director: Studies (CAS) Poor and Hagar. Bernadette Glisse (012-735-477) Community Development Email: [email protected] Phnom Penh Team Leader: Action (CDA) Website: www.caritas.org.au Independent institution devoted to Barry Higgins (023-880-019) Battambang research, education and public debate on HIV/AIDS contact: issues affecting the development of Tim Razloff (023-883-653) Has prevention projects in Banan and Cambodian society. Since 1998, it has Email: [email protected], Battambang districts. Part of the Frontiers completed surveys and other research [email protected] Prevention Project, it aims to extend related to HIV/AIDS. prevention activities and services to more

102 NON-GOVERNMENT ORGANIZATIONS 103 than 1,000 men who have sex with men Country Director: Head of Delegation: Ensemble pour une including Battambang,Thmar Kol and Sangke Sharon Wilkinson Agnes Lesage (023-212-945, Solidarite Therapeutique operational districts. (023-215-267/8/9, 012-424-019) Hospitaliere En Reseau Fax: 023-426-233) Phnom Penh Medical Coordinator: Country Director: HIV/AIDS contact: Beatrice Mea (012-263-617) (Esther) Im Luom (012-530-525) Dr. Sok Pun (012-914-129) Sihanoukville Medical Coordinator: Phnom Penh Email: [email protected] NON-GOVERNMENT ORGANIZATIONS Emails: [email protected], Rozenn Le Meliner (012-325-925) [email protected] Email: crf-cambodge-hod@every Supports anti-retroviral treatment at Community Poverty Calmette Hospital and Siem Reap Regional Reduction (CPR) Website: www.care-cambodia.com day.com.kh, Koh Kong (012-661-165) [email protected], Hospital in partnership with three French Kampong Chhnang Poipet (012-520-014) [email protected] university hospitals (Bicetre, Tours and Pursat (012-910-931) Website: www.croix-rouge.fr Brest). Project had reached almost 1,000 Provides home support for PLHA as well Sisophon (012-725-962) patients as of 2004. as orphans and vulnerable children. Also DHAMMYIETRA SECTION 17 Oddar Meanchey (012-725-962) provides education on prevention and Country Representatives: referrals for testing. Mongkol Borei Ly Cheng Huy (012-977-933) Coordination of Action HIV/AIDS contact: Director: Research on AIDS and Cares for people with AIDS who are dying Heng Tay Kry (023-426-948, Roth Sophea (012-797-930) Mobility (CARAM) at home. 011-810-790) Cooperation for a Phnom Penh Team Leader: Ouk Vara (011-820-035) Arlys Herem (012-924-248) Email: [email protected], Sustainable Cambodian Aims to reduce HIV/AIDS among migrant Email: [email protected] [email protected], Society (CSCS) workers including Cambodians going to [email protected], work abroad as well as Vietnamese and Phnom Penh Douleurs Sans [email protected] Cambodian sex workers. Provides home Frontieres (DSF) Website: www.esther.fr Administrator: care, support groups, education and Chim Chan Nang (012-668-853, counseling. Phnom Penh Family Health 023-726-181) International (FHI) Program Director: French-based organization working in the Email: [email protected] Tep Mony (023-218-065, areas of pain management and palliative Phnom Penh 012-847-976) care for people with chronic diseases Cooperative for Assistance American-based organization which Sex Worker Project Coordinator: including HIV/AIDS and cancer. Based at and Relief Everywhere provides technical support to NCHADS Ek Salan (012-782-193) Calmette Hospital, it works closely with for the HIV Sentinel Surveillance system (CARE) Email: [email protected] the Ministry of Health and Ministry of and interpretation of the data. FHI is also Phnom Penh National Defense. Supported by the Croix Rouge Francaise Global Fund on HIV/AIDS, Tuberculosis involved in preventing HIV among those The Cambodian partner of the Bangkok- (CRF) and Malaria, it also operates a care center most at risk of sexual transmission, based Asian Business Coalition on HIV/ at Preah Keat Mealea Hospital in Phnom providing care to PLHA in Battambang AIDS works with youth, casino workers, Phnom Penh Penh. and reducing the impact of AIDS on sex workers, mobile populations, married Operates program funded by the Global orphans and vulnerable children. Future couples, garment factory workers, soldiers Country Director: priorities include expanding prevention Fund on AIDS, Tuberculosis and Malaria Auk Phany (023-430-334, and police, seafarers, men who have for adults and children with HIV/AIDS in for families of high-risk men and expanding sex with men, PLHA, orphans and vulner- 012-917-971) a pilot care and treatment program to Phnom Penh and Sihanoukville including Email: [email protected] able children and moto-taxi drivers. In access to anti-retroviral treatment.Works more areas. Operations in Kampong Cham, Cambodia for more than 20 years. Website: www.douleurs-sans- Koh Kong, Kep, Siem Reap, Kampong Thom, with the Cambodian Red Cross and the frontieres.org National Pediatric Hospital. Battambang,Pursat,Pailin,Banteay Meanchey,

104 NON-GOVERNMENT ORGANIZATIONS 105 Kandal, Kampong Chhnang and Phnom Takeo. Dim Vy Penh as well as at the national policy level. Hagar (053-952-797, 012-949-375) Country Representative: Email: [email protected], Phnom Penh Marc Vandenberghe FHI Country Director: [email protected] Dr. Chawalit Natpratan (023-213-561, 012-803-065) Project run by Swiss organization Associ- Website:www.helpage.org (023-211-914, 012-808-980) Email: [email protected] azione Bambini Bisognosi d'Asia (ABBA)

NON-GOVERNMENT ORGANIZATIONS Website: www.healthinternational.org HIV/AIDS contact: with a shelter for women and children in HIV/AIDS Coordinating Caroline Francis (012-804-292) Phnom Penh. Provides counseling and Health Unlimited Committee (HACC) Senior Surveillance and Evaluation Officer: support for women with HIV/AIDS and Dr. Guy Morineau (023-211-914) Phnom Penh referral for home care. Some women also Rattanakiri Email: [email protected], A network of some 80 local and interna- receive vocational training. Hagar also British-based organization working to [email protected], tional non-government organizations operates a soymilk factory. prevent HIV among the Tampoeun,, [email protected] working in the HIV/AIDS sector. Plays a Website: www.fhi.org Director: Brao and Jarai indigenous peoples in 32

SECTION 17 leading role in coordinating yearly national villages in Rattanakiri. Working with Keiv Rany (023-217-478, 012-569-299) awareness campaigns. Also publishes Friends Association Shelter Manager: Population Services International. Pioneer information on caring for PLHA and a Mam Savath (012-910-536) Project Manager: directory of members. HACC is managed (FAP) Email: [email protected], Caroline McCausland by a voluntary steering committee of seven Siem Reap [email protected] (075-974-109, 023-215-192) members and is headed by a full-time Website: www.hagarproject.org Email: [email protected], coordinator. Major donors in 2003 were Provides care and support for PLHA as [email protected] KHANA, USAID, Pact and Pfizer. well as orphans and vulnerable children in Handicap International Website: www.healthunlimited.org Sothnikom operational district. Works France (HIF) Coordinator: closely with Médecins Sans Frontières to Seng Sopheap (012-774-373) Siem Reap Helen Keller provide anti-retroviral treatment. International (HKI) Email: [email protected] French-based organization which provides Executive Director: HIV/AIDS education to people living in Phnom Penh Hope for Persons with Peng Sakun (012-943-155) Kralanh district through the Sen Sok, Prey HIV/AIDS Email: [email protected] New York-based organization carrying Chouk, Sleng Spean and Sam Bour health out a food production project in Banteay Organization (HPHAO) Frontiers Prevention centers. Meanchey for people affected by HIV/ Kampot AIDS. Project (FPP) Country Manager: Provides free traditional medicine to the Siem Reap and Battambang Yvan Thebaud (012-441-982) Health contact: poorest PLHA, allowing them to prolong Health contact: Hou Kroeun (012-824-061) their lives as they wait for anti-retroviral Works with government and non-govern- Dr. Chuo Vivath (012-812-990) Website:www.hki.org treatment. Also runs free child-care centers ment agencies to avoid duplication. Also Email:[email protected], in Kampot and Kampong Chhnang. works with sex workers, men who have [email protected] Helpage International sex with men and PLHA in Battambang (HAI) Director: operational district. Healthnet International El Sma El (012-934-261) Battambang and Siem Reap Coordinator: Phnom Penh Banteay Meanchey Hope Worldwide Dr. Kros Sarath (012-695-676) Netherlands-based organization working British-based organization which implements Phnom Penh Battambang Coordinator: with NCHADS and the Antwerp Institute income generation and home care programs Dr. Ouk Vichea (012-621-351) of Tropical Medicine to educate young American faith-based organization targeting targeting older care givers, orphans and Email: [email protected], people about HIV prevention and provide destitute PLHA as well as patients at the vulnerable children and PLHA. [email protected] care to PLHA.Activities in Sampow Meas Russian, Calmette and Military hospitals operational district in Pursat and Kirivong HIV/AIDS contact: and the Sihanouk Center for Hope in and Ang Roka operational districts in

106 NON-GOVERNMENT ORGANIZATIONS 107 Phnom Penh. [email protected], [email protected] (042-941-783, 012-300-042) Faith-based organization with a child- Website: www.fhi.org Email: [email protected], welfare project in Phnom Penh and Community Project Coordinator: [email protected] Kandal training orphanages on how to Chhavelith Vathdama (011-822-113) Indradevi Association care for children affected by or living Officer Manager: (IDA) Institut Pasteur du with HIV/AIDS.Another project targeting Ms Kao Pov (023-211-524, Cambodge (IPC) indigenous people in Rattanakiri deals 023-882-614, 011-822-113) Phnom Penh NON-GOVERNMENT ORGANIZATIONS Phnom Penh with HIV/AIDS education. Volunteer Coordinator: Operates a clinic for sexually-transmitted Teav Roth Mith (011-850-473, infections and provides education about Private foundation dedicated to prevention Project Manager: 023-882-613, 011-932-663) prevention and home care for PLHA in and treatment of diseases through biological Deth Yim Symons Team Leader: Phnom Penh and Kien Svay district in research, education and public health (023-215-200, 023-213-310) Phoung Bunthy (011-841-366) Kandal province. Covers people ranging activities. Several projects funded by the Program Manager: Email: hopecambodia@ from sex workers, factory workers and French organization for AIDS research. Sarah Chhin (012-563-144) bigpond.com.kh, young people out of school to police and Email: [email protected], SECTION 17 [email protected], military. Country Director: [email protected], Website: www.hopeww.org Dr. Jean-Louis Sarthon Website: www.icc.org.kh Country Director: (023-368-036) Implementing AIDS Dy Ratha HIV/AIDS contact: Inthanou (023-214-804, 012-897-161) Dr. Phoung Viseth (012-802-979) Prevention and Care Phnom Penh Project (Impact) Program Coordinator: Email: [email protected], Uy Soung Chhan Sothy [email protected] Cambodia's first HIV/AIDS hotline. Started Phnom Penh (012-556-270) Website: www.pasteur-kh.org in 2000 with support from UNICEF USAID's flagship effort for addressing the Kandal Team Leader: and Mobitel. It provides information on global epidemic. Managed by Family Health Som Sin Sokha (011-923-217) Institute of Tropical transmission, prevention and care as well International (FHI), the project works Email: [email protected] Medicine of Antwerp (ITM) as psychological support for PLHA. The with government and non-government Phnom Penh hotline operates from 11 a.m. to 8 p.m. organizations in Cambodia to reduce HIV Inner Change and was receiving 160 calls a day in its transmission, improve HIV/AIDS care and Kampong Cham Provides technical advice to NCHADS fourth year. Partners include the Ministry support, mainly for sex workers and their and works with the Sihanouk Hospital of Education,Youth and Sport, UNESCO, clients. The programs help women to A program for poor people run by Center for Hope in Phnom Penh. Also RHAC and HACC. negotiate safe sex, educate uniformed Church Resource Ministries, an American works with British-based organization Country Director: personnel about HIV/AIDS, build capacity faith-based group. In Kampong Cham, it Health Unlimited. Operations cover Dr. Loun Monyl (012-911-664) for institutional care and support, and runs a home-care project for PLHA called Sihanoukville,Takeo and Pursat as well as Hotline: (012-999-008, 012-999-009) reintegrate orphans and other vulnerable Sunrise which provides simple drugs, Phnom Penh Email: [email protected] children into extended or foster families. food, accommodation and referrals to Medecins Sans Frontieres for anti-retroviral Project Manager: FHI Country Director: treatment. Dr. Francois Crabbe (012-809-330) Jeannine's Children Dr. Chawalit Natrapan Clinician: Association (JCA) Program Director: Dr. Paul de Munther (012-678-925) (023-211-914, 012-808-980) Phnom Penh HIV/AIDS contact: Diane Moss: Email: [email protected], Caroline Francis (012-804-292) [email protected] Runs an orphanage in Tuol Kork for children Senior Surveillance and Evaluation Officer: whose parents have died of AIDS.Works Dr Guy Morineau (023-211-914) International Cooperation with HIV-positive children with Maryknoll. Email: [email protected], Cambodia (ICC) Country Director: Phnom Penh Kong Sovanlay

108 NON-GOVERNMENT ORGANIZATIONS 109 (012-803-040, 012-932-285) Nguon San (012-928-290) Director: Email: [email protected], Email: [email protected] Email: [email protected] Ing Soeurn (012-816-971) [email protected] Program Manager: Kaksekor Thmey Khemara Pak Kimsan (012-912-727) Khmer Rural Development Kampong Cham Phnom Penh E-mail: [email protected], Association (KRDA) [email protected] Battambang NON-GOVERNMENT ORGANIZATIONS Implements a program that integrates Educates women in Russey Keo district HIV/AIDS education within its agricultural about HIV/AIDS. Also runs a shelters for Khmer HIV/AIDS NGO Provides care and support for more than activities. women victims of domestic violence. Alliance (KHANA) 100 PLHA in Moung Russey district. Director: Director: Phnom Penh Works closely with CPN+ and is increasingly Men Savann (012-968-605) Koy Phallany (023-430-620) involved in human rights-related work. Provides technical and financial support Email: [email protected] HIV/AIDS contact: Home care includes treatment, counseling, to more than 50 local non-government Pol Rithy (012-927-279) food, home repairs, and education about

SECTION 17 organizations to carry out a wide range of Kien Kes Volunteer Email: [email protected] hygiene. Most staff are teachers from Thai Network (KKVN) HIV/AIDS activities including prevention border camps. Khmer Buddhist for sex workers, garment factory workers Director: Battambang Association (KBA) and young people. Partners also take care of PLHA and their families including Pouk Cham Roeun Provides care and support for orphans Banteay Meanchey orphans and vulnerable children. Home (012-920-029, 012-420-057) and vulnerable children as well as PLHA in care in collaboration with NCHADS Email: [email protected] Thmor Kol district. Supports PLHA and orphans in Thmar involves staff from government health Website: www.krda.org.kh Pourk operational district. Provides home Tel:012-681-450 centers and volunteers including monks. support, food through the World Food Khmer Women's Teams provide basic medical care, psycho- Programme and referrals to health facilities Key of Social Health logical and social support, counseling, Cooperation for for testing and care. Also conducts HIV Education Road welfare and referrals. They also negotiate Development (KWCD) (KOSHER) prevention activities. waivers of schools fees and provide Sihanoukville Phnom Penh Project Director: school clothes and materials as well as Ros Monichoth: (012-824-373) advice to parents with HIV/AIDS. Partners Provides home care for PLHA and support Supports four home-care teams in Phnom Facilitator: are also involved in reducing stigma and for orphans and vulnerable children. Also Penh for more than 400 adults and Yan Somaly: (ICOM 146520, discrimination against PLHA, their families works with sex workers and men who children with HIV/AIDS and more than call sign "kilobase") and other marginalized people like sex have sex with men in addition to making 600 children affected. Teams provide workers and men who have sex with men. referrals for other services including anti- clinical management, nursing, health Khmer Development of Operates in Banteay Meanchey, Seam retroviral treatment. Operates a gardening education and referrals as well as Freedom Organization Reap, Battambang, Kampong Thom, Kratie, project in partnership with Helen Keller counseling, education to reduce stigma and (KDFO) Kampong Cham, Kampong Chhnang, International. discrimination. Also provides food and Pursat, Kampong Speu, Prey Veng, Svay clothing and supports schooling and Phnom Penh Director: Rieng, Kampot, Takeo, Phnom Penh and funerals.Works with the National Center Sum Satum (012-866-617) Works with men who have sex with men Sihanoukville. for Tuberculosis and Leprosy Control, Other contact Heng Bunhak in three areas of Phnom Penh (Boung voluntary counseling and testing centers, (011-884-121) Tompon, Veal Vong and Chba Ampeou) Director: clinics for sexually-transmitted infections Dr. Oum Sopheap Email: [email protected], and also tries to prevent sexual health and government hospitals as well as local (023-211-505, 012-349-635) clinics from over-charging for services. authorities and pagodas. Distributes free condoms. HIV/AIDS contact: Dr. Phum Sophiny (012-809-250) Director:

110 NON-GOVERNMENT ORGANIZATIONS 111 [email protected], sex workers, migrants and casino workers supports provides group homes from department at Calmette Hospital offering [email protected] in the borders areas of Kam Rieng and children infected and affected by HIV/AIDS, 55 beds and an outpatient department Phnom Prek districts. as well as income generating activities for specializing in HIV/AIDS care. Moved all Kratie Women's Welfare families affected by HIV/AIDS HIV/AIDS activities to Preak Kossamak Country Director: Hospital in 2004. Association (KWWA) David Mueller Program Director:

