Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Associated Press - November 11, 2005
Ker Munthit
Cambodia has had no known cases of HIV being spread by blood transfusions, but if HIV infected blood entered the hospital system in even a single case it "would be a disaster," said Dr. Massimo Ghidinelli, a World Health Organization adviser on HIV/AIDS in the country.
Transfusions using infected blood are one of the key ways HIV can be spread, and can put people who otherwise would have little chance of catching the virus at risk.
Injecting heroin users are one of the groups most at risk for spreading HIV through the shared use of contaminated syringes. Amphetamine users are also considered high risk because the stimulant clouds their judgment and can lead to unsafe sex practices.
A survey by the U.N. Office on Drugs and Crime recently found that some Cambodian drug addicts were working in "teams, taking turns selling their blood" through brokers who supplied it to hospitals.
Addicts sometimes sold their blood as often as twice a week and earned around $4.80 each time, said Kathryn O'Connell, the report's author.
Officially, all blood used by hospitals in Cambodia is supposed to be tested for diseases at the state-run National Blood Transfusion Center and tainted blood is discarded, said Nhem Thuok, the center's director.
But the country's health system is decrepit and poorly funded. Regular healthy blood donors are in short supply, leading to a reliance on paid donors and correct testing procedure often were not followed.
"That's not good for a sustainable and high standard blood transfusion service," said Ghidinelli.
A large sex industry, traditional male promiscuity and low levels of condom use in Cambodia helped give the country one of the highest HIV infection rates in Asia - though education campaigns have helped curb dangerous sexual activity.
The HIV infection rate in the 15-49 year olds age group is 1.9 percent - down from 3.8 percent seven years ago.
Cambodian authorities have failed to effectively tackle the illicit drug trade. Methamphetamine and heroin use in Cambodia has been steadily rising since the 1990s, the U.S. State Department said in its International Narcotics Control Strategy Report this year.
"Despite awareness-raising efforts, the Cambodian populace has an extremely limited understanding of the associated risks," the report said.
The practice of blood-selling was uncovered by a UNODC survey of 66 drug users in the capital Phnom Penh and Poipet town near the border with Thailand.
Sleeping on the streets and often drifting from one location to another to avoid the police, addicts usually scavenge for cans and plastic bottles to sell.
But several interviewed for the survey said that when they are feeling lazy, they just loiter outside a hospital, waiting to be called in to sell blood.
For roughly 0.74 pints of blood, addicts said they earned $4.80 from a broker, who pocketed $9.60 out of the total $14.50 paid by a buyer.
David Harding, of the nonprofit group Mith Samlanh that works with homeless youths, said he would be "amazed" if HIV-positive addicts were not among those selling their blood.
Of the 400 injecting drug users his group has worked with, Harding said 40 took voluntary HIV tests last year, and just under one-third of them tested HIV-positive.
He said blood selling by addicts could quickly reverse the gains Cambodia has made in fighting HIV.
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