Voice of America - September 4, 2007
Rory Byrne
Phnom Penh

Like many small, poor countries in Asia and Africa, Cambodia faces a challenge from HIV - the virus that causes AIDS. By all measures, Cambodia should be devastated by AIDS. Brothels are commonplace, illegal drugs are widely available and Cambodia's health-care system is so poor the government can only spend about two dollars a person a year. Yet despite these problems, the rate of new infections has dropped steadily. VOA's Rory Byrne has more from Phnom Penh.

Reth is a tuk-tuk taxi driver in Phnom Penh. He was diagnosed as HIV positive in 1997.

He nearly died from an AIDS-related illness about five years ago before free drug therapy became available.

Today, about 80 percent of all HIV-positive people in Cambodia receive free life-saving anti-retroviral drugs. International aid groups largely pay for the medications. U.N. officials say Cambodia spends about $49 million in public and private funds to combat the virus. "Now I make power enough, that I can do a job, anything, it's no problem now," says Reth.

The number of AIDS cases here has fallen in the last decade from 3.2 percent of the population to 0.9 percent today. Credit is given to condom distribution programs and education on how to prevent transmission of the virus.

The United Nations AIDS co-ordinator in Cambodia, Tony Lisle, says the government has done a good job. "I think the main reasons behind this remarkable success is the enormous commitment of government. I think very strong partnerships between government and civil society, NGOs, and other partners to ensure that we had a very, very comprehensive program that addressed the high points of the epidemic, the epicenter of the epidemic, which is basically sex workers and their clients."

Cambodia is poor and is recovering from decades of conflict. Thousands of women see no choice but to become sex workers.

Health workers, like Dr. Sophal Kaing, teach safe-sex practices in brothels. "We prevent HIV from (by) using 100 percent condom use. It means she use the condom to (with) every client, even her sweetheart."

One Cambodian prostitute says, "We have to beg the customer, we have to talk to him. And if he still does not agree to use a condom, I will refuse to have sex with him."

Despite the progress, experts warn there remains a chance the infection rate could still rise, particularly among gay men, injecting drug users and so-called indirect sex-workers -- women working in bars and clubs.

Tony Lisle from UNAIDS adds, "I think the biggest challenge for all the partners who are at the front line of the response is to really ensure that we address indirect sex work (ers) and their clients because behavioral trends are changing, people are moving to sweethearts and indirect sex work so that's what we really need to keep our accelerator on."

Despite these dangers, experts say the lesson from Cambodia is that if the political will is there, the disease can be contained, even in the poorest nations.

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