NON-GOVERNMENT ORGANIZATIONS Kratie (023-881-100, 012-791-191) Father Jim Noonan (023-425-018) Country Director: Program Coordinator: Email:[email protected], Dr. Pierre-Regis Martin Provides home care for PLHA as well as Albert Weinmann (012-791-193) [email protected] (023-882-238) support for orphans and vulnerable Email: [email protected], Email: [email protected] children in Kratie operational district.Also [email protected], Media Consulting and www.medecinsdumonde.org educates people about HIV prevention, Website: www.lwfcam.org.kh, Development (MCD) especially young people, and makes www.lutheranworld.com Médecins Sans Frontières- referrals to health facilities. Phnom Penh Belgium (MSF-B) SECTION 17 Marie Stopes Provides HIV/AIDS clippings from local Director: Phnom Penh Yous Thy International (MSI) press and developing annual HIV/AIDS press monitoring report. Also working on film Belgian organization providing care through (072- 971-586, 012-916-329) Phnom Penh Email: [email protected] projects with Action IEC and NCHADS. chronic disease clinics in provincial referral British-based reproductive health organi- hospitals in Siem Reap and Takeo and the Leadership's Khmer zation with outreach activities targeting Country Director: district referral hospital in Sotnikum in Sebastien Drans factory workers and karaoke girls, Seam Reap. Services include treatment Women for Development (023-224-303, 012-550-110) (LKWD) community condom distribution and for opportunistic infections like pneu- education programs on HIV/AIDS. HIV-AIDS contact: mocystis carinii pneumonia and crypto- Cedric Jancloes (012-803-670) Banteay Meanchey coccal meningitis as well as counseling Email: [email protected] Project Director: and education to promote adherence to Executive Director: Ros Thoeun anti-retroviral treatment.The number of Buth Hiev (012-633-687) (023-720-125, 023-720-724) Médecine de l'Espoir Email: [email protected] Cambodge (MEC) people receiving highly-active anti-retroviral Nurse Lab Technician: treatment was estimated to reach 1,500 in Dr. Nop Sothearanak (012-838-347) Lutheran World Phnom Penh 2004. Email: [email protected] Federation (LWF) Operates clinic for sex workers in Country Director: Phnom Penh Maryknoll Seedling of Psa Thmei. Also works with men who Richard Veerman Hope have sex with men. Partnership with (023-880-334, 012-811-302) The Swiss-based federation of Christian Family Health International. Phnom Penh HIV/AIDS contact: churches in the Lutheran tradition works Bart Janssens (012-871-447) Director: closely with the government in Kampong American faith-based organization targeting Email: [email protected], Keth Thairth Speu, Kampong Chhnang and Battambang poor PLHA and Vietnamese in 15 fishing [email protected] (023-986-715, 012-844-449) in the field of rural development including villages in and around Phnom Penh including Website: www.msf.be HIV/AIDS-related activities. It works with Takhmao. Provides education and informa- HIV/AIDS contact: Dr. Ung Prohot (012-939-250) provincial and district AIDS committees tion on how to care for people with AIDS Médecins Sans Frontières- Email: [email protected] and offices as well as volunteers, educators, and works to reduce stigma and discrimi- France (MSF-F) monks, traditional birth attendants and nation. Provides home or office care to Médecins Du Monde (MDM) Phnom Penh PLHA, focusing on awareness, prevention, hundreds of PLHA including medicines, care and support. In Battambang, it works food, money, emotional support, rent Phnom Penh French organization providing anti-retroviral with provincial AIDS officials in targeting support and monitoring of children. Also treatment at the infectious diseases depart- French organization with an inpatient ment of Preah Bat Norodom Sihanouk

112 NON-GOVERNMENT ORGANIZATIONS 113 Hospital in Phnom Penh and the HIV clinic Programme and makes referrals to HIV/AIDS contact: Association (NAPA) at the provincial hospital in Kampong Cham. USAID-supported clinics. Touch Setha (012-472-305) Also trains doctors and nurses working Email: [email protected], Kampong Speu Director: for the Ministry of Health and supports [email protected] Penh Sinal (012-898-258) Provides home care for PLHA in Kampong other organizations such as the Association Website: www.mloptapang.org Email: [email protected] Speu as well as support for orphans and of Users of Anti-Retrovirals. By 2004, the vulnerable children. Also educates young

NON-GOVERNMENT ORGANIZATIONS Nak Akphivath Sahakum French organization was providing anti- Missionaries of Charity people about prevention. retroviral treatment to more than 1,300 (NAS) people. Phnom Penh Director: Kampong Cham Ang Chamroeun (016-838-387) Faith-based organization running a hospice Head of Mission: Operates three home-care teams for up for tuberculosis patients in Chaom Chau. Catherine Quillet to 130 patients in as many as 10 villages. Nyemo Also has orphanages in Phnom Penh (012-211-281, 012-854-395) The teams are based in local health centers and Siem Reap for HIV-positive children Phnom Penh

SECTION 17 and include part-time government staff Medical Coordinator: abandoned by their families. Dr. Didier Laureillard as well as volunteers. Also educates Runs a center for vulnerable women and (012-815-393) Hospice Contact: local villagers about HIV/AIDS and children in Phnom Penh. Services include Email: [email protected], Sister Mary Paul (023-363-435) recruits monks to help reduce stigma and counseling, health care, psychological msffr.sida@online,com.kh Orphanage Contact: discrimination. support, day care for children, temporary Website: www.msf.org Sister Bertina (023-213-491) shelter. vocational training and job Director: placement . Men's Health Cambodia Mith Samlanh/Friends Savan Samol (012-579-048) Project Coordinator: Director: (MHC) Phnom Penh Pho Sophorn Ky Kanary (023-216-944, 012-889-956) Phnom Penh Targets street children, vulnerable youth (012-897-103, 012-579-048) Email: [email protected] Coordinator: Carries out prevention activities with and their families. Provides information, Hoeung Vireak (012-965-253) men who have sex with men and sex condoms and medical supervision including National Center in HIV Email:kykanary_nyemo@everyday. workers in Phnom Penh and Siem Reap. access to anti-retroviral treatment when com.kh, hvireak_nyemo@every- possible, as well as funding for cremation Epidemiology and Clinical HIV/AIDS contact: Research (NCHECR) day.com.kh ceremonies. Website: www.nyemo.com Mao Kim Run Phnom Penh (016-885-535, 011-783-354) Coordinator: Operations Enfants [email protected] Sebastien Marot (023-220-596) Australian research center collaborating Program Director: with NCHADS since 2000. Provides de Battambang (OEB) Minority Organization Ms Ly Sophat (023-426-748) funding and support for anti-retroviral Battambang Development Economy Email: [email protected] treatment at the Cambodia Treatment (MODE) Website: www.streetfriends.org Access Clinic including full-time technical Local organization helping children and advisors and training for health staff disabled people to become self-reliant. Kampong Thom Mlop Tapang providing HIV/AIDS treatment. Also Also helps abandoned AIDS patients with counseling as well as material and financial Runs HIV prevention activities and home supports NCHADS surveillance systems. Sihanoukville support. Works with UNICEF in training care for PLHA as well as orphans and Technical Advisor: Buddhist nuns. vulnerable children in Kampong Thom Italian organization educating street children about HIV/AIDS at a day-care center in Dr. Sarah Huffam (023 223 146) operational district. Provides food in Email: [email protected] partnership with the World Food Sihanoukville. Works closely with Khmer Women's Cooperation for Development. Website: www.med.unsw.edu.au/nchecr Maggie Eno (012-587-407) National Prosperity

114 NON-GOVERNMENT ORGANIZATIONS 115 Director: Judi Harris (012-492-348) Coordinator: operations in more than 40 countries Tith Davy Email: [email protected], Or Van Din including Cambodia and Vietnam. The (053-952-752, 012-910-095) [email protected], (011-926-037,012-975-873) project is implemented by the Washington- Email:[email protected] [email protected] Email: [email protected] based Futures Group, a Constella company, www.partnersfordevelopment.org in collaboration with the Centre for Pact Cambodia Pharmaciens sans Development and Population Activities

NON-GOVERNMENT ORGANIZATIONS Partners for Health Frontières (PSF) and Research Triangle Institute. In Phnom Penh Reformplus (PHR) Phnom Penh Cambodia, initiatives include working with Independent corporation based in Phnom Penh monks to combat stigma and discrimina- Washington. Works with Cambodia French organization which provides tion, protecting human rights, empowering People Living with HIV/AIDS Network USAID-project providing information consultations and education on sexually- people infected and affected by HIV/AIDS, (CPN+) and the HIV/AIDS Coordinating support to four referral hospital pilot transmitted infections at mobile clinics in and strengthening partnerships between Committee (HACC) in developing infor- sites in Banteay Meanchey, Battambang, bars and is also working to improves access government and civil society. Other

SECTION 17 mation materials such as booklets and Sihanoukville and Phnom Penh. The to anti-retroviral treatment by proving a activities include developing guidelines calendars. four sites are supported by the Japan long-term reliable supply of drugs. Partners for the HIV/AIDS law passed in 2002, International Cooperation Organization include NCHADS, Mith Samlanh and and working with marginalized groups. Country Director: (JICA), the Centers for Disease Control Medecine de l'Espoir Cambodge. Kurt MacLeod (CDC), the World Health Organization HIV/AIDS contact: (023-217-820, 012-811-705) Country Coordinator: (WHO) and Family Health International Candice Sainsbury (023-726-255) HIV/AIDS contact: Jean Yves Dufour (FHI). Email: [email protected] Phon Yut Sakar (012-956-389) (023-216-594, 012-867-500) Website: www.policyproject.com Email: [email protected], Coordinator: HIV/AIDS contact: [email protected], Jayaseeli Bonnet Emmanuel Wintx (012-633-021) Population Services [email protected] (023-222-420, 012-315-152) Email: psf_cambodia@online. com.kh International (PSI) Website: www.pactworld.org Website: www.psfci.org Technical Manager: Phnom Penh Kunrath Seak (012-958-347) Partners for Development Email: [email protected], Phnom Srey Association American-based organization which (PFD) [email protected] for Development (PSAD) launched Number One condoms in Phnom Penh Website: www.phrplus.org Cambodia in late 1994. By the end of Kampong Cham 2003, more than 120 million had been American-based organization offering Partners in Compassion Works with sex workers and brothel sold and the brand had an estimated 80 counseling on HIV prevention, sales of Takeo owners in three operational districts in percent share of the market. In 2002, PSI pills and condoms, referrals to health partnership with Family Health International. launched the United Health Network centers and training of barbers and Works with monks in providing home (UHN) of local and international NGOs motorcycle taxi drivers. Also works with care for PLHA in Takeo Bati and Prey Kabas Country Director: and the Sun Quality Health Network sports clinics, pagodas, primary school operational districts.Also makes referrals Hany Fiya (012-684-528) (SQHN) of private-sector clinics. PSI has teachers. Activities cover Kratie and to government and USAID-supported HIV/AIDS contact: also introduced Care female condoms, Chlong operational districts in Kratie and clinics. Runs a hospice and community Real Sophy (042-941-670) a water-based lubricant called Number Sre Ambel and Smach Meanchey districts center for PLHA as well as orphans Email: [email protected] One Plus, which mainly targets sex workers in Koh Kong. and vulnerable children and provides and men who have sex with men, as well food support through the World Food as OK condoms, which are targeted at Country Director: POLICY Project Programme. couples. Chris Smith Phnom Penh (023-213-335, 012-404-156) Country Director: HIV/AIDS contact: A five-year project funded by USAID with Andrew Boner (023-210-814)

116 NON-GOVERNMENT ORGANIZATIONS 117 Deputy Director: among young people to HIV transmission. [email protected], Sim Kalyan Jaqueline Devine Operates in Kampot, Pursat, Battambang, [email protected], (044-945-820, 012-940-755) Website:www.psi.org Banteay Meanchey, Siem Reap and Phnom [email protected], Email:[email protected], Penh. [email protected], [email protected] Program for Appropriate [email protected], Technology for Health Country Director: [email protected] Sacrifice Families and Chan Theary NON-GOVERNMENT ORGANIZATIONS (PATH) Orphans Development (023-213-724, 023-726-257) Rural Association for Association (SFODA) Phnom Penh HIV/AIDS contact: Development of Economy Vong Chesda (012-866-099) American-based organization with projects (RADE) Phnom Penh Email: [email protected] targeting migrant workers in Prey Vaeang. Website:www.rc.racha.org.kh Pursat Runs an orphanage and a home-care Also targets sex workers, police and program.Also has an education program. military, men who have sex with men, Reproductive Health Works with sex workers and brothel SECTION 17 orphans and vulnerable children. Partners Association of Cambodia owners in Pursat town as well as Krakor Director: include Cambodian Women for Peace (RHAC) and Sampeameas districts, in partnership Pen Sophan and Development and Family Health with Family Health International. (016-859-005, 012-936-805) International. In addition to Prey Veng, Phnom Penh HIV/AIDS contact: Director: activities cover Banteay Meanchey, Siem Ouk Moninarom (012-936-805) Educates adolescents, garment factory Var Bunny Reap, Battambang, Pursat, Koh Kong, workers, sex workers and fishermen about (052-951-709, 012-893-134) Kratie and Phnom Penh. Salvation Center HIV/AIDS. Provides diagnosis and treatment HIV/AIDS contact: Cambodia (SCC) Country Director: of sexually-transmitted infections, voluntary Chea Sokny (011-704-166) Stephen Croll (012-902-690) counseling and testing, pre-marital coun- Email: [email protected], Phnom Penh Email: [email protected], seling, youth friendly services and services [email protected] Provides home care and support for PLHA [email protected] to prevent mothers transmitting HIV to Rural Economic as well as orphans and vulnerable children. Website: www.path.org their children. In addition to Phnom Penh, Also provides education about sexually- RHAC operates in Battambang, Siem Reap, Development Association Reproductive and Child transmitted infections and makes referrals Sihanoukville,Takeo, Kampong Cham, Svay (REDA) to government and RHAC clinics. Healthcare Alliance Rieng and Kampong Speu. Svay Rieng (RACHA) Country Director: Country Director: Provides care and support for more than Prum Theoun Phnom Penh Dr. Ouk Vong Vathiny 200 people including almost 70 children (023-365-311,012-901-738) (023-855-135, 012-720-022) HIV/AIDS and sexually-transmitted affected by HIV/AIDS. Also provides HIV/AIDS contact: Health contact: infections form one of six focus areas of education in 40 villages located in eight Yai Bun Chhen (012-886-510) Dr.Var Chivorn (012-982-294) RACHA's program in Cambodia.Although communes and supports three self-help Email: [email protected] Phnom Penh, Psa Depo it works closely with the Ministry of Health, groups. Has created jobs for HIV/AIDS (023-885-135, 016-865-215) it also works extensively with local volun- households to earn money from making Save the Children Phnom Penh, Psa Toul Tompong teers and businesses as well as other bags, weaving baskets and feeding animals. Australia (SCA) (023-218-504, 012-777-216) NGOs and international agencies. It Battambang (053-952-616, Country Director: Phnom Penh supports voluntary counseling and testing 012-877-830) and access to nevirapine treatment for Australian organization that works with Kampong Cham (012-855-055) pregnant women. Also targets migrant adolescents, children affected by HIV/AIDS, Sihanoukville (034-933-942, couples and sex workers in rural areas, and monks. Education programs target 012-818-807) and works with the Ministry of Health adolescents in rural areas in Kratie, slums Takeo (012-823-595) to build social acceptance of condoms in Phnom Penh and poor areas in Prey Veng Siem Reap (063-964-960) and address issues of vulnerability Email: [email protected],

118 NON-GOVERNMENT ORGANIZATIONS 119 and Takeo provinces. Pagoda HIV/AIDS Mean Chey district. HIV/AIDS prevention activities for children Organizes group discussions and distributes committees are located in the Chbar and young people. Also helps fund programs condoms.Also provides nutrition counseling Country Director: Ampeou area of Phnom Penh, Prey Veng run by Servants to Asia's Poor and World and makes referrals for testing. Craig Greenfeld town and Bati district in Takeo. Relief as well as the Evangelical Fellowship (023-425-045, 012-947-462) of Cambodia. Director: Country Director: HIV/AIDS contact: Dr. Nea Seryotanak (012-891-827) Carol Mortensen (023-214-334) Or Ee (011-880-471) HIV/AIDS contact: NON-GOVERNMENT ORGANIZATIONS Email: [email protected], Email: [email protected] Pang Sophany (023-214-106) University Research [email protected] Website: www.servantsasia.org Email: [email protected] Company (URC) Website: www.savethechildern.org.au Social Environmental 24-Hour Television Phnom Penh Seek of the Pious Friend's Agricultural Development Charity American-based organization that plans, Association (SPFA) Organization (SEADO) Committee - Cambodia manages and implements HIV/AIDS and family health programs Koh Kong,

SECTION 17 Siem Reap Banteay Meanchey (24HTV-CA) Kratie, Banteay Meanchey, Siem Reap, Has prevention and care activities including Has HIV/AIDS activities in Au Chrov, Kandal Pursat, Battambang and Phnom Penh. referrals to key health services, raising Serey Sophon and Svay Check districts, Compiled the comprehensive Directory Japanese organization providing home-care awareness of HIV/AIDS and reducing stigma covering five communes including three of Organizations Implementing or Supp- in Kandal Stung. Affiliated with Nippon and discrimination. high schools and six cement factories. orting HIV/AIDS Activities in Cambodia, Television, one of Japan's biggest television Also supports home-care teams in Poipet, on which much of this list is based. Director: Soun Chea (012-635-649) networks which is also affiliated with Kop and Au Bhey Jhon. Japan's leading newspaper, the Yomiuri Country Director: Servants for Health in Director: Shimbun. Margaret Peggy Cook Asian and African Regions Kong Sam Nang (023-222-420) (SHARE) (054-958-843, 012-867-480) Project Advisor: Email: [email protected] Masahiro Ishizeki (023-216-256) Email: [email protected] Website: www.urs-chs.com Japanese organization with health educa- Representative: tion projects including HIV/AIDS awareness Sihanouk Hospital Center Naoki Takeda Urban Sector Group (USG) and prevention. Targets include young Email: [email protected] people, school teachers, health workers for Hope (SHCH) Website: www.bigpond.com.kh/users/ Phnom Penh and traditional birth attendants. Phnom Penh ca24h/ Works with Family Health International Country Coordinator: Government hospital supported by the Unaccompanied in providing education and support for Miki Ueda (023-212-427) non-government organization Hope World- Association (Unacas) sex workers in eight operational districts Email: [email protected] wide, which cares for up to 400 PLHA. in Phnom Penh. Many of those targeted Provides anti-retroviral treatment with Kandal are park or street-based sex workers. Servants to Asia's Collaborates with other non-government support from Belgium's Institute of Tropical Operates a hospice and also provides Urban Poor Medicine and the Global Fund to Fight organizations as well as NCADS, municipal home care including counseling, medicine AIDS offices and clinics for sex workers. Phnom Penh AIDS,Tuberculosis and Malaria. and support. Hospital Director: Director: Faith-based organization with project Contact: Lim Phai (023-721-188, 012-859-226) helping children whose parents are dying Dr. Gary Jacques (023-882-484) Pen Chantha (012-921-015) HIV/AIDS contacts: Program Assistant: or have died from AIDS. Provides rice, Email: [email protected] Meas Chanthan (011-728-397) loans, advice, clothing, education and school Dr. Sok Phorn (023-882-484) United Neutral Khmer Program Officer: uniforms. Also provides basic medicine, Tearfund Tun Samphy (012-636-798) food and nutritional supplements for HIV- Students (UNKS) Email: [email protected] positive children and operates a weekly British faith-based organization implementing Phnom Penh clinic for sex workers in Phnom Penh's Vithey Chivit

120 NON-GOVERNMENT ORGANIZATIONS 121 Phnom Penh Phnom Penh orphans and vulnerable children. developing a mobile HIV/AIDS resource center and a faith-based AIDS network in Provides care, support and counseling. Runs education programs for garment Director: Kampong Cham. A second project in Chear Sarith Also provides home-care, conducts hospital factory workers and young people out of Kampong Cham, Kampong Thom, Kandal (023-884-271, 012-949-982) visits, and conducts advocacy workshops school. Also trains volunteers from villages and Phnom Penh promotes sexual purity Email: [email protected] in hospitals. and factories. and supports families affected by HIV/AIDS. NON-GOVERNMENT ORGANIZATIONS Director: Country Director: Womyn's Agenda for Country Director: Hout Totem Soreach Sereithida Change (WAC) Tim Astutz (023-308-090, 012-864-193) (023-720-807, 012-955-105) (023-214-085, 012-898-265) Project Manager: Wat Norea Peaceful Phnom Penh HIV/AIDS contact: Un Chanthol (012-945-745) Geof Bowman (012-401-371) Children's Home Email: [email protected] Works to empower women through a network in Phnom Penh and 13 Project Director: provinces. Targets include sex workers, Joke van Opstal (023-881-827) SECTION 17 Battambang Women's Network for Unity (WNU) men who have sex with men, lesbians, gar- Email: [email protected] Educates monks about HIV/AIDS care, ment workers and beggars. Website: www.wr.org prevention and support. Monks then Phnom Penh disseminate information, organize self- Sex Worker Project: World Vision help groups and make referrals. Work is Supports 5,000 members in 13 provinces Pry Phally Puong (012-988-054) Phnom Penh integrated into the monks' daily duties. and municipalities. Targets sex workers, Tel:023-722-314 garment factory workers and self-help Email: [email protected] American faith-based organization that Director: groups. Receives financial and technical Website: womynsagenda.org has projects covering prevention, voluntary Kim Ngoun Chea support from Womyn's Agenda for Change. testing and counseling as well as home (053-370-246, 012-754-613) Operates in Phnom Penh, Kandal, Kampong World Education and community-based care.Works with Other contact: Speu, Kampong Cham, Kampong Thom, Cambodia (WEC) the Ministry of Health and the World Dol Samphan: (012-911-602) Kampong Chhnang, Kampot, Battambang, Phnom Penh Food Program in providing food to PLHA Woman and Youth Action Pailin, Pursat, Banteay Meanchey, Siem Reap in four provinces.Targets include children, and Takeo. Works with the Ministry of Education, pregnant and lactating women, factory (WYA) Youth and Sports in providing HIV/AIDS workers and youth. Operates in Phnom Director: education to students and teachers in Penh as well as Kandal,Takeo, Kampong Kratie Keo Tha (012-471-093) targeted provinces. Has also completed Speu, Kampong Chhnang, Battambang and HIV/AIDS contact: Working with Family Health International an HIV/AIDS curriculum for Grades One Kampong Thom. to reduce transmission and vulnerability Sou Sotheavy (011-660-152) to Six. to HIV among sex workers in Kratie. Email: womensnetwork@womyn- Country Director: sagenda.org Country Director: Talmage Payne Country Director: Mark Kowalski (023-216-854) (023-216-052, 012-816-536) Phoeuk Phalkun (012-614-862) Women's Organization for Program Manager: HIV/AIDS contact: HIV/AIDS contact: Modern Economy Mr Chum Thou Srey Mony (012-692-920) Van Serey Lakena (012-771-158) and Nursing (WOMEN) (012-858-807, 012-811-501) Email: [email protected] Email: [email protected], Website: www.wvi.org Phnom Penh [email protected] Women’s Development Provides home care, supports self-help Website: www.worlded.org Youth Council of Association (WDA) Cambodia (YCC) groups, makes referrals and also supports World Relief Phnom Penh Phnom Penh American faith-based organization

122 NON-GOVERNMENT ORGANIZATIONS 123 Program Coordinator: [email protected], Mek Sarath [email protected] (023-220-861, 012-992-401) Health Program Officer: Sok Sopha (012-777-454) Email: [email protected] NON-GOVERNMENT ORGANIZATIONS Youth With A Mission (YWAM) WEBSITES Steung Treng 18. American faith based organization working to educate young people about HIV/AIDS.

SECTION 17 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 WEBSITES

he following sites are part of a HIV/AIDS News and Health-E New Mexico AIDS Info Net multimedia training kit developed Information Portals Tby Julie Clayton, HIV/AIDS coordi- www.health-e.org.za www.aidsinfonet.org nator at the Science and Development AIDS Education Global Network of science journalists reporting HIV Insite Mostly US based information and Information System (AEGIS) links.

SECTION 18 in developing countries, with contribu- www.hivinsite.com tions from TV Padma of Panos India www.aegis.com HivNet.ch (www.itrainonline.org/itrainonline/mmtk/ Integrated Regional Information hivaids.shtml). For the specific websites of AIDSchannel guide to AIDS Networks (IRIN) www.hivnet.ch/e/index-frame.html institutions operating in Cambodia see the preceding sections. www.aidschannel.org/guide/ www.irinnews.org/AIDSfp.asp Swiss information and exchange site on HIV/AIDS. The World Bank AIDS Media Website AfroAIDSinfo.org Kaiser Network launched in late 2004 can be found at: You and AIDS www.afroaidsinfo.org www.kaisernetwork.org www.aidsmedia.org www.youandaids.org AIDScience Science and Development HIV/AIDS Quick Guide produced by the Network The United Nations Development www.aidscience.org Science and Development Network Programme's HIV/AIDS Portal for Asia www.scidev.net/ describes the content and usefulness of A web site providing researchers with Pacific. sites: an online source of HIV/AIDS research The Body International HIV/AIDS Alliance updates. www.scidev.net/quickguides/index. www.thebody.com www.aidsalliance.org/_docs/ cfm?fuseaction=links& All Africa.com qguideid=1&subcat=22 index_eng.htm Global Treatment Access www.allafrica.com/aids/ The International AIDS Economics Network Campaign Support for communities in developing provides a table of HIV/AIDS-related countries in tackling the spread and impact AmFAR www.globaltreatmentaccess.org/ information resources most commonly of HIV /AIDS. used by its members: www.amfar.org UNAIDS The HIV/AIDS Search www.iaen.org/files.cgi/9821_iaen_ Global Treatment Access Campaign www.unaids.org/ survey_summary.pdf www.kaisernetwork.org www.globaltreatmentaccess.org National AIDS Map A search engine for links relating to living with HIV/AIDS. Health and Development Networks www.aidsmap.com

www.hdnet.org/home2.htm Mostly UK and Europe based IAEN: International AIDS information. Economics Network www.iaen.org/

126 WEBSITES 127 WEBSITES HIV and Development International AIDS Society HIV/AIDS, Gender and International Center for Research on Women www.hivandevelopment.org/ www.ias.se Human Rights www.icrw.org The United Nations Development Progr- Kaiser Network Gender, HIV/AIDS and human rights amme's South East Asia HIV and Develo- section: Inter Press Service (IPS) HIV/AIDS, Gender and Rights: pment Programme. www.kaisernetwork.org Media Training Manual for the Media

World Health Organization South- Conference and Other www.ipsnews.net/aids_2002/index. www.ipsnews.net/hivaids_form.shtml East Asia Regional Office HIV/AIDS Reports shtml Home Page IPS Inter Press Service International Health and Development Networks Gender and HIV/AIDS Information Association, Rome, Italy. w3.whosea.org/hivaids/ Pack SECTION 18 www.hdnet.org/home2.htm United Nations Development Fund Program for the Collaboration www.ipsnews.net/hivaids_form.shtml for Women Against AIDS and Related Kaiser Network Epidemics Media tool for gender sensitive www.unifem.undp.org/human_ www.kaisernetwork.org reporting on HIV/AIDS rights/hiv_aids.html www.procaare.org/ Medscape www.genderandaids.org/modules.php? United Nations Population Fund Discussion forum and e-mail alert. name=News&file=article&sid=268 www.medscape.com/ www.unfpa.org/hiv/prevention/ Family Health International conferencedirectory/hiv Centre for Advocacy and Research hivprev4a.htm (CFAR) in Delhi, UNIFEM and Positive www.fhi.org Microbicides 2002 Women's Network (PWN+). World Health Organisation

International AIDS Vaccine Initiative www.itg.be/micro2002/ Gender and Photojournalism in www.who.int/gender/hiv_aids/en/ (IAVI) Southern Africa: A manual for The Body beginners and Gender and International Guidelines on www.iavi.org HIV/AIDS: A training manual for HIV/AIDS and Human Rights www.thebody.com/confs/reports.html Southern African media and International Meeting Communicators www1.umn.edu/humanrts/instree/ Calendars Missing the Message? t4igha.html Follow link to "publications" from this site. http://www.comminit.com/ma2003/ The Asia Pacific Forum of National ELDIS sld-9136.html www.genderlinks.org.za Human Rights Issues www.eldis.org/hivaids/hivaidsevents. This report by Thomas Scalway argues htm ELDIS Gender and HIV/AIDS page www.asiapacificforum.net/human/ that while "current international interest, issues/hiv_aids.htm Johns Hopkins University AIDS funding and mobilisation for AIDS are www.eldis.org/gender/dossiers Service creating a unique opportunity to build an United Nations High Commission effective response to the crisis, few of the Gender and AIDS on HIV/AIDS and Human Rights www.hopkins-aids.edu/resources/ lessons of the past are contributing to calendar/calendar1.html current approaches." www.genderandaids.org/ www.unhchr.ch/hiv/index.htm

128 WEBSITES 129 WEBSITES HIV and Human Rights:A Training Media tools for sensitive reporting, Media & HIV/AIDS in East and HIV/AIDS images Manual extracted from HIV/AIDS Media Southern Africa Guide, 2nd Edition AIDS Clock www.undp.org.vn/mlist/health/ www.unesco.org/webworld/publica- 022003/post28.html www.actoronto.org/website/home. tions/media_aids/ www.unfpa.org/aids_clock/ nsf/pages/mediaguide?opendocu- United Nations Development Programme, ment&menuitem=mediaitem United Nations Educational, Scientific and Boehringer-Ingleheim Vietnam. Cultural Organisation (UNESCO). HIV/AIDS and Human Rights: a train- www.boehringer-ingleheim.com Scientific and Medical ing manual for NGOs, community HIV/AIDS Media Guide, 2nd Edition Literature groups and people living with Textbook of AIDS pathology HIV/AIDS www.ancahrd.org/pubs/pdfs/ mediaguide.htm www.medlib.med.utah.edu/

SECTION 18 British Medical Journal www.comminit.com/ma2003/ WebPath/TUTORIAL/AIDS/AIDS. www.bmj.com sld-8241.html Australian National Council on AIDS, html Hepatitis and Related Diseases. Nature How to spot HIV/AIDS Fraud The Big Picture Book of Viruses: Multimedia Presentations Retroviridae www.nature.com www.aidsinfonet.org/articles.php? articleID=206 Video cast plus transcript from www.virology.net/Big_Virology/ New England Journal of Medicine Kaiser Network on HIV/AIDS in BVretro.html Reports on Media India www.nejm.org AVERT Coverage of HIV/AIDS www.kaisernetwork.org/health_ PUBMED database of scientific and cast/hcast_index.cfm?display=detail www.avert.org/pictures.htm What's New: Perspectives on medical publications &hc=919 HIV/AIDS in the South African Center for Diseases Control Public www.ncbi.nlm.nih.gov/ Media, 2002 www.kaisernetwork.org/health_ Health Image Library cast/uploaded_files/062703_kff_ www.cadre.org.za/pdf/Whats The Lancet indiaaids_transc.pdf http://phil.cdc.gov/Phil/default.asp %20news.pdf www.lancet.com www.kaisernetwork.org/health_ Aaron Diamond AIDS Research Centre for AIDS Development, Research cast/hcast_index.cfm?display=detail Center and Evaluation (CADRE), Johannesburg, Reporting on HIV/AIDS &hc=994 South Africa. www.adarc.org/hiv/stages/index.htm African Women's Media Center HIV/AIDS and the Mass Media: HIVinsite online chapter "Molecular www.awmc.com/pub/p-4680/e-4681/ a Literature Review, 2001 Radio programme about HIV Insights into HIV Biology" vaccine research in South Africa AIDS Reports: Investigating an www.cadre.org.za/pdf/LITREV%20 www.hivinsite.com/InSite?page= Epidemic media%20and%20HIVAIDS.pdf www.radio.oneworld.net/index.php? kb-02-01-01 fuseaction=audio.view&audio_ www.panos.org.np/resources/ Centre for AIDS Development, Research Johns Hopkins University AIDS id=3916 publications/ and Evaluation (CADRE), Johannesburg, Service South Africa. Panos South Asia. www.hopkins-aids.edu/hiv_lifecycle/ hivcycle_txt.html

130 WEBSITES 131 SECTION 18 WEBSITES 132 /wgbh/nova/aids/action.html "See HIVin Action" http://www.pbs.org Archive National InstitutesofHealthImage Fighting Back /#HIV http://aidshistory.nih.gov/imgarchive immune.html. www.pbs.org/wgbh/nova/aids/ statistics andgeneral knowledge. sex, AVERT Quizzes oncondoms, HIV quizzes AIDSMeds Chicago Museum ofScienceandIndustry, www.avert.org/hivquiz.htm CycleIntro.htm www.aidsmeds.com/lessons/Life AIDS/AIDSlc1.html http://www.msichicago.org/exhibit/ 19. reverse transcriptase. of HIV(viralRNA)andviralproteins including The nucleoapsid containsthegenetic information Picture and text: Boehringer Ingleheim TERMS GLOSSARY OF GLOSSARY OF TERMS GLOSSARY OF TERMS

abacavir Acquired Immune as fever, malaise, sore throat, headache with children defined as those below the and sometimes a rash. Following the age of 15. This definition overlaps with a An anti-retroviral drug used to treat HIV Deficiency Syndrome primary infection, the body's immune separate UN definition which classifies infections. See nucleoside analogue reverse (AIDS) system develops antibodies to the virus, children as all young people below the age transcriptase inhibitors. A collection of symptoms and illnesses usually within an average of three weeks of 18. See defining the young.

SECTION 19 but sometimes several months. It was abbreviations and acronyms known as opportunistic infections that develop as a result of damage to the previously thought that the virus was affected community relatively dormant during this phase. With the exceptions of HIV and AIDS, immune system caused by years of attack People with HIV/AIDS and others such as avoid if possible -- unless you're writing or by HIV. The term was adopted by the families and friends whose lives are broadcasting to a medical audience. Centers for Disease Control in 1982. acyclovir directly influenced by HIV infection and Abbreviations and acronyms are great for People with AIDS often have infections of A drug used to treat two of the herpes its physical, psychological and social taking notes. But they can confuse readers, the lung, brain, eyes and other organs, and viruses that can become opportunistic ramifications. listeners and viewers. By all means, use frequently suffer debilitating weight loss. infections for people with AIDS. such terms if they are widely known such People with HIV do not necessarily have AIDS as CPP (an abbreviation) and Funcinpec AIDS. But all people with AIDS have HIV. ADC (an acronym). But why alienate your A diagnosis of AIDS can be based on the See Acquired Immune Deficiency Syndrome. audience by saying that NAA and presence of one or more opportunistic See AIDS dementia complex. NCHADS plan to tackle OI with ARV? infections in a person with HIV. Another AIDS carrier way of diagnosing AIDS is when the CD4 adherence There's no such thing as an AIDS carrier. ABC approach cell count of people with HIV falls below The extent to which a patient takes People with the virus are usually referred Abstaining from sexual activity, mutual 500 cells per microliter (the CD4 cell medicine according to the prescribed to as being HIV-positive which means their monogamy, and condom use are three key count of person with a normal immune schedule. immune system has developed antibodies behaviours that can prevent or reduce the system usually ranges from 500 to 1,500 to the virus in the three-month period likelihood of sexual transmission of HIV. cells per microliter). Note that AIDS does adolescent after exposure. not stand for Acquired Immunodeficiency These behaviours are often included UN agencies define adolescents as young together under a comprehensive “ABC” Syndrome (which would be AIS) or AIDS-defining illness Acquired Immuno Deficiency Syndrome people between 10 and 19 years of age. approach: “A” for Abstinence (or delayed Early adolescence is defined as 10 to 14 See opportunistic infections. sexual initiation among youth), “B” for (the prefix is never detached). Most writers use upper-case AIDS but some prefer Aids years and late adolescence as 15 to 19 being faithful (or reduction in number of years. See defining the young. AIDS dementia complex sexual partners), and “C” for correct and to make it clear that it's a pronounceable word. consistent condom use, especially for adult Also known as AIDS-related dementia casual sexual activity and other high-risk and HIV-associated dementia. A brain situations. acute HIV infection In comparing rates of HIV prevalence disorder which can affect people with The four to seven-week period of rapid worldwide, UN agencies focus on the advanced AIDS. Symptoms include loss of abstinence viral replication that immediately follows adult population between 15 and 49 years coordination,mood swings,loss of inhibition of age. For the actual number of people and widespread cognitive dysfunction. Abstaining from sexual activity to prevent exposure to HIV. Most people exposed develop this primary infection which is with HIV,the global survey by UNAIDS and Although it usually occurs after the or reduce the likelihood of sexual trans- the WHO includes children and adults development of major opportunistic mission of HIV. characterized by flu-like symptoms such

134 GLOSSARY OF TERMS 135 infections, AIDS dementia complex can AIDS wasting syndrome antibodies ART appear before such complications.Treatment Anti-retroviral therapy. See highly active consists of anti-retroviral drugs. See oppor- The loss of at least 10 percent of the body Proteins produced by the body's immune anti-retroviral therapy. tunistic infections. weight of people with HIV accompanied by system to destroy foreign organisms, or at GLOSSARY OF TERMS either chronic diarrhea (two loose stools least render them harmless. Antibodies AIDS patient a day for more than 30 days) or chronic stick to antigens -- tiny portions of foreign ARV weakness and fever (for 30 days or more, organisms such as viruses, bacteria, fungi See anti-retroviral drugs. A person with AIDS who is being treated intermittent or constant). and parasites -- and tag them for removal. in a hospital or some other medical estab- People with HIV produce antibodies but Asian Business lishment. Most people with HIV are not amprenavir they do not get rid of the virus because it patients. hides inside cells and changes its outer Coalition on AIDS An anti-retroviral drug used to treat HIV surface so that antibodies fail to stick. A partnership between companies AIDS sufferer infections in people with HIV/AIDS. See that aim to prevent and control HIV/ SECTION 19 protease inhibitors. AIDS in the workplace and non-profit Be careful with this expression. Many antifungal organizations that provide related people object to the term because it was A substance that kills or inhibits the anal sex technical services. With a secretariat in widely misused in the early years of the growth of a fungus. Bangkok, the coalition has partners in 11 epidemic to refer to all HIV-positive Sex involving a man inserting his penis countries -- Bangladesh, Cambodia, India, people regardless of whether they were into the anus of the other partner.Carries antigen Indonesia, Malaysia, Myanmar Nepal, sick, suggesting a loss of power and control a high risk of HIV transmission without a A substance that causes the immune the Philippines, Singapore, Thailand and over their lives. Many people with HIV are condom if one of the partners is infected. system to produce antibodies. Usually a Vietnam.It has also had a formal partnership not suffering from AIDS. But those who Abstinence is the safest way to protect protein or a protein with sugar molecules. with the develop opportunistic infections after five against HIV from sexual transmission. See Global Business Coalition on AIDS Antigens can be on the surface of a live since 2002.The Asian Business Coalition's or 10 years of living with the virus may be, sexual transmission. organism or be a fragment of an organism. Cambodian partner, CARE International, albeit to varying degrees. ante-natal operates a reproductive health program anti-retroviral drugs including HIV prevention in more than 20 AIDS test Adjective describing the medical care garment factories in Phnom Penh. The given to pregnant women. In Cambodia, Drugs that kill or prevent the replication program targets mostly young female There is no such thing as an AIDS test. women attending ante-natal clinics have of retroviruses like HIV. The three main workers, although there is also training See HIV test. been one of the main classes of drugs used for treating HIV are sentinel groups for middle managers in Chinese. The included in the HIV Sentinel Surveillance nucleoside analogue reverse transcriptase and companies participating are Gennon AIDS victim program since 1994. See sentinel groups. inhibitors, protease inhibitors non- anonymity nucleoside reverse transcriptase inhibitors. Garment Manufacturing Ltd., Supreme Avoid this term as it is often misused to Using a combination of drugs from three Garments Pte. Ltd., June Textiles Co. Ltd., Tack Fat Garment Ltd., Pak Shun Knitting refer to people with HIV. Many people with See confidentiality and anonymity. classes is known as highly active anti-retroviral HIV/AIDS feel these terms imply they are therapy. Although such treatment reduces Factory Ltd., Thai Pore Garment powerless with no control over their lives. antibiotic the amount of HIV in the bloodstream, Manufacturing Co. Ltd., PCCS Garments Ltd., PDC Garment Ltd., Wearwel This may be true, and HIV-positive people in A natural or synthetic substance that kills the virus is still present and can rise again Cambodia Ltd., QMI Industrial Co. Ltd., some countries insist that they are indeed or inhibits the growth of but not to dangerous levels. In addition, the drugs bacteria Wilson Garment Co. Ltd., Sportex victims of the failure of their societies to a Often used to treat diseases caused can have serious and even potentially life- virus. Industry Co. Ltd., Suntex Pte. Ltd., Leun warn them of the risks of contracting the by bacterial infection. In Cambodia, antibi- threatening side effects including Thai Co. Ltd., Cambodia Sportwear Mfg. virus. But this is largely not the case in otics are often used inappropriately as diarrhea, liver problems, rashes, nerve Ltd.,Archid Garment Cambodia Ltd., New Cambodia, and most victims of AIDS are distribution is unregulated. As a result, damage and neurological problems. Island Clothing (Cambodia) Ltd., Yung those people who have died. Others may antibiotics are frequently sold by pharmacists Wah Industry (Cambodia) Co. Ltd., Jusca be victims of something other than unqualified to prescribe such drugs. anti-viral drugs Garment Ltd., CHP Garment Factory Co. HIV/AIDS. See victims. Drugs that kill or prevent the replication Ltd., San San Garment (Cambodia) Co. of a virus.

136 GLOSSARY OF TERMS 137 Ltd., You Cheng Garment Co. Ltd. and bauk blood products, tissue and But it is misleading as HIV can only be Eternity Apparel (Cambodia) Co. Ltd. transmitted by some body fluids - blood, A Cambodian term that literally means organs semen, pre-ejaculate, vaginal fluids and 'plus', or more than one. Recently, this Asian Development Bank In Cambodia, all blood products, tissue breast milk. HIV cannot be transmitted via GLOSSARY OF TERMS term has been used within the health sector and organs have to be tested for HIV Regional development bank set up in other body fluids such as saliva, sweat, to refer to gang rape. before they are used under Article 14 of Manila in 1966 with Cambodia as one of tears or urine. the the founding members. Working with Law on the Prevention and Control of beer-promotion girls HIV/AIDS. Article 15 stipulates that nobody UNAIDS, the ADB has been involved in bridge group In Cambodia, women who work in can keep any donated blood, tissue or estimating the amount of money needed A group of people at high risk of HIV restaurants and bars promoting certain organs that have not been tested for HIV for a successful response to HIV/AIDS in infection who may transmit the virus to a brands of beer.Some are also sex workers. in advance. First-time violators face a fine the Asia-Pacific region. The ADB has also larger population at lower risk of infection. The Khmer term is based on of up to one million riel and up to one co-authored a series of joint studies with (srey langseh) One example is male clients of sex workers.

SECTION 19 the French expression for launching new year in jail. The law also provides for UNAIDS including Comparing the Impact NCHADS has also identified injection drug products. relatives or other recipients of donated of HIV/AIDS at National and Selected users, fishermen and garment factory work- blood, tissue or organs the right to Sub-national Levels in Cambodia, India, ers as other possible bridge groups in demand a second test, except in medical Thailand and Vietnam (ADB/UNAIDS Behavioral Surveillance Cambodia. The term needs to be used emergencies. Study Series Paper II) and The Impact of Survey with care, however, as it can imply that HIV/AIDS on Poverty in Cambodia, India A survey of the risk behavior of sentinel blue virus high rates of HIV infection or risk activities Thailand and Vietnam (ADB/UNAIDS groups carried out by NCHADS since in bridge groups can be ignored if the larger Study Series Paper I, II and III). 1997. Commonly known as the BSS and English translation of an incorrect population is unlikely to be affected. It can not to be confused with HIV Sentinel Cambodian term for HIV. Derived from also falsely imply that being part of a azdotymidine (AZT) Surveillance, which is also carried out by merok (virus) and hiou, the way HIV is group --rather than risky behavior --makes pronounced as a Cambodian acronym One of the first anti-retroviral drugs used NCHADS. See page 153. people susceptible to HIV infection. based on the letter V which can denote a to treat HIV. Originally developed for final diphthong when transliterating cancer, American scientists announced in BFR syndrome Bristol-Myers Squibb Khmer into Roman script. When spoken 1986 that AZT appeared to benefit A US pharmaceutical company that Body Fat Redistribution syndrome. See quickly, the two words form merokiou, people with HIV. See nucleoside analogue produces the anti-retroviral drug known as fat redistribution. with kiou being the Cambodian word for reverse transcriptase inhibitors. d4T for use in WHO-recommended first blue.The National AIDS Association does lines of drug treatment or first-line blood-borne transmission not use to describe the virus AZT merok hiou regimens. The company has a policy of not but merok eith ("AIDS virus") as distinct See azdotymidine. In reference to HIV, when blood infected letting its patents prevent access to with the virus enters the bloodstream of from chamngeu eith ("AIDS disease"). affordable HIV treatment in sub-Saharan bacteria an uninfected person.HIV can be transmitted Africa. See separate entries for anti-retroviral through blood, blood products, tissue and Body Fat Redistribution drugs and Roche. The simplest and smallest forms of plant organs. The most common method is Syndrome life. Bacteria exist in large numbers in air, through contaminated needles and syringes See BSS water and soil, and also in living and dead fat redistribution. that often contain a small amount of See Behavioral Surveillance Survey. creatures and plants. They are often a blood after injections. Needles used for body fluids cause of infection. The word is plural. tattoos or acupuncture can also transmit cachexia The singular form is bacterium and the HIV if not sterilized. Avoid if referring to HIV transmission. adjective is bacterial. Drugs that fight This used to be a polite term which A state of weakness and weight loss that bacteria are called antibiotics. oversimplifies how HIV is transmitted can occur in people with HIV. See AIDS ("through the exchange of body fluids"). wasting syndrome.

138 GLOSSARY OF TERMS 139 candidiadis children cocktail therapy confidentiality and A common fungal infection, generally In estimating the number of people with See highly-active anti-retroviral therapy. anonymity known as Candida albicans. It most HIV, children are defined by UN agencies Confidentiality is when you expect GLOSSARY OF TERMS commonly involves the skin, oral mucosa, as young people below 15 years of age. combination therapy someone to keep a secret. Anonymity is respiratory tract and vagina. Candidiasis This definition overlaps with a separate See highly-active anti-retroviral therapy. the state of remaining unknown to most of the oesophagus, trachea, bronchi, or UN definition which classifies children as other people. Under Articles 33 and 34 lungs is an indicator disease for AIDS. young people below the age of 18. See commercial sex of the Law on the Prevention and Control Oral or recurrent vaginal candida infec- defining the young. of HIV/AIDS, the confidentiality of all tion is an early sign of immune system Sex involving payment for services. people with HIV/AIDS has to be maintained deterioration. Oral candida, also known as chlamydia except in cases involving court orders, thrush, can be controlled by fungicidal A sexually-transmitted disease that infects commercial sex workers government monitoring and health

SECTION 19 lozenges, mouthwashes and other med- the genital tract.The infection often shows Sex work is a form of commerce so the workers directly or indirectly involved in ications. See opportunistic infections. no symptoms and can cause infertility in adjective is redundant. This cumbersome treatment or care. First-time violators women if left untreated. expression to be avoided also implies face a fine of up to 200,000 riel and up to catch AIDS there are such people as non-commercial six months in jail. Anonymity for all HIV People don't catch AIDS but can be infected circulating recombinant sex workers, which is absurd. testing is guaranteed under Article 22 of with HIV. If people with the virus do not forms the law. Under Article 31, the government's receive treatment, they will eventually communicable disease program for monitoring HIV/AIDS has develop AIDS-related illnesses. New types of HIV that can be created to use a coding system that promotes when a person infected with one strain of Illness caused by an infection that can be anonymity. CD4 cells the virus is re-infected by another strain, transmitted from an infected person to a causing different parts of the virus to susceptible host. contagious The type of cell mainly targeted by HIV. "recombine" into a new form that can be Any infection that can be transmitted by The cells have a docking molecule called transmitted to another person.The most compulsory HIV testing "cluster designation 4" on their surfaces. casual contact between people. Casual efficient way of recombining HIV is through Testing for HIV with no option to refuse. Also known as CD4+ (positive) cells and contact means normal day-to-day contact blood transmission, especially among In Cambodia, compulsory testing is T cells, they coordinate the response of such as between people at home, school injection drug users. See HIV strains. allowed only if ordered by a court. Any the immune system to infections such as or work. Chicken pox and SARS are testing for employment, education, housing, viruses. HIV replicates inside these cells, contagious. HIV is infectious not contagious circumcision travel, medical services and other services destroying them and weakening the as it is transmitted by direct or intimate is "strictly prohibited" under Article 20 of immune system. A CD4 count is a test See male circumcision. contact (such as unprotected sex). the Law on the Prevention and Control of measuring the number of these cells and HIV/AIDS. is commonly used to monitor the health clade continuum of care of people with HIV. Sub-type. See HIV strains. complementary treatment A continuum is a series of items in which each is almost the same as the ones next chancroid clinical trial A broad range of healing philosophies, to it but the last is very different from the approaches and therapies that conventional A highly-contagious sexually-transmitted first. In HIV/AIDS, the term refers to care Study involving volunteers testing the Western medicine does not commonly disease. The bacterial infection causes across a continuum ranging from homes effects of a new drug or vaccine. use to promote well being or treat health ulcers and symptoms which may facilitate and communities to health centers and conditions. Examples include herbs and HIV transmission. Symptoms usually appear hospitals. Home care might include people CMV acupuncture. Some complementary three to five days after exposure. caring for themselves or care given by See cytomegalovirus. treatments can relieve symptoms of HIV- family, friends, neighbors, health workers related illnesses. and social workers. Community care

140 GLOSSARY OF TERMS 141 might include nurses, midwives, trained cytomegalovirus over the previous three months, the same Forum on AIDS in Denver in 1983.The volunteers, community health workers, period used when surveying military, principles called for support for HIV- traditional healers, non-government See herpes viruses. police and motorcycle taxi drivers about positive people opposing stigma and organizations, local leaders, teachers, their use of condoms with sex workers discrimination. People with HIV should GLOSSARY OF TERMS youth groups and lay or religious leaders. ddC, ddI and d4t and girlfriends. The separate Youth Risk "be involved at every level of decision Care in health centers might involve Three types of anti-retroviral drug used to Behavior Survey in 2003 meanwhile asked making" and "serve on the boards of nurses, midwives, counselors, social treat HIV infections in people with HIV/ those who were sexually-active if they directors of provider organizations, and workers, traditional healers and volun- AIDS. The drug d4t is one of three drugs used condoms always, most of the time, participate in all AIDS meetings with teers. Hospital care might involve doctors, used in the most widely-prescribed fixed sometimes or never. as much credibility as other participants nurses, counselors, social workers, educa- dose combination (with 3tc and nevirapine), to share their own experiences and tion services and legal aid. enabling patients to take one pill twice a defining the young knowledge." These principles were the precursor to the formation of coalitions day instead of six pills a day if taken sepa- UN agencies define young people as all SECTION 19 cryptococcal meningitis rately. In Thailand,the combination drug is people between 10 and 24 years of age. for people with HIV/AIDS in dozens of countries, including; the Global Network A life-threatening fungal infection of the known as GPOvir.The US pharmaceutical Youths are defined as those between 15 of People Living with HIV/AIDS (GNP+), membranes around the brain and spinal company Bristol-Myers Squibb produces d4t and 24 years of age. Adolescents are the International Community of Women chord. Symptoms include headache, for use in WHO-recommended first line between 10 and 19 years of age, with Living with HIV/AIDS in 1992, and the dizziness and a stiff neck. If left untreated, regimens. See separate entries for anti- early adolescence defined as 10 to 14 GIPA principle adopted in Paris in 1994. In it can result in coma and death. See retroviral drugs, highly-active anti-retroviral years and late adolescence as 15 to 19 Cambodia, the Cambodian People Living opportunistic infections. therapy, nucleoside analogue reverse tran- years. In estimating number of people with HIV/AIDS Network (CPN+) has scriptase inhibitors and GPOvir. with HIV, children are defined by UN CRF01_AE agencies as young people below 15 years been actively involved in policy development decentralization of age. This definition overlaps with a and helped draw up a successful funding The circulating recombinant form of HIV proposal to the Global Fund to Fight Recommended by the UNDP for gover- separate UN definition which classifies that is dominant in Southeast Asia. See children as young people below the age of 18. AIDS, Tuberculosis and Malaria. See HIV strains. nment efforts in the field of HIV/AIDS. In Greater Involvement of People Living with Cambodia, the agency's "community delavirdine HIV/AIDS. CSW enhancement program" works with the Ministry of Rural Affairs to encourage A different type of anti-retroviral drug used deoxyribonucleic See commercial sex worker. communes to develop their own strategies. to treat HIV infections in people with acid (DNA) The program includes collecting and HIV/AIDS. See non-nucleoside analogue cure analyzing HIV/AIDS data. Most commune reverse transcriptase inhibitors. The molecular chain that carries the genetic Eradication of a medical condition to councilors have identified HIV/AIDS as a information for cells to reproduce. Found restore normal health, including the local priority and have said they are willing dental procedures in genes within the nucleus of each cell. elimination an infectious organism from to create detailed care and prevention plans. In Cambodia, dental procedures are direct sex workers the body. As far as HIV is concerned a subject to precautions determined by the cure is non-existent as of 2004. The Law defining correct and National AIDS Authority under Article 14 In surveys by NCHADS, the term "direct on the Prevention and Control of HIV/AIDS of the Law on the Prevention and Control sex workers" (srey roksiplauphet ptoll) also recognizes that "there is no known consistent use of condoms of HIV/AIDS. Dentists who fail to follow applies exclusively to female brothel-based cure." Definitions vary.The Behavioral Surveillance correct infection control precautions can sex workers. But the NAA defines direct Survey of 2003, for example, asked direct face a fine of up to one million riel and up sex workers as people who either have cytokine sex workers if they used condoms to one year in jail for first-time violations. no other job besides selling sex or derive A natural protein produced by the body consistently with clients and boyfriends most of their income from such activities. which acts as a chemical messenger. See over the previous week. But surveyors Denver Principles In addition to women working in brothels, this broader definition would include people immune-based therapies. asked indirect sex workers if they did so Principles against stigma and discrimination such as orange sellers and male sex workers. adopted at America's Second National

142 GLOSSARY OF TERMS 143 In the narrower definition used by spell out penalties for discrimination in embalming violate National AIDS Authority guide- NCHADS,most women working in brothels the workplace, first-time violators of the lines or lack a medical or scientific basis. are Cambodian but some migrate (or are other provisions face a fine of up to one In Cambodia, embalming is subject to Under the Law on the Prevention and trafficked) from other countries.According million riel and up to six months in jail. infection-control precautions determined Control of HIV/AIDS, first-time violators GLOSSARY OF TERMS to a POLICY Project study on sex workers by the National AIDS Authority under face a fine of up to one million riel and up and condom use in 2003, many have been DNA Article 13 of the Law on the Prevention and to one year in jail. Under the Press Law, Control of HIV/AIDS. There are penalties sold into prostitution with bonds as high See deoxyribonucleic acid. false advertising carries a penalty of up to as 700 dollars that have to be repaid to for failing to follow specified precautions. five million riel. brothel owners. Many are from rural Doha Declaration First-time violators face a fine of up to areas, lured by brokers offering honest one million riel and up to one year in jail. fat redistribution and well-paid jobs.Those who "voluntarily" See World Trade Organization. Change in body fat distribution that can enter the profession may also have big enzyme-linked occur in people taking two of the three SECTION 19 debts if they borrow money to send back drug companies immunosorbent assay classes of anti-retroviral drugs. to their families or are charged for rent, See pharmaceutical companies. The most commonly used HIV test. Accumulation of abdominal fat is known food, clothing, make-up or jewelry. Direct Known as ELISA, it tests for the presence as "protease paunch" while increased sex workers commonly live in the brothel economic impact of of antibodies to HIV not the virus itself. deposits of fat between the shoulder where they work. A profile by NCHADS HIV/AIDS See HIV testing. blades is sometimes referred to as "buffalo in 2001 showed that a typical direct sex hump." Women may also experience nar- worker was female, 22 years old and had In 1999, the United Nations estimated the rowing of the hips and enlargement of the more than four clients a day, earning potential cost of HIV/AIDS in Cambodia at epidemic breasts. Also known as Body Fat about 550,000 riel a month. She had been more than two billion dollars. The UNAIDS defines epidemic as a disease that Redistribution Syndrome and in the business for less than two years burden of illness and death is expected to spreads rapidly through a demographic Lipodystophy Syndrome. including about five months in the latest fall heavily on households, increasing segment of the human population. Such brothel. Almost 60 percent had regular indebtedness, asset sales, malnutrition and segments can be everyone in a given clients and about 50 percent had boyfriends. school dropout rates. A joint report by geographic area or a military base or first-line regimen A typical brothel had nine workers. UNAIDS and the Asian Development Bank everyone of a certain age or sex, such See regimen. (ADB) in 2004 noted that studies had as the children or women of a region. estimated that HIV/AIDS would slow Epidemic diseases can be spread from fishermen discrimination Cambodia's poverty reduction by 60 person to person or from a contaminated The estimated 30,000 Cambodian men An infringement of the human rights that percent a year between 2003 and 2015. source such as food or water. Smaller who cross the border to work as fishermen often leads to people being subjected to That compares with estimated slowdowns than a pandemic. UNAIDS tends to use in Thailand have been identified as being various forms of abuse (UNAIDS definition of only 38 percent in Thailand and 23 epidemic. vulnerable to HIV infection. in 2004). In Cambodia, any discrimination percent in India during the same period. in the workplace based on a person's epidemiology fixed-dose combination actual, perceived or suspected HIV/AIDS efavirenz status is prohibited under Article 35 of The study of the causes, spread and A combination of three anti-retroviral An anti-retroviral drug used to treat HIV control of diseases within a population.A the Law on the Prevention and Control of infections in people with HIV/AIDS. See drugs in one pill that only has to be taken HIV/AIDS. Termination of employment on person who specializes in this field is an twice a day instead of different pills several non-nucleoside analogue reverse transcriptase epidemiologist. the same basis is unlawful. Other articles inhibitors. times a day. Cheaper to produce and easier for doctors, pharmacists and guarantee freedom of abode, lodging and false advertising travel and the right to seek public office ELISA patients to deal with. Such combinations for people with HIV/AIDS and prohibit In Cambodia, misleading information or increase the likelihood of patients adhering See enzyme-linked immunosorbent assay. discrimination by educational, financial and advertisements on HIV/AIDS treatment and to the treatment, thereby reducing the health institutions.While the law does not prevention are strictly prohibited if they chances of resistance developing. See

144 GLOSSARY OF TERMS 145 highly active anti-retroviral drugs. An estimated 170,000 young rural British drugmaker GlaxoSmithKline. Tobacco, Chevron Texaco (Caltex), DHL full-blown AIDS women working in garment factories GFATM Worldwide, FedEx Corporation, Heineken in Phnom Penh, Kandal, Kampong Cham NV,PepsiCo, Siemens, Standard Chartered Avoid. The term was initially coined to See Global Fund to Fight AIDS, Tuberculosis and Sihnoukville have been identified as a Bank,Total and Unilever. GLOSSARY OF TERMS distinguish between healthy people with and Malaria. "bridge group" to HIV transmission. See HIV and sick people with AIDS. But it Asian Business Coalition on AIDS. implies that there is such a thing as "half- GIPA Principle Global Fund to Fight AIDS Tuberculosis and Malaria blown AIDS" and is therefore misleading. GBC See Greater Involvement of People Living It is also an affront to people with AIDS. with HIV/AIDS. Set up by government, civil society and See Global Business Coalition on HIV/AIDS. the private sector in 2002 to find new funding requirements GlaxoSmithKline money and create news ways to finance gender The Asian Development Bank (ADB) and British based drugmaker producing one of the fight against three diseases that kills SECTION 19 UNAIDS estimated that the countries The Oxford dictionary defines gender as three fixed-dose combinations of anti- more than six million people every year. of the Asia-Pacific region needed more "the fact of being male or female" while retroviral drugs approved by the WHO. By the end of 2003, the fund had approved than 1.5 billion dollars to finance a UNAIDS defines gender as "differences As of mid-2004, Indian generics producers 227 grants worth 2.1 billion dollars with comprehensive response to the HIV/AIDS in social roles and relations between Cipla and Ranbaxy were producing two about 60 percent earmarked for AIDS. By epidemic in 2003. But only 200 million men and women" (unlike sex which refers other fixed-dose combinations for first-line 2004, almost five billion dollars had been dollars was available from donors and to biological differences only). USAID regimens recommended by the WTO. See pledged up to 2008 and beyond, although governments.The ADB and UNAIDS have defines gender as the "economic, social, separate entries for anti-retroviral drugs only 2.1 billion dollars had been paid into also estimated that the region will need political and cultural attributes and and highly-active anti-retroviral therapy. the fund's bank account by the middle of 5.1 billion dollars a year for HIV/AIDS opportunities associated with being male the year.By August 2004,approved funding care prevention and treatment by 2007. or female" and a "socio-cultural expres- Global Business Coalition for HIV/AIDS grants to Cambodia exceed- This amounts to only 4.4 percent of the sion of particular characteristics and roles ed 25 million dollars. In the longer term, region's health spending and 0.2 percent that are associated with certain groups of on HIV/AIDS the fund is seeking more money from the of gross national income in 2001. people with reference to their sex and Established in 1997 as an alliance of private sector, which accounted for only sexuality." Definitions vary and change international companies, the coalition two percent of contributions in 2004. fungus over time. See also transgender. entered a formal partnership with the About 100 non-government organizations A group of primitive organisms including Asian Business Coalition on AIDS in 2002 have started a "Fund the Fund" campaign mushrooms, yeasts, rusts and moulds. generic drugs and had more than 100 members by 2004. to increase support for the initiative. Located in the New York headquarters of Fungus is singular. The plural is fungi and Drugs made by companies that don't own Viacom, one of the 22 companies that Global Media AIDS the adjective is fungal. Drugs that fight the patents. Such manufacturers use the founded the Global Media AIDS Initiative. fungi are called anti-fungal drugs. international non-proprietary name, which Initiative Richard Holbrooke, the former US is the official name given to the molecule ambassador to the United Nations, was Launched by senior executives of 22 global FSW or medicine rather than the registered appointed president and chief executive media companies during a special meeting brand name. Generic drug companies Female sex worker. See sex workers. officer in 2001. The coalition has been with United Nations Secretary General can often manufacture drugs more cheaply chaired by GlaxoSmithKline (1997 to 2000), Kofi Annan in January,2004. In a statement, than the companies that own the patents. gancyclovir television operator MTV Networks the media executives resolved to "expand Indian generics producers Cipla and A drug used to treat people infected International (2000 to 2002) and German- public knowledge and understanding Ranbaxy have developed fixed-dose with the cytomegalovirus, an opportunistic American carmaker DaimlerChrysler. about HIV/AIDS" through their companies. combinations allowing three anti-retroviral infection that can be developed by people Many members are establishing HIV treat- For details, see page 26. drugs to be taken in one capsule or tablet. with AIDS. See herpes viruses. ment programs as called for by the As of mid-2004, the WHO had approved International Labor Organization. Coalition Glycoprotein 120 these two combinations for use in first-line members with a presence in Cambodia garment factory workers regimens along with a third produced by A protein on the outer surfaces of HIV include BHP Billiton, British American which is used as an antigen in some vaccines.

146 GLOSSARY OF TERMS 147 Derived from the way the abbreviation replicate. A third class of drugs known as gonorrhea hemophilia HIV is pronounced as an acronym based non-nucleoside reverse transcriptase inhi- on hi/he for HI and V which can denote also targets the A sexually-transmitted disease which can A hereditary blood disorder that prevents bitors reverse transcriptase the Cambodian letter for the final diphthong protein. Combinations can include two

GLOSSARY OF TERMS also be transmitted from mother to child blood clotting.Treatment involves lifelong during birth. injections of a synthetic version of the ou/uw when transliterating Khmer into nucleoside reverse transcriptase inhibitors clotting factor extracted from normal Roman script. Hiou is a French spelling, with either a protease inhibitor or a non- Gp120 blood. If it is not heat treated, the clotting Heuw is English. nucleoside reverse transcriptase inhibitor. Whatever the combination, people taking See Glycoprotein 120. factor can carry HIV. In many developed countries, the early cases of HIV infection high-risk behavior the medication have to be monitored reg- were among hemophiliacs who had Behavior that can lead to HIV-infected ularly with tests to determine whether the combination is effective.Adhering to GPOvir received contaminated blood products. blood, semen, pre-ejaculate or vaginal fluids the therapy is important to avoid resist- A combination drug made in Thailand as of one person entering the bloodstream SECTION 19 HAART of another. Sex without condoms, known ance, and this can be difficult due to the part of the government's anti-retroviral number of tablets that have to be taken, as unprotected sex, is the most common treatment program which offers free See highly-active anti-retroviral therapy. the frequency of doses and side effects. treatment to HIV-positive patients. The form of high-risk behavior, along with the sharing of needles used for injections. People taking these drugs still have HIV, drug -- a combination of d42, 3tc and herbal remedy even if the presence of the virus falls to Tattooing and acupuncture carry a risk if nevirapine -- has reduced the cost of treating levels which cannot be detected using a patient from 300 dollars a month to 29 Treatment usually based on plant extracts. needles are not sterilized properly. Some complementary treatments can routine methods. As of mid-2004, the dollars a month. See highly active anti-retro- relieve symptoms of HIV-related illnesses WHO had approved three fixed-dose viral therapy. high-risk group and some have been tested and scientifically combinations under its pre-qualification Avoid. The term wrongly implies that Greater Involvement of proven by randomized control trials. But quality assessment program. Two were many remain scientifically unproven. See membership of a group (soldiers or beer being produced by Indian manufacturers People Living with complementary treatment. girls, for example) is a significant factor in of generic drugs, Cipla and Rambaxy, and HIV/AIDS HIV transmission.As a result, non-members the third was being made by British phar- herpes viruses tend to be lulled into a false sense of maceutical company GlaxoSmithKline. A principle recognized by 42 countries at security. HIV is mainly transmitted by Patients taking the most widely available Troublesome and sometimes fatal an AIDS summit in Paris in 1994 when oppor- high-risk behavior not high-risk groups. fixed-dose combinations of d4t, 3tc and that can affect they agreed to "strengthen the capacity tunistic infections people with The preferred term is sentinel group. nevirapine -- marketed as GPOvir in Thailand and coordination of networks of people AIDS. Two of the viruses, herpes simplex where it also produced -- can take one pill living with HIV/AIDS and community- and varicella zoster (related to chicken highly-active twice a day instead of six pills a day if the pox), are usually treated with an based organizations." The United Nations acyclovir, three drugs are taken separately. Medecins anti-viral drug. A third virus, anti-retroviral therapy endorsed the principle in 2001. The cytome- sans Frontieres strongly advocates such principle was also upheld by the WHO galovirus (CMV), can cause an eye condition Treatment involving at least three classes combinations, saying it pays only 270 dollars in the Three by Five Initiative in 2003. See called CMV retinitis which can lead to of drugs which inhibit the replication of a year for each patient for such treatment Denver Principles blindness. It is treated with gancyclovir HIV in different ways. Until recently, compared with 562 dollars if the drugs which can have bad side effects including treating HIV involved a class of anti-retrovi- are bought separately from the originators. health-seeking behavior bone marrow suppression and severe ral drugs called nucleoside analogue reverse nausea. transcriptase inhibitors. These drugs, which HIV The way in which people seek health target a protein known as reverse trans- services. Health services in Cambodia range hiou, heuw criptase, were only moderately effective. See human immunodeficiency virus. from traditional healers, traditional birth A Cambodian term for HIV which is not Since 1996, however, a new class of attendants, doctors, nurses, midwives, drugs called protease inhibitors has been HIV/AIDS pharmacies and drug sellers. used by the National AIDS Authority. developed.These drugs target the protease Non-specific term for both HIV and AIDS. enzyme which the virus needs to Not always necessary. For example, a

148 GLOSSARY OF TERMS 149 person infected with the virus who is not in developed countries including those tests for the presence of antibodies. But as saying TVK television or the CPP party. sick is HIV positive not HIV/AIDS positive. in East Asia (hence the focus on this sub- it takes up to three months for the hospital inpatients And an HIV-positive person who dies from type for vaccine research) and sub-type C immune system to produce the antibodies, One of the main sentinel groups included opportunistic infections has died from is most common in developing countries. the result of tests during this window GLOSSARY OF TERMS in HIV Sentinel Surveillance system between AIDS not HIV/AIDS. See also people with If a person is infected with different strains period can be negative even if the person 1997 and 2000. Dropped in the 2002 HIV/AIDS. of the virus, different parts can "recom- is infected by HIV.Another test known as survey. See HIV Sentinel Surveillance on bine" into a new form which can be trans- polymerase chain reaction (PCR) tests for page 46. HIV-associated dementia mitted to others. These are known as the virus itself and can detect HIV within (CRF). One two weeks of infection. A special blood See AIDS dementia complex. circulating recombinant forms of these sub-types, known as CRF01_AE, test involving a process called nucleic acid HPV HIV positive is dominant in Southeast Asia. Formerly amplification can detect HIV infection See human papilloma virus. known as the Thai-A sub-type, it is closely during the window period. With the

SECTION 19 The presence of antibodies to HIV in a associated with female sex workers and exception of court orders, all testing HSS person's bloodstream. Different types of their clients. Some researchers believe in Cambodia is required by law to be See HIV Sentinel Surveillance on page 46. HIV tests can detect the antibodies or the CRF01_AE is easier to transmit than sub- voluntary. See compulsory HIV testing. virus itself. Antibodies usually develop type B which is more closely associated Human Immunodeficiency within three months of infection. Positive with men who have sex with men and HIV transmission results indicate antibodies. Negative injection drug users. According to the Virus (HIV) HIV is transmitted through semen, pre- results indicate no antibodies. Hyphens Monitoring the AIDS Pandemic (MAP) ejaculate, blood, vaginal fluids and breast The virus that causes AIDS. First isolated are only used when the word is written Network, a unique variant of CRF01_AE milk. The ability of the virus to survive in 1983 by a team led by Dr Luc Montagnier as a compound adjective, as in “HIV-positive has been found among injection drug outside of the body is very limited. So at the Institut Pasteur in Paris.Taken from man”. But “the man is HIV positive”. See users in northern Vietnam and southern compared with other diseases, HIV is not a West African blood sample, it was seropositive. China. And a new recombinant of sub- particularly easy to transmit. HIV is not named Lymphadenopathy Associated Virus types B and CRF01_AE, known as CRF01- contagious like air-borne viruses such as (LAV).The virus was also isolated in 1984 HIV Sentinel Surveillance 01B, is reported to be circulating widely in influenza or SARS, and you cannot get it by an American team led by Dr Robert Thailand among injection drug users as A regular NCHADS survey of HIV infection by shaking hands, coughing or sneezing. Gallo of the National Cancer Institute. well as female sex workers and their in sentinel groups in Cambodia.The survey Nor can it be transmitted by glasses, Taken from the blood of Senegalese clients. The MAP report for 2004 said is commonly abbreviated as HSS and forks, spoons, chopsticks, mosquito sex workers, it was called the Human sharing infected needles was believed to should not to be confused with the bites, toilets or swimming pools. T-Cell Leukemia Virus (HTLV) III.Following be a particularly efficient way of recom- Behavioral Surveillance Survey (BSS) which Transmission through kissing is extremely a dispute over the discovery, Montagnier bining HIV sub-types into new forms of is also conducted by NCHADS. See page 49. rare - the one noted case in the United and Gallo agreed to be named the virus. In Ho Chi Minh City, where States involved two people with severe co-discoverers of the virus which was injection drug users are a major sentinel HIV strains dental disease. For similar reasons, trans- renamed as HIV. Note that HIV does not group, the report said researchers in 2001 mission through households items like stand for Human Immune Deficiency By 2002, scientists had classified HIV had found that eight percent of the HIV toothbrushes or razor blades is consid- Virus (which would be HIDV) and that the strains into three groups and many isolated was a combination of at least two ered extremely unlikely. See separate V stands for virus so "HIV virus" is wrong. sub-types (known as clades). Major strains sub-types. In Yunnan province in China, entries for sexual transmission, blood-borne Upper-case HIV is universal. As the (M) have at least 10 sub-types that are researchers have even found recombinants transmission and mother to child transmis- letter V is often used to denote a final classified as A, B, C, D, E, F, G, H, I and J. of two different recombinants.These were Outer strains (O) may have a similar sion. diphthong when transliterating Khmer reported to be circulating among nine into Roman script, some people pronounce number of sub-types. A strain found by percent of one group of injection drug users. French researchers in a woman with AIDS HIV virus HIV as hiou in which case hiv makes more sense. See also VIH. in Cameroon fell into neither category HIV tests The V in HIV stands for virus. HIV virus is group and was classified into a third group redundant as it would mean Human known as non-M non-O (N). Among the The most common test is the enzyme- human papilloma virus Immunodeficiency Virus virus, which is like major strains, sub-type B is most common linked immunosorbent assay (ELISA) which

150 GLOSSARY OF TERMS 151 The virus that causes genital warts. See immune-based therapies. own house) as well as streets and parks recently, amphetamines -- from the Golden Transmitted through sexual contact, the incidence (both male and female sex workers). Triangle region of Laos, Myanmar and virus has also been linked to cervical Under this definition, indirect sex workers northern Thailand.A survey in 2001 found The number of new cases -- of a disease, cancer.In HIV-positive women, infection with also includes female factory workers and that nine percent of Phnom Penh street

GLOSSARY OF TERMS for example --occurring in a given population the virus increases as CD4 counts decline. orange sellers engaged in informal sex children had injected drugs, up from three over a certain period of time. Although there is no cure, anti-retroviral work. NCHADS surveys indicate that the percent a year earlier. A separate survey drugs are used to treat genital warts.The proportion of beer-promotion girls involved found that three percent of men who warts can also be removed by laser treat- infectious in indirect sex work in five provinces have sex with men had injected drugs ment or conventional surgery. An infection that can be transmitted by almost doubled from 21 percent in 1997 over the previous 12 months. According intimate contact (sex, for example) as to 39 percent in 1999.The POLICY Project to an unpublished estimate, the number IL-2 opposed to casual contact (such as shaking study in 2003 said the apparent surge may of injection drug users in Cambodia hands). See also contagious. have reflected direct sex workers leaving exceeded 1,000 in 2004. See Interleukin 2. SECTION 19 brothels to enjoy more freedom, avoid indinavir police raids or increase earnings.Another innocent victim immune-based therapies possible factor was increased numbers An anti-retroviral drug used to treat HIV Avoid. The discriminatory notion of Treatment used to maintain, stimulate or of urban poor. NCHADS data released infections. See protease inhibitors. innocence and guilt in relation to HIV/ repair the immune system. For HIV, the in 2004 indicated that the proportion AIDS suggests that some people deserve most extensive trials have involved of beer promotion girls and karaoke to be punished and that others don't. Interleukin-2, a natural protein produced indirect sex workers hostesses involved in sex work had It also fails to take into account limited by the body that can dramatically raise the In recent NCHADS surveys, the term dropped to 37 percent of those surveyed access to HIV testing facilities. Such number of CD4 cells. "indirect sex workers" (srey roksiplauphet in 2003, down from 40 percent in 2001. language lacks objectivity, putting journalists proyol) has referred to "beer girls" (srey in the position of judging who is innocent langseh) and "karaoke girls " (srey karaokeh) immune system injection drug user and who is guilty. Leave that to the judicial who sell sex. But the term previously The body's natural defense against system. Such language could also be included "massage girls" (srey massa) and People who inject illegal drugs into their disruption caused by invading foreign agents defamatory. Describing an HIV-positive "bar girls" (srey baa) who sell sex, referred blood stream. Without sterilization, HIV such as microbes and viruses. There are baby as an innocent victim could imply to as "freelance sex workers" in the HIV can easily be transmitted from one injection two aspects of the immune system's that the father is guilty for contracting the Sentinel Surveillance of 1999. The NAA drug user to another if they are using the response to disease: innate and acquired. virus and passing it to his wife. Saying a has a broader definition that defines indi- same needle. In the former Soviet Union The innate part is mobilized very quickly recipient of HIV-contaminated blood is an rect sex workers as people who have and Eastern Europe, and more recently in in response to infection and does not innocent victim could imply that a hospi- other work besides selling sex or who Vietnam, the HIV epidemic has been heavily depend on recognizing specific proteins tal is guilty of negligence.As a government derive most of their income from other concentrated in injection drug users. In or antigens foreign to an individual's normal campaign launched in Australia in 1993 work. 2004, UNAIDS said contaminated needles tissue. It includes macrophages, dendritic were believed to account for two thirds put it, “HIV doesn't discriminate -- people cells and granulocytes. The acquired, or In between these two extremes is a third of new HIV infections in Vietnam.In addition do.” learned, immune response arises when definition used in a 2003 study by the to HIV outbreaks among injection drug dendritic cells and macrophages present POLICY Project.This defined indirect sex users in Ho Chi Minh City, recent out- interleukin-2 pieces of antigen to lymphocytes, which workers as anyone who sells sex outside breaks have been reported in several A natural protein produced by the body are genetically programmed to recognize a brothel. Settings include karaoke bars Vietnamese provinces including Can Tho that can dramatically raise the number very specific amino acid sequences. The (with sex taking place either on or off the on the Mekong Delta. Injection drug of CD4 cells. Recent evidence suggests ultimate result is the creation of cloned premises) as well as regular bars and users are not thought to have signifi- that injections of Interleukin-2 combined populations of antibody-producing B cells restaurants (where beer promotion girls cantly contributed to the epidemic in with anti-retroviral drugs can halt the and cytotoxic T lymphocytes primed to or waitresses may sell sex in addition to Cambodia. But there is cause for concern progression of HIV by keeping a person's respond to a unique pathogen. their jobs, usually at a guest house or given Cambodia's role as an alternative CD4 cell count within the normal range. hotel). Other settings include private trading route for heroin -- and more immunomodulating houses (freelancers working from home or independent sex workers managing their

152 GLOSSARY OF TERMS 153 See immune-based therapies. phed steu proh steu srey). On this basis, can be revoked for people who violate is as severe as that experienced in African International AIDS khteuy refers either to an "incomplete male" articles dealing with false advertising and countries such as Ethiopia and Nigeria Vaccine (steu proh) or an "incomplete female" (steu safe practices for medical and other pro- which have much higher HIV prevalence Initiative srey). The term is widely used and under- cedures. Penalties are doubled for repeat rates of about six percent. GLOSSARY OF TERMS A global not-for-profit organization stood in Cambodia and similar words offenders. The Khmer version has been working to accelerate the search for a derived from Sanskrit are used in Laos, printed into a booklet which is available lipodystophy syndrome Myanmar and Thailand and as far away as from the National AIDS Authority. vaccine to prevent HIV/AIDS, focusing See fat redistribution. on developing countries. Founded in 1996 India and Sri Lanka.The term is considered and operating in 22 countries, the pejorative by some Cambodians but not by LDC others. See also men who have sex with lubricant network researches and develops vaccine See least developed countries. candidates. In 2004, it had partnerships men. The "Number One" brand condoms with more than 25 private companies and lentivirus marketed by Population Services Inter- SECTION 19 academic and government institutions. KS national (PSI) in Cambodia are lubricated. A "slow" virus that takes a long time for Lubricant is often recommended for use See Kaposi's Sacoma. International Labor symptoms to develop after infection. HIV with condoms. Water-based lubricants is a lentivirus, as is the Simian Immuno- should always be used. Oil-based lubri- Organization Law on the Prevention and deficieny Virus (SIV) which effects non- cants should never be used as they can Established in 1919 and based in Geneva. Control of HIV/AIDS human primates. weaken the latex. PSI has recently started One of the 29 individual UN agencies and The law, passed by the National Assembly marketing a conveniently packaged lubri- one of 10 cosponsors of UNAIDS as of on June 14, 2002, is modeled on a 1998 least developed countries cant in Cambodia under the name Number One Plus. 2004.The work of ILO in the field of AIDS Philippine law considered as best practice The United Nations determines the focuses on HIV and the workplace. See legislation by the United Nations. The criteria for least developed countries that separate entry for Global Business Coalition law states that HIV/AIDS has a "serious qualify for special treatment under the low-income countries on HIV/AIDS. impact on social security, stability and World Trade Organization, including cheap- See least developed countries. socio-economic development" in Cambodia. er access to drugs. Under these criteria, Kaposi's Sacoma Under its general provisions, Cambodia Cambodia, Laos and Myanmar are all least lymphatic cancer is committed to promoting public awar- developed countries while Vietnam has A rare skin cancer caused by a virus, People with advanced AIDS can develop a eness of HIV/AIDS, prohibiting discrimi- "graduated" to a higher level. The World originally seen almost exclusively in central type of cancer known as non-Hodgkins nation against people with the virus, taking Bank uses different criteria and different Africa and among elderly Mediterranean lymphoma. In these types of cancers, cells precautions, addressing all factors behind terms. Under these criteria, all four countries men but now an opportunistic infection of the lymphatic system grow abnormally the epidemic, promoting a greater public are classified as low-income economies. for people with AIDS. The cancer attacks and develop into tumors that can appear internal organs and can cause purple role for people with HIV/AIDS and making See World Trade Organization. prevention and control a priority in in the stomach, liver, brain and bone lesions on the skin. Controlled through marrow of people with AIDS. Treatment chemotherapy. See opportunistic infections. national development plans. Additional life expectancy chapters have provisions for education, involves chemotherapy or radiotherapy The Asian Development Bank (ADB) and but complete remission is uncommon. karaoke hostesses safe practices and procedures, testing and counseling, health and support services, UNAIDS have estimated that Cambodia's See opportunistic infections. Women who work in karaoke lounges. monitoring, confidentiality, discrimination life expectancy in 2007 will be 2.3 years Some are also sex workers. See indirect and the role of the National AIDS lower than it otherwise would have been MAC without HIV/AIDS. In Siem Reap province, sex workers. Authority. The law provides for penalties See mycobacterium avium complex. for first-time violators of several articles where HIV prevalence is nearly double khteuy with fines of up to one million riel and jail the national average, life expectancy is estimated to be 7.3 years lower.The ADB male circumcision The Chuon Nath dictionary defines khteuy terms of up to one year. Administrative sanctions apply to civil servants who and UNAIDS have noted that this sharp Cutting and removing the foreskin that as "as a person whose sex is not completely reduction in life expectancy in Siem Reap covers the penis.Widely practiced by the male or completely female" (menou min break the law and professional licenses

154 GLOSSARY OF TERMS 155 TERMS

Muslim and Jewish faiths, and some other been strongly supported by the daughter GLOSSARY OF religions. Some studies suggest that of the former prime minister. See also morbidity nelfinavir circumcision may help protect against HIV Section 9 and in glossary. khteuy Sickness. An anti-retroviral drug used to treat HIV infection as the foreskin contains cells infections Produced by the Swiss pharma- that could pick up HIV if the penis comes microbicide mother-to-child ceutical company Roche for use in WHO- into contact with the skin, semen or vaginal A chemical or antibiotic foam or gel that recommended second-line regimens. See fluids of another person. transmission can be applied to the lining of the vagina protease inhibitors, Roche and regimens. or anus to protect against viral and other Perinatal infection and breast feeding MAP Network infections. are the two main routes of mother to neo-natal See Monitoring the AIDS Pandemic Network. child transmission, also known as MTCT military and vertical transmission. Perinatal The first six weeks of life after birth. men who have sex infection involves an HIV-positive mother SECTION 19 Male members of the Royal Cambodian transmitting the virus to the child during nevirapine with men Armed Forces have been one of the main pregnancy or at birth. See mother to child An anti-retroviral drug used to treat In the world of HIV/AIDS, a relatively new sentinel groups included in the Behavioral transmission on page 56. HIV infections. Nevirapine is used to carried out by NCHADS term that is now used internationally Surveillance Survey prevent mother to child transmission in and by Cambodian government and non since 1997. In the 2002 survey, men motorcycle taxi drivers Cambodia. It is also one of three drugs government agencies. It recognizes that serving in the military and policemen used in the most widely-prescribed fixed- were combined into a single group with One of the main sentinel groups included some men who have sex with other men dose combination (with d4t and 3tc), equal numbers. See sentinel groups and in the Behavioral Surveillance Survey also have sex with women.The term also carried out by NCHADS since 1997. See enabling patients to take one pill twice a recognizes that men who have sex with Behavioral Surveillance Survey. sentinel groups and Behavioral Surveillance day instead of six pills a day if taken men (proh delrourm phet jimoi proh Survey. separately. The combination drug is dôchknir) may not "identify" with being Monitoring the AIDS produced in Thailand, where it is known homosexual (nea rourm rea phet dôchknir). Pandemic Network MSM as GPOvir. See non-nucleoside analogue In its HIV Sentinel Surveillance of 2002, and A group of epidemiologists and public reverse transcriptase inhibitors GPOvir. NCHADS recognized men who have sex See men who have sex with men. health professionals from around the with men as a "highly-vulnerable popula- world who have produced independent NNRTI tion" but said that more information was MTCT reports on trends in the HIV epidemic needed on how many were involved.The See non-nucleoside analogue reverse tran- since 1995. Many MAP members work See mother to child transmission. NAA says the group is "difficult to scriptase inhibitor. in prominent positions in government, address" and that more research was international organizations and community mycobacterium avium required to determine sexual behavior, non-nucleoside analogue groups but come together under the culture and identities. In 2000, a survey in complex reverse transcriptase network without their institutional affilia- Phnom Penh found that 14 percent of tions. As a result, MAP conclusions are People with advanced AIDS can develop inhibitor men who have sex with men were HIV sometimes not in step with the priorities this bacterial infection which usually positive. Separate surveys have found A class of anti-retroviral drugs which of communities, international organiza- starts in the stomach before spreading comparative rates of 5.7 percent in Ho target reverse transcriptase, the enzyme tions or donor agencies.The MAP report to other parts of the body. Symptoms Chi Minh City and 17 percent in Bangkok. HIV uses to convert its genetic material "AIDS in Asia: Time to Face the Facts" include night sweats, high fever, cough, UNAIDS has noted that men who have sex into DNA. NNRTI drugs include nevirapine, published in July, 2004, was financed weight loss, poor absorption of food with men in North America, Europe and delavirdine and efavirenz. See highly-active by UNAIDS, WHO, UNICEF, the Japanese and diarrhea. Treatment involves a Australia were "early HIV-prevention anti-retroviral therapy. Foundation for AIDS Prevention, the combination of drugs. Few people without pioneers" in the early 1980s. Such leadership United States Agency for International HIV develop the disease. Also known as in promoting safe sex has also been seen nucleic acid Development and Family Health Interna- MAC. in some developing countries, notably in tional. A substance found in all living cells that Malaysia, where the Pink Triangle group has stores hereditary information.

156 GLOSSARY OF TERMS 157 can be easily transmitted by oral sex. See epidemic. nucleic acid amplification opportunistic infections Abstinence is the safest way to protect Paris Summit on HIV/AIDS against HIV from sexual transmission.The A test that can detect very small amounts Infections that take advantage of a weak See Greater Involvement of People Living risk of HIV and STI transmission by oral GLOSSARY OF TERMS of genetic material in blood, plasma or immune system. People with AIDS can with HIV/AIDS. tissue. It can also detect HIV during the die from opportunistic infections that are sex can be reduced by the use of a barrier method such as a male condom or a dental window period of up to three months treatable, and many infections can be dam. PCP before the immune system produces cured with drugs. In Cambodia and many See antibodies to the virus. African countries, tuberculosis (TB) is the pneumocystis carinii pneumonia. most common life-threatening oppo- oral thrush NRTI tunistic infection for people with See candidiasis. PCR HIV/AIDS. In the United States, doctors See See nucleoside analogue reverse transcriptase polymerase chain reaction. linked two opportunistic infections -- a organs SECTION 19 inhibitor. type of pneumonia and a rare form of See blood products, tissue and organs. people living with cancer -- to immune deficiency in 1982. HIV, AIDS or HIV/AIDS nucleoside analogue reverse The first, known as pneumocystis carinii transcriptase inhibitor pneumonia (PCP), is caused by a micro- orphans and other The term emerged over the past decade organism that usually lies dormant in the vulnerable children / chil- to counter the perception that people The class of anti-retroviral drugs first dren used to treat HIV. The most famous is lungs of people with healthy immune sys- with HIV will die immediately and encourage affected by HIV/AIDS the idea that infected people can lead azdotymidine (AZT), an anti-cancer drug tems. Treatment involves regular doses of found to benefit people with HIV in 1986. common antibiotics. The second, known Children who have lost either or both normal lives. But it can be misleading. People who have access to Others are ddI, ddC, 3tc, d4t and as Kaposi's Sacoma, is a rare skin cancer parents to an AIDS-related illness as well anti-retroviral may be living with HIV or AIDS. But abacavir. NRTI drugs target reverse caused by a virus that can be controlled as children who are affected by the drugs people without access to such drugs may transcriptase, the enzyme HIV uses to through chemotherapy. Other common prolonged illness of one or both parents, be dying. The abbreviation PLWHA and convert its genetic material into DNA. See opportunistic infections are the herpes by stigma and discrimination associated similar constructions are unfamiliar to highly-active anti-retroviral therapy. viruses and candidiasis, a common fungal with HIV/AIDS, and by other burdens on, infection of the mouth, airways and vagi- or changes in, their social, educational and most people. NVP na. Among opportunistic infections that financial well-being as a result of HIV/ occur after significant immune damage AIDS. Do not refer to AIDS orphans as people with HIV, AIDS See nevirapine. are lymphatic cancer, a gastro-intestinal this sets them apart from other orphans or HIV/AIDS condition called mycobacterium avium who share and experience the same issues A woman with HIV and an HIV-positive OI complex (MAC) and a major brain disorder affecting their health and well-being. man are people with HIV (neah min merok See opportunistic infections. called toxoplasmosis. A fungal infection called cryptococcal meningitis can also palliative care eith). A woman with AIDS and a man with affect the brain. an AIDS-defining illness are people with opiates Treatment involving symptomatic relief to AIDS (neah min chumngeou eith). Under The WHO has produced guidelines oral sex comfort and support patients and their Cambodian law, they are collectively indicating that drugs derived from opium families who are living with a life-threatening referred to as people with HIV/AIDS (neah including oral morphine are necessary for Sex involving the mouth of one partner illness, such as the advanced stages of min merok eith/neah min chumngeou eith). palliative care for people suffering from coming into contact with the genitals of AIDS. See also HIV/AIDS. AIDS. Although morphine and other another.Carries a much lower risk of HIV strong painkillers are often illegal in many transmission, but the risk rises if there are pandemic PEP countries, they are legal in Cambodia cuts or sores in the mouth. Many other A disease prevalent throughout an entire See post-exposure prophylaxis. when prescribed by a doctor. infections (e.g., syphilis and herpes viruses) country, continent or the whole world.

158 GLOSSARY OF TERMS 159 healthy immune systems. Can also occur in pre-ejaculate prophylaxis perinatal the skin, eye, spleen, liver or heart.Treatment A clear liquid that lines the male urethra Treatment or drugs to prevent an Around the time of birth. involves regular doses of common antibi- otics. Known as PCP, it was initially the during sexual stimulation. Released before infection or disease. See post-exposure GLOSSARY OF TERMS ejaculation, it can transmit HIV prophylaxis. perinatal infection biggest killer of people with AIDS. It was also the topic of the first report on the See mother to child transmission. HIV/AIDS epidemic, published by the President’s Emergency prostitution Center for Disease Control in Atlanta in Plan for AIDS Relief In Cambodia, the term is usually used in PHA 1981-- more than a year before the term (PEPFAR) the negative sense, especially in reference Most people are not familiar with this AIDS was adopted and two years before to human trafficking. This is in line with the was first isolated. The link with The President’s Emergency Plan for AIDS abbreviation, which stands for people with virus Article 46 of the Cambodian constitution, goes back to 1959 when a Relief was announced by US President HIV/AIDS. See Cambodian terminology on HIV/AIDS which prohibits "running a business in the

SECTION 19 George W. Bush during his ‘State of the page 33. Haitian sailor died of PCP in New York. A field of prostitution" without any mention blood sample taken from a person in what Union’ address in January 2003. In May, of prostitutes or sex workers. pharmaceutical companies is now the Democratic Republic of President Bush signed the U.S. Leadership Congo later tested positive for HIV anti- Against HIV/AIDS, Tuberculosis and protease Manufacturers of anti-retroviral drugs bodies in 1986. Malaria Act of 2003 into law. The plan mentioned in the Report on the Global calls for $15 billion over five years, with An enzyme that HIV needs to replicate AIDS Epidemic by UNAIDS in 2004 policemen nearly $10 billion being new funding. (reproduce). include BristolMyersSquibb (United States), About $9 billion will be directed to 15 One of the main included Cipla (India), GlaxoSmithKline (Britain), sentinel groups heavily-affected target countries, One billion protease inhibitors in NCHADS surveys since 1997. In the Ranbaxy (India) and Roche (Switzerland). is pledged to the Global Fund, and the One of three classes of anti-retroviral But UNAIDS stresses it does not endorse Behavioral Surveillance Survey of 2003, remaining five billion will be used to policemen and men serving in the military drugs. Drugs that inhibit protease, an or recommend these companies in support current HIV/AIDS, tuberculosis, enzyme needed by HIV to replicate, include preference to others not mentioned. were combined into a single group with and malaria programs. The Emergency equal numbers. See sentinel groups, HIV saquinavir, indinavir, ritonavir, amprenavir Plan’s three long-term objectives are to and nelfinavir. PI Sentinel Surveillance and Behavioral Surveil- avert seven million new HIV infections; lance Survey. provide ARV treatment to two million See protected sex protease inhibitor. people; and provide a range of care and polymerase chain reaction support to 10 million people living with Sex with condoms where there is no PLA, PLH, PLHA, PLWHA A sensitive laboratory technique that can HIV/AIDS and orphans and vulnerable exchange of semen, pre-ejaculate, vaginal Most people are not familiar with these detect and quantify HIV in a person's children. fluids or blood. abbreviations, which stand for people blood or lymph nodes. See also HIV tests. living with AIDS, people living with HIV and prevalence PWA, PWHA people living with HIV/AIDS. post-exposure The proportion of individuals in a popu- Most people are not familiar with these prophylaxis (PEP) lation having a disease at a given time. For abbreviations, which stand for people with PMTCT AIDS and people with HIV/AIDS. A potentially preventative treatment using example, Cambodia's rate of HIV preva- Prevention of mother-to-child transmission. anti-retroviral drugs within 72 hours of lence in 2003 was 1.9 percent of the adult See mother-to-child transmission on page 56. high-risk exposure to HIV (a needlestick population (defined as those between 15 regimen injury or unprotected sex, for example). and 49 years old), down from 3.3 percent When referring to HIV/AIDS, a drug or pneumocystis carinii The drugs are highly toxic and their use in 1998.The actual number of adults with treatment combination and the way it is pneumonia over several weeks can be difficult and HIV was estimated at almost 158,000, taken. In the broader sense, a regimen is a demanding. down from 175,000 in 1998. set of rules about food and exercise or Caused by a micro-organism that usually lies dormant in the lungs of people with

160 GLOSSARY OF TERMS 161 medical treatment that is followed to stay reproductive health ritonavir saquinavir healthy or improve one's health. A first- line regimen is used when starting Reproductive health is defined by the An anti-retroviral drug used to treat HIV An anti-retroviral drug used to treat treatment for the first time. If a first-line WHO as a state of physical, mental, and infection. See protease inhibitors. opportunistic infections in people with GLOSSARY OF TERMS regime is too toxic or fails to control HIV social well-being in all matters relating to HIV/AIDS. Produced by the Swiss pharma- replication in an infected person, a second- the reproductive system at all stages of life. Roche ceutical company Roche for use in WHO- recommended second-line regimens. See line regimen may be used. The cause of A Swiss pharmaceutical company that protease inhibitor. treatment failure may be complex and retrovirus produces the anti-retroviral drugs saquinavir there is no clear evidence to guide the A virus such as HIV that stores its genetic and nelfinavir for use in WHO-recommended choice of replacement drugs. information on a single-stranded RNA second line of drug treatment or second- second-line regimen molecule instead of the more usual double- line regimens. The company has a written See regimen. In poorer countries, the World Health stranded DNA. Retrovirus is singular. policy that it will not file or enforce existing SECTION 19 Organization was recommending in 2004 The plural form is retroviruses and the patents on HIV-related medicines in sentinel that a single first-line regimen should be adjective is retroviral. Drugs that fight sub-Saharan Africa and least-developed A soldier who guards something. In epidemi- identified to treat most new patients. retroviruses are called anti-retroviral drugs. countries such as Cambodia. it is used as an adjective denoting This would consist of two nucleoside ology, people susceptible to an infection being analogues and either a non-nucleoside or reverse transcriptase safe sex monitored for the appearance or recur- abacavir, or a protease inhibitor. Zidovudine An enzyme important for the functioning Using a condom during sex. Also known rence of the microorganism that causes it. (ZDV)/3tc was the initial recommendation of HIV. as Some people use the for a dual nucleoside analogues with d4t/ protected sex. term safer sex, as condoms can never be 3tc, ZDV/ddI and ddI/3tc as possible sentinel groups 100 percent effective if they are not used alternatives. Efavirenz and nevirapine were reverse transcriptase In Cambodia, NCHADS has been moni- properly. Problems include failing to use recommended non-nucleosides, while inhibitors toring different sentinel groups through new condoms after each ejaculation, failing recommended protease inhibitors included HIV Sentinel Surveillance (HSS) dating back Two separate classes of anti-retroviral drugs. to unroll them completely and failing to put ritonavir-boosted protease inhibitors (indi- to 1994 and Behavioral Surveillance Surveys The drugs inhibit reverse transcriptease, an condoms on before genital contact. With navir, lopinavir, saquinavir) or nelfinavir. A (BSS) since 1997. While HSS estimates enzyme important to the functioning of unlubricated condoms, problems include second-line regimen should be chosen to HIV prevalence in specific groups of people, HIV, and were among the first used to failing to use a water-based lubricant. substitute first-line regimens when needed BSS monitoring focuses on the high-risk treat people with the virus. Drugs in the Oil-based lubricants weaken the latex.The (for toxicity or treatment failure). An behavior of such groups. The five HSS first class are called nucleoside analogue safest sex is between two people who have entirely new second-line regimen could be sentinel groups in the 2003 survey were reverse transcriptase inhibitors, sometimes twice tested negative at three month prescribed in some cases. In others -- direct female sex workers, indirect female known as NRTI drugs.Drugs in the second intervals and who have not risked HIV when toxicity or resistance is related to sex workers, policemen, pregnant women class are called non-nucleoside analogue infection during the same period, which an identifiable drug in the regimen -- the attending ante-natal clinics and tuberculo- reverse transcriptase inhibitors, also known is the time it can take for antibodies to offending drug could be replaced. The sis patients.The four BSS sentinel groups as NNRTI drugs. develop. Unprotected sex with a person WHO also noted that countries planning in the 2003 survey were direct female sex who tests negative for HIV after having anti-retroviral programs should also have a workers, beer and karaoke hostesses, men ribonucleic acid (RNA) sex with someone else last week, is not HIV-drug-resistance sentinel surveillance serving in the military and policemen, and safe.Abstaining from sexual activity is the system to detect drug resistance among A nucleic acid used to synthesize motorcycle taxi drivers. Other sentinel safest way to protect against HIV from people and modify regimens accordingly. proteins. Mostly found in the cytoplasm of groups targeted by the two surveys over sexual transmission. See also highly-active anti-retroviral treatment. cells rather than the nucleus. Some viruses the years have included women who such as HIV carry RNA instead of the work, vocational students, tuberculosis replication more usual genetic material. saliva patients and hospital in-patients. Men who Saliva cannot transmit HIV. See What a virus does to reproduce. body fluids. have sex with men, young people, fishermen,

162 GLOSSARY OF TERMS 163 garment factory workers and other migrant virus can enter the body through linings effects are potentially life-threatening. Control of HIV/AIDS. Failure to follow the populations have been identified as of the vagina, vulva, penis and anus. The Simian Immunodeficiency authority's guidelines can result in a fine vulnerable to HIV infection. presence of sexually-transmitted diseases Virus (SIV) of up to one million riel and up to one increases the risk of transmission. In year in jail for first-time violators. GLOSSARY OF TERMS seroconversion addition to causing open sores, such An HIV-like virus that infects monkeys, diseases bring immune cells to the site of The development of a detectable level of chimpanzees and other non-human syphilis the infection, enhancing the ability of HIV antibodies that occurs after a person has primates. A sexually-transmitted bacterial infection to enter the body.Women with sexually- been exposed to and infected by a virus which can also be acquired in the uterus transmitted diseases are at greater risk such as HIV. No hyphen. during pregnancy. Curable with antibiotics. and are often unaware they have the spread disease due to an absence of symptoms. Handy for headlines. The medical terms seropositive are transmit and transmission. tattooing

SECTION 19 Carrying antibodies to any virus. No hyphen. sexually-transmitted In Cambodia, tattooing is subject to Rarely used in English outside medical disease or infection STD precautions determined by the National circles although séropositif and séropositive AIDS Authority under Article 14 of the See sexually-transmitted disease. are widely used in French, both as an A disease spread by the transfer of organ- Law on the Prevention and Control of adjective and noun, and are commonly isms during sexual activity. Strictly speaking, STI HIV/AIDS. First-time violators face a fine understood to mean HIV positive. Séropo is the term STD excludes HIV, which is not of up to one million riel and up to one an informal abbreviation. Related terms a disease but an infection transmitted in Sexually transmitted infection. See sexually year in jail. See high-risk behavior. are seropositivity (séropositivité) along several ways, including sex. The wider transmitted disease. with seronegative (séronégatif, séronéga- term, sexually-transmitted infection (STI), TB tive) and seronegativity (séronégativité). stigma includes HIV. Both terms are now used in See tuberculosis. A serologist (sérologiste) is a person who preference to venereal disease (VD), Devaluation that tends to reinforce specializes in serology (sérologie). which is somewhat dated. People with negative connotations by associating Serological (sérologique) work might T-cells STDs can be more susceptible to HIV HIV and AIDS with already-marginalized involve serodiagnosis (sérodiagnostic) and See CD4 cells. infection than people without STDs. See groups. Stigma lies at the root of discrim- serotherapy (sérothérapie). In English, separate entries for candidiasis, chancroid, inatory actions that exclude people who serosity (sérosité) is also known as serous chlamydia, gonorrhea, herpes viruses, human need AIDS-related services (UNAIDS tears fluid. papilloma virus, syphilis. definition in 2004). See also discrimination Tears cannot transmit HIV. See body fluids. on page 42. serosurveillance SIDA, Sida tenofovir Surveys of HIV infection rates in sentinel susceptible French acronym for AIDS. Written in A protease inhibitor found to be effective in groups. See sentinel groups and HIV Sentinel both upper and lower case, it stands for Very likely to be influenced, harmed or treating HIV infections. In July 2004, Prime Surveillance. Syndrome d'immunodéficience acquise. The affected by somebody or something. Minister Hun Sen intervened to halt a sex workers adjective acquise agrees with the feminine controversial trial planned for Cambodia noun immunodéficience rather than syndrome, sweat following objections from sex workers. Individuals who engage in sexual activity which is masculine. Sweat cannot transmit HIV. See body fluids. for money. Avoid commercial sex workers, Three by Five Initiative which can be misleading. See separate side effects surgical procedures A plan unveiled by the World Health entries for direct sex workers and indirect The effects of a drug other than those Organization (WHO) in 2003 to provide sex workers. In Cambodia, surgical procedures are desired. Side effects of anti-retroviral drugs treatment to three million HIV-positive subject to precautions determined by can include headaches, diarrhea, skin people in low and middle-income countries the National AIDS Authority under sexual transmission irritations, liver damage, nerve damage and by 2005. WHO and UNAIDS have urged Article 14 of the Law on the Prevention and HIV can be transmitted during sex. The neurological effects. Some of the side

164 GLOSSARY OF TERMS 165 non-government organizations and the and meat, especially pork. In most healthy men. more common in people with HIV. private sector to support expanded people, the immune system prevents the transsexual, transvestite tuberculosis patients treatment programs. By mid-2004, 40 parasite from causing disease. But in A transsexual is a person who feels One of the main sentinel groups included countries had said they wished to take people with HIV, the parasite can start GLOSSARY OF TERMS emotionally that they want to live and in the HIV Sero-Surveillance by NCHADS part in the initiative while Canada, Sweden to multiply and cause severe disease. dress as a member of the opposite sex, since 1997. Discontinued as of 2003. See and Britain had provided important One condition known as toxaplasmosis especially one who has a medical operation sentinel groups and HIV Sero-Surveillance. financial support. encephalitis forms lesions on the brain to change their reproductive organs. A which can disrupt mental processes and transvestite is a person, especially a man, sometimes lead to personality change. UNAIDS Three Ones who enjoys dressing as a member of the Toxoplasmosis is an opportunistic infection Joint United Nations Program on The UNAIDS-recommended approach opposite sex. In Cambodia, some resear- almost exclusively associated with very HIV/AIDS. Established in 1995 and based in to national responses to HIV/AIDS -- one chers call transsexuals and transvestites advanced stages of AIDS and can be treated Geneva, the program brought together 10 action framework, one coordinating "long-haired men who have sex with men" to SECTION 19 with antibiotics. agencies as of mid-2004 -- the United authority and one monitoring and evaluation distinguish them from less-easily identifi- Nations Children's Fund (UNICEF),the United system. Donors as well as low and middle- able "short-haired men who have sex with Nations Development Program (UNDP), the income countries adopted the principles Trade-Related Aspects of men." The Cambodian term khteuy is United Nations Population Fund (UNFPA), at a meeting chaired by UNAIDS, Britain Intellectual Property more widely understood and less cumber- the United Nations Drug Control Program and the United States in Washington in 2003. some, although many transvestites in Rights (UNDCP), the International Labor Organi- Phnom Penh say they find khteuy offensive zation (ILO), the United Nations Educational, See World Trade Organization. and prefer to be known as srey sros ("beau- 3tc Scientific and Cultural Organization (UNESCO), tiful girl"). See also transgender, khteuy and An anti-retroviral drug used to treat the Office of the United Nations High transgender men who have sex with men. opportunistic infections in people with Commissioner for Refugees (UNHCR), the HIV/AIDS. The drug is one of three drugs A newly-invented adjective to refer to World Health Organization (WHO), the used in the most widely-prescribed fixed both transsexuals and transvestites (see TRIPS World Bank and the World Food Program dose combination (with d4t and nevirapine), below). The word literally means "across Trade-related aspects of intellectual property (WFP). enabling patients to take one pill twice gender" or "beyond gender" and is usually rights. See World Trade Organization. a day instead of six pills a day if taken defined by dictionaries as an adjective undetectable viral load separately. In Thailand, the combination is meaning transsexual. But the term is tuberculosis (TB) A potentially misleading term that refers known as GPOvir. See also anti-retroviral sometimes used as a noun and even a A bacterial infection affecting the lungs and to levels of HIV in the blood of people drugs, highly-active anti-retroviral therapy, verb. In Cambodia, the term is usually a leading cause of AIDS-related deaths in taking anti-retroviral drugs that are so low nucleoside analogue reverse transcriptase translated as khteuy. A more literary Cambodia. Spread by airborne droplets that they cannot be detected using standard inhibitors. translation might be the Pali-derived neak bongsak galeung ("person with no specific expelled when a person with TB coughs, tests. Low levels of HIV do not mean that thrush genitals") or simply akleung referring to sneezes or speaks. In healthy people, TB a person is no longer infected with HIV. a person's appearance. A more clinical rarely spreads beyond a small area of the The virus is capable of regrouping and rising See candidiasis. term is op pakdau leung ("person with lungs. But if the body’s immune again to levels that are potentially dangerous. incomplete genitals"). But unlike khteuy, system is impaired by malnutrition, aging tissue the terms are not widely understood. or other factors including HIV infection, UNDP the bacteria can spread more widely in See blood products, tissue and organs. In the absence of an English definition, See United Nations Development Program. the UNAIDS Terminology Database trans- the lungs or other tissues. TB can also toxoplasmosis lates transgender and transgendered as occur in the larynx, lymph nodes, brain, UNESCO transsexual in French, Spanish and Russian. kidney and bones. Such extrapulmonary A bacterial infection caused by a parasite Some countries now have laws that TB infections (not involving the lungs) are See United Nations Educational, Scientific found in cats, birds and other animals as prohibit transgender discrimination. See and Cultural Organization. well as in soil contaminated with cat feces also khteuy and men who have sex with

166 GLOSSARY OF TERMS 167 UNFPA as of mid-2004. UNESCO specializes in AIDS education. United Nations vaginal fluids See United Nations Population Fund (formerly Fund for Population Activities). Population Fund Vaginal fluids can transmit HIV. See body

GLOSSARY OF TERMS United Nations General Established in 1969 and based in New fluids. UNGASS Assembly Special Session York. One of the 29 individual UN agencies and one of the 10 cosponsors of vaginal sex See United Nations General Assembly on HIV/AIDS as of mid-2004.The AIDS-related Special Session on HIV/AIDS. A special meeting of heads of state and UNAIDS A sexual activity that carries a high risk of government in New York in 2001. The work of UNFPA is concentrated on gender HIV transmission if a condom is not used UNHCR assembly adopted a resolution known as and young people. and one of the partners is infected. the Declaration of Commitment on HIV/ Abstinence is the safest way to protect See United Nations High Commissioner for AIDS which calls for "strong leadership at United Nations Secretary against HIV from sexual transmission. See

SECTION 19 Refugees. all levels of society" and additional General's Special Envoys sexual transmission. resources to respond to the global crisis. on HIV/AIDS UNICEF The declaration sets out commitments varicella zoster There are four special envoys-for Africa, See United Nations Children's Fund. and targets in a wide range of areas from See herpes viruses. prevention, care, support and treatment to Asia, the Caribbean and countries in United Nations Children's human rights, vulnerability, orphans and the transition in Eastern Europe and Central victims Fund socio-economic impact of HIV/AIDS. It Asia. The special envoys have increased also covers research and development as attention towards HIV/AIDS among See AIDS victims, innocent victims. Established in 1946 and based in New well as HIV/AIDS in conflict and disaster politicians, donors, civil society and the York. One of the 29 individual UN areas. media. vertical transmission agencies and one of the 10 cosponsors of See mother to child transmission. UNAIDS as of mid-2004. In AIDS-related United Nations High UNODC work, UNICEF specializes in orphans and United Nations Office on Drugs and Crime. VIH mother-to-child transmission. Commissioner for Refugees Established in 1950 and based in Geneva. unprotected sex French abbreviation for HIV. Always United Nations One of the 29 individual UN agencies and written in the upper case, it stands for Development Program one of the 10 cosponsors of UNAIDS as of Sex without a condom. See safe sex. virus de l'immunodéficience humaine. The mid-2004. Formally known as the Office of adjective humaine agrees with the feminine Established in 1958 and based in New the United Nations High Commissioner urine noun immunodéficience rather than virus York. One of 29 individual UN agencies for Refugees and informally known as the which is masculine. Urine cannot transmit HIV. See body fluids. and one of the cosponsors of UNAIDS as UN Refugee Agency. It has two technical of mid-2004. UNDP work in the field of experts on HIV in Geneva and four HIV viral load HIV/AIDS focuses on HIV, governance and vaccine regional coordinators in Africa.A regional The amount of HIV in the blood. Measured development. See separate entry for A substance that contains antigen coordinator for Asia is planned for 2005. as the number of copies in each milliliter decentralization. components from an infectious organism. of blood plasma.Viral load can range from By stimulating an immune response -- but United Nations Office on many hundreds of thousand of copies per United Nations Educational, not the disease itself -- it protects against Drugs and Crime milliliter in some people to less than 50 subsequent infection by the organism. Scientific and Cultural copies, which is the level of detection. Established in 1997 and based in Vienna. Preventive vaccines can stop people getting Viral load tests are seen as a better Organization One of the 29 individual UN agencies and sick from viruses such as measles or indicator of the risk of AIDS developing Established in 1945 and based in Paris. one of the 10 cosponsors of UNAIDS as of mumps.Therapeutic vaccines, also known than CD4 cell counts - the lower the viral mid-2004. Its AIDS-related work focuses as treatment vaccines, are being used in One of the 29 individual UN agencies and load, the longer the time to AIDS diagnosis on injection drug users. people with HIV to stimulate an immune one of the 10 cosponsors of UNAIDS and the longer survival time. See also system response. See immune-based therapies. undetectable viral load.

168 GLOSSARY OF TERMS 169 virus cosponsors of UNAIDS as of 2004. Also developing countries were allowed a five- urged governments, civil society and the known as the International Bank for year transitional period ending in 2000 private sector to "actively evaluate" the Organism mainly comprised of nucleic acid Reconstruction and Development (its and least-developed countries were given new flexibility under the TRIPS agreement. coated by protein. When viruses enter a official name), the World Bank oversees a 11 years up to 2006. At a meeting in the the agency said such action was "essential" GLOSSARY OF TERMS living plant or animal, they make use of the multi-country AIDS program. Qatari capital of Doha in 2001, world to promote access to affordable HIV drugs. host cell to replicate. Sometimes the host trade ministers extended the deadline At the same time, UNAIDS noted that cell is dissolved, sometime it becomes World Food Programme to 2016 for pharmaceutical patents in some regional and bilateral trade agree- cancerous. Some viruses cause illness and least-developed countries. Recognizing ments, especially those involving the Established in 1963 and based in Rome. then seem to disappear but later cause the importance of promoting access to United States, had provisions that "overly" One of the 29 individual UN agencies and another disease that is sometimes even existing medicines as well as research and protect patent rights, offsetting much of one of the 10 cosponsors of UNAIDS as of more severe. In humans, viruses cause development into new medicines,ministers the flexibility under the TRIPS Agreement. mid-2004. The WFP executive director chicken pox, measles, mumps, yellow fever, adopted a separate declaration on has been involved in raising awareness of SECTION 19 poliomyelitis, influenza and the common interpreting the 1995 agreement.The Doha the deadly combination of AIDS, drought WTO cold. Drugs that fight viruses are called Declaration on the TRIPS Agreement and and shrinking human capacity in southern See World Trade Organization. anti-viral drugs. Public Health recognized difficulties faced Africa. by countries with limited drug-making vulnerable young people World Health capacity (Canada has since passed laws to Weak and easily hurt physically or Organization allow its producers of generic drugs to Anyone between 10 and 24 years of age. export to such countries). On the eve of See also defining the young. emotionally. Established in 1948 and based in Geneva. the ministerial meeting in the Mexican One of the 29 individual UN agencies and city of Cancun in 2003, the WTO agreed youth WFP one of the 10 cosponsors of UNAIDS as of to a case-by-case system to make it easier Anyone between 15 and 24 years of age See World Food Programme. mid-2004. In 2003, the WHO increased its for such countries to find sources for See also role in the global expansion of access to defining the young. generic drugs. But by mid-2004, this WHO anti-retroviral drugs. See separate entries new system had not been used by any zidovudine (ZDV) for anti-retroviral drugs and highly-active See World Health Organization. WTO member. UNAIDS subsequently anti-retroviral therapy. See azdotymidine. William J. Clinton World Trade Organization Presidential Foundation Set up in 1995 to succeed the General A foundation that has engaged generic Agreement on Tariffs and Trade (GATT) drug manufacturers in India and South established in Geneva in 1947. World Africa in moves to cut prices for anti-retro- trade ministers approved Cambodia's viral drugs. By the end of 2003, it membership application in 2003 and the announced that it had negotiated prices National Assembly ratified the legislation as low as 140 dollars a year.The foundation in 2004, paving the way for Cambodia to has offered the same prices to UNICEF join the WTO. Under the WTO's Trade- and to beneficiaries of programs runs by Related Aspects of Intellectual Property the World Bank and the Global Fund to Rights Agreement, patents on industrial Fight AIDS, Tuberculosis and Malaria. property including new drugs are protected under international law. When World Bank the TRIPS agreement came into effect One of the 29 individual UN agencies. in 1995, developed countries were given Based in Washington and one of the 10 one year to comply with the rules. But

170 GLOSSARY OF TERMS 171 SECTION 19 GLOSSARY OF TERMS 172 20. Picture andtext: Boehringer Ingleheim in theplasmaenables physicians todetect thelevels. infected CD4cell. Measuringtheamountofvirus Many budfrom viralparticles the surfaceofan AND ABBREVIATIONSACRONYMS ABBREVIA- AND ACRONYMS ABBREVIATIONS AND ACRONYMS he abbreviations and acronyms listed ARH adolescent reproductive CCASVA Cambodian Children Against CHEMS Cambodia Health Education here are commonly found in reports health Starvation and Violence Media Service Trelating to the Cambodian health Association sector and the broader area of HIV/AIDS ARV anti-retroviral CHHRA Cambodian Health and worldwide. The use of abbreviations and CCFC Christian Care for Cambodia Human Rights Alliance acronyms when writing for general audi- AusAID Australian Agency for ences is discouraged. International Development CCWD Community of Cambodian CHRHAN Cambodian Human Rights SECTION 20 Women for Development and HIV/AIDS Network ADB Asian Development Bank BCC behavior change communication CDA Community Development CIDA Canadian International ADRA Adventist Development Action Development Agency Relief Agency BFD Buddhism For Development CDC Centers for Disease Control CMS central medical stores AEM Asian Epidemic Model BS birth spacing and Prevention (US); com- municable disease control CMV cytomegalovirus AFD Association for Farmer BSS Behavioral Surveillance Development Survey CDRCP Cambodian Development and COERR Catholic Office for Emergency Relief Center for the Poor Relief and Refugees AHRN Asian Harm Reduction BS/SM birth spacing/safe mother Network hood CECI Centre Canadien d'Etude et COHD Cambodian Organization for de Cooperation Internationale Human Rights and AIDS Acquired Immune BTC Belgian Technical Cooperation Development Deficiency Syndrome CEDPA Center for Development and BWAP Battambang Women's AIDS Population Activities COPHA Cambodian Organization of AMDA Association of Medical Project People Living with HIV/AIDS Doctors of Asia CENAT National Center for CAA children affected by AIDS Tuberculosis and Leprosy COTF Central Outreach Task Force Aide Medicale Control AMI CARAM Coordination of Action Internationale CPA complementary package of Research on AIDS and CFDS Cambodia Family activities ANC ante-natal care Mobility Development Services CPN+ Cambodian People Living With AOC Asian Outreach Cambodia CARE Cooperative for Assistance CHC Cambodia Health Committee HIV/AIDS Network and Relief Everywhere APHEDA Australian People for Health, CHEC Cambodia HIV/AIDS CPR contraceptive prevalence rate; Education and Development CAS Center for Advanced Education and Care Community Poverty Abroad Studies Reduction CHED Cambodian Health ARC Australian Red Cross CAT central advisory team Education Development CRC Cambodian Red Cross

174 ABBREVIATIONS AND ACRONYMS 175 SECTION 20 ABBREVIATIONS AND ACRONYMS 176 CSDA CSCS CRS CRF DHS DHAC DFSW DFID DAC CWS CWPD CWDA CVD CUWG CUMEC CU CSW CSES Cambodian Socio-economic Cambodian Society Cooperation for aSustainable Catholic ReliefServices Croix-Rouge Francaise Survey Demographic andHealth Committee Drug andHIV/AIDS direct female sexworker (Britain) International Development for Department committee district AIDS Service Church World and Development Peace for Cambodian Women Development Association Cambodian Women's Development for Cambodian Vision Condom Use Working Group and EvaluationCommittee Condom UseMonitoring condom use commercial sexworker services entertainment commercial sexand Development Association HAART GTZ GO GIPA GBV GAP FPP FSW FHI FAP EWC EU ESTHER ELISA EC DYMB DSW DSF DOTS therapy highly-active anti-retroviral Zumsammenarbeit Gesellschaft für Technische government organization by HIV/AIDS people livingwithoraffected greater involvement of gender-based violence Project Global Action (CDC); Program Global Aids Frontiers Prevention Project female sexworker Family HealthInternational Pioneer Friends Association Center East West European Union En Reseau Therapeutique Hospitaliere Ensemble pouruneSolidarite immunosorbent assay enzyme-linked European Commission Dhammayietra Mongkol Borei direct sexworker Douleurs SansFrontieres treatment strategy direct observation IDU IDA ICC ICAAP IBRD HU-CHEMS HSS HPHAO HKI HIV HIS HIF HCW HC HBC HAI HACC injection druguser Association Indradevi Association, International Development Cambodia International Cooperation AIDS in Asia andthePacific International Congress on Development Reconstruction and International Bankfor Media Service Cambodian HealthEducation Surveillance HIV/AIDS Sentinel HIV/AIDS Organization Hope for Persons with Helen Keller International Virus Human Immunodeficiency health information system Handicap InternationalFrance health care worker health center home-based care International Help Age Committee HIV/AIDS Coordinating Health Unlimited- KOSHER KKVN KHANA KfW KDFO KBA KAP JOICFP JICA JCA ITM ITF ISW IPC INGO ILO IFSW IEC ABBREVIATIONS AND ACRONYMS Education Road Key ofSocialHealth Kien Kes Volunteer Network Alliance Khmer HIV/AIDSNGO Weideraufbau Kreditanstalt für Freedom Organization Khmer Development of Khmer Buddhist Association practice attitudeand knowledge, in Family Planning International Cooperation Japan Organizationfor Cooperation Agency Japan International Association Jeannine's Children Institute of Tropical Medicine Interim TrustFund indirect sexworker Institut PasteurCambodge non-government organization international Organization International Labor indirect female sexworker communication educationand information, 177 SECTION 20 ABBREVIATIONS AND ACRONYMS 178 KWCD KT KRDA MoP MoND MoJ MoI MoH MoEYS MODE MHD MHC MDM MEC MCH MCD MAP LWF LKWD KWWA Khmer Women's Kaksekor Thmey Association Khmer RuralDevelopment Ministry ofPlanning Ministry ofNationalDefense Ministry ofJustice Ministry ofInterior Ministry ofHealth Ministry and Sport Youth ofEducation, Ministry Development Economy Minority Organization municipal healthdepartment Men's HealthCambodia Médecins duMonde Cambodge Médecine del'Espoir maternal andchildhealth Development Media Consultingand Pandemic Monitoring the AIDS Federation Lutheran World for Development Leadership's Khmer Women Association Kratie Women's Welfare Cooperation for Development NCHADS NBTC NBP NAS NAPA NAP NACD NAA MWVA MTCT MSW MSM MSF-F MSF-B MSI MPA MoWA MoSVY MoRD AIDS, Dermatology and STDs Dermatology AIDS, National Centerfor HIV/ Center National Blood Transfusion national bloodpolicy Sahakum Nak Akphivath Association National Prosperity Program National AIDS Combating Drugs for National Authority National AIDSAuthority Veteran's Affairs of Ministry Women's and mother-to-child transmission male sexworker men whohave sexwithmen France Médecins SansFrontières - Belgium Médecins SansFrontières - Marie StopesInternational minimum packageofactivities of Ministry Women's Affairs Rehabilitation Veterans and Youth ofSocial Ministry Affairs, Development ofRural Ministry OVC OI OHCHR OEB OD NVP NSP NRTI NRHP NPC NNRTI NMCHC NIPH NHS NGO NCHP NCHECR children orphans andvulnerable infection opportunistic Human Rights High Commissionerfor Office oftheUnitedNations Battambang Operation Enfantsde operational district nevirapine national strategicplan transcriptase inhibitor nucleoside analoguereverse Program National Reproductive Health Norea Peaceful Children inhibitor reverse transcriptase non-nucleoside analogue Health Center National MaternalandChild Health National Institutefor Public National HealthSurvey organization non-government Promotion National Centerfor Health Research andClinical Epidemiology National CenterinHIV POT PMTCT PLWHA PLHA PLH PLA PI PHR PHD PHC PHA PFD PEP PCR PCP PC PB PATH PAS PAO PAC ABBREVIATIONS AND ACRONYMS provincial outreach team child transmission prevention of motherto people livingwithHIV/AIDS people livingwithHIV/AIDS people livingwithHIV people livingwith AIDS protease inhibitor Reformplus for Health Partners provincial healthdepartment heathcare primary people withHIV/AIDS provincial healthadvisor; for DevelopmentPartners post-exposure prophylaxis polymerase chainreaction pneumonia pneumocystis carinii inCompassion Partners policy board Technology for Health Program for Appropriate secretariat provincial AIDS office provincial AIDS committee provincial AIDS 179 SECTION 20 ABBREVIATIONS AND ACRONYMS 180 SEADO SCF SCC SCA RTI RHAC RH REDA RADE RACHA QSA PWHA PWA PTC PSI PSF PSAD PRSP Organization Agricultural Development Social Environmental Save theChildren Fund Salvation CenterCambodia Save theChildren Australia Research TriangleInstitute reproductive tractinfection; Association ofCambodia Reproductive Health hospital referral reproductive health, Association Rural EconomicDevelopment Development ofEconomy for Rural Association Healthcare Alliance Reproductive andChild Quaker Services Abroad people withHIV/AIDS people with AIDS provincial transfusioncenter International Population Services Borders) (Pharmacists Without Pharmaciens SansFrontières Development Phnom Srey Association for paper poverty reduction strategy 24HTV-CA TRIPS TOT TBA TB SW STI STD SSS SRA SQHN SPFA SM SIDA SHCH SHARE SH SFODA SEDP Committee -Cambodia 24-Hour TelevisionCharity intellectual property rights trade-related aspectsof training oftrainers attendant traditional birth technicalboard tuberculosis, sex worker infection sexually transmitted sexually-transmitted disease survey STI surveillance situation andresponse analysis Sun QualityHealthNetwork Association Seek ofthePiousFriends safe motherhood Agency Development Cooperation Swedish International for Hope Sihanouk HospitalCenter Regions and African for Healthin Servants Asian sweet heart Development Association Sacrifice FamiliesandOrphans Development Plan Socio-Economic UNAIDS UNACAS UHN TWG UNODC UNKS UNICEF UNHCR UNGASS UNFPA UNESCO UNDP UNDCP UNCT UNCOHCHR Unaccompanied Association United HealthNetwork technical working group Drugs andCrime United NationsOfficeon Students United NeutralKhmer Fund United NationsChildren's Commissioner for Refugees United Nations HIV/AIDS Assembly SpecialSessionon United NationsGeneral Activities) Fund (Fundfor Population United NationsPopulation Organization Scientific andCultural United NationsEducational, Program United NationsDevelopment Program United NationsDrugControl United NationsCountry Team for HumanRights of theHighCommissioner Program onHIV/AIDS Joint UnitedNations UN CambodiaOffice High YWAM YCC WYA WVI WVC WTO WOMEN WNU WHO WG WFP WEC WDA WAC VCT VC USG USAID URC UP ABBREVIATIONS AND ACRONYMS Youth With A Mission YouthA With Youth CouncilofCambodia Women and Youth Action International World Vision Cambodia World Vision World TradeOrganization Nursing Modern Economy and Women's Organizationfor Womyn's Network for Unity World HealthOrganization working group World Food Programme World EducationCambodia Association Women's Development Womyn's Agenda for Change testing counselingand voluntary Vithey Chivit Urban SectorGroup International Development United States Agency for University Research Company universal precautions 181 SECTION 20 ABBREVIATIONS AND ACRONYMS 182 21. -- MahatmaGandhi wish toseeintheworld.’ ‘You must you bethechange REFERENCES SELECTED Picture: Boehringer Ingleheim SELECTED REFERENCES SELECTED REFERENCES

African Women's Media Center; Reporting Garrett, Laurie; You Just Signed His Death Joint United Nations Programme on Ministry of Education, Youth and Sport; on HIV/AIDS; Warrant: AIDS Politics and the Journalists’ HIV/AIDS; Keeping the Promise: Summary Cambodia National Youth Risk Behavior www.awmc.com/programs/77 Role; Columbia Journalism Review; New of the Declaration of Commitment on Survey; Phnom Penh, 2004 York, November-December, 2000 HIV/AIDS; Geneva, 2002 Agence France-Presse; English Service Ministry of Education, Youth and Sport, Stylebook; Paris, 2001 Goldstein, Norm; The Associated Press Joint United Nations Programme on Interdepartment Committee for HIV/ SECTION 21 Stylebook and Briefing on Media Law; HIV/AIDS; The Media and HIV/AIDS: AIDS; Strategic Plan 2001 - 2005 Associated Press, New York, 2003 Making the Difference; Geneva, 2004 Asian Development Bank and Joint United Nations Programme on HIV/AIDS; Asia- Ministry of Health; Strategic Plan for Pacific's Opportunity: Investing to Avert an HIV/AIDS Coordinating Committee; Joint United Nations Programme on HIV/AIDS and STO Prevention and Care in HIV/AIDS Crisis; 2004 Annual Report; Phnom Penh, 2003 HIV/AIDS, United Nations Children's Cambodia 2001 - 2005 Fund and United States Agency for International Development; Children on the Brooks, Brian, James Pinson and Jean Institut Bouddhique; Dictionnaire Cambodgien, Ministry of Planning; Cambodian Millennium Brink 2004; United Nations Children's Gaddy Wilson; Working With Words; Cinquieme Edition; Japan Committee for Development Goals Report; Phnom Penh, Fund, New York, 2004 Bedford/St Martins, Boston, 2000 Republication and Relief of Cambodian 2003 Buddhist Books,Tokyo, 1989 Joint United Nations Programme on HIV/ Clayton, Julie with contributions from National AIDS Authority; Building a Better AIDS and the World Health Organization; TV Padma and Joe Thomas; Reporting John, Kylie, and Sainsbury, Candice; The Understanding of the Situation and Response Epidemic Update; Geneva, 2003 on HIV/AIDS: Multimedia Training Kit; Impact of HIV/AIDS on Older People in to HIV/AIDS in Cambodia; Phnom Penh, www.itrainonline.org/itrainonline/mmtk/ Cambodia; HelpAge International, 2003 2001 hivaids.shtml Kaiser Family Foundation; The Global Joint United Nations Programme on HIV/AIDS Epidemic: A Timeline of Key National AIDS Authority; National Strategic Milestones; 2004 Department of Health and Human HIV/AIDS; Glossary of HIV-Related Terms; Plan for a Comprehensive and Multisectoral Services (United States); Glossary of HIV/ 2004 www.kff.org Response to HIV/AIDS 2001-2005 AIDS-Related Terms - 4th edition; 2002 www.unaids.org Kha Sovannara and Chris Ward; Men Who National Center for HIV/AIDS, Dermatology Family Health International; Sexual Joint United Nations Programme on Have Sex with Men in Cambodia; POLICY and Sexually-Transmitted Diseases; HIV Behavior, STIs and HIV among Men who HIV/AIDS; 2004 Report on the Global AIDS Project, Phnom Penh, 2004 Sentinel Surveillance 2002; Phnom Penh, have Sex with Men in Phnom Penh; Epidemic; Geneva, 2004 undated Phnom Penh, 2002 Lowe, David; Perceptions of the Cambodian Joint United Nations Programme on 100% Condom Use Program: Documenting National Center for HIV/AIDS, Dermatology the Experiences of Sex Workers; POLICY Fowler, H.S; A Dictionary of Modern English HIV/AIDS; 2002 Report on the Global AIDS and Sexually-Transmitted Diseases; HIV Project, 2003 Usage; Oxford University Press, London, Epidemic; Geneva, 2002 Sentinel Surveillance 2003: Results, Trends 1954 and Estimates; Phnom Penh, 2004

184 SELECTED REFERENCES 185 National Center for HIV/AIDS, Dermatology Pichara Leang and Kim Ann Oeun; Analysis and Sexually-Transmitted Diseases; National of Reporting on HIV/AIDS in Cambodia; Guidelines for the Selection of People Living POLICY Project, Phnom Penh, 2004 with HIV/AIDS for Antiretroviral Therapy; Phnom Penh, 2003 SELECTED REFERENCES Pillai, Gita, Barbara Donaldson and Sok Keang; A Directory of Organizations Imple- National Center for HIV/AIDS, Derma- menting or Supporting HIV/AIDS Activities in tology and Sexually-Transmitted Diseases Cambodia (Draft); Phnom Penh, 2004 and World Health Organization; National Policy for Preventing Mother-to-Child Trans- Pisani, Elizabeth et al; AIDS in Asia: Face the mission of HIV; Phnom Penh, 2001 Facts; Monitoring the AIDS Pandemic, 2004

SECTION 21 National Center for HIV/AIDS, Dermatology POLICY Project; HIV/AIDS in the Mekong and Sexually-Transmitted Diseases; Policy Region; 2003 for HIV/AIDS and STI Prevention and Care in the Health Sector in Cambodia; Phnom Penh, 2001 Pollard, Ruth; HIV/AIDS Media Guide, Second Edition; Australian Federation of AIDS Organizations and the Australian National Center for HIV/AIDS, Dermatology National Council on AIDS, Hepatitis C and Sexually-Transmitted Diseases; BSS and Related Diseases, 2000 2003: Sexual Behavior Among Sentinel Groups; Phnom Penh, 2004 Soul City Institute for Health and Development Communication (South National Center for HIV/AIDS, Dermatology Africa); HIV/AIDS: A Resource for Journalists; and Sexually-Transmitted Diseases; Policy; Undated Strategy and Guidelines for HIV/AIDS Counseling and Testing; Phnom Penh, 2002 UNAIDS Cambodia, the National AIDS Authority and the POLICY Project; HIV/ National Center for HIV/AIDS, Dermatology AIDS and Human Rights in Cambodia: and Sexually-Transmitted Diseases; Strategy Report to the Asia Pacific Regional Office of and Guidelines for Implementation of the the High Commissioner for Human Rights; Targeted Outreach Program for Sex Enter- Phnom Penh, 2004 tainment Services; Phnom Penh, 2001 World Health Organization; Health National Institute of Statistics, Directorate Promotion Glossary; Geneva, 1998 General for Health and ORC Macro; www.who.org Cambodia Demographic Health Survey 2000; Phnom Penh and Calverton, Maryland, 2001

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:

Dr. Sim Kim San Chief of Advocacy and Communication Unit, National AIDS Authority 186 E-mail: [email protected]