Cambodia, with WHO's Support, Expands 100% Condom-Use Programme
This year, the Government of Cambodia will expand the 100% condom-use programme among sex workers and their clients nationwide to control the spread of HIV and other sexually transmitted diseases. This is a result of the successful implementation of the 100% condom-use programme in the sex establishments in Sihanoukville, test site of the project. As the next step, plans are underway to introduce the programme in Battambang and the military prior to its implementation nationwide this year.
Three percent of the adult population in Cambodia is infected with HIV. Results from many studies and surveys indicate that HIV is already widespread in the general population. The main mode of transmission is sexual activities among commercial sex workers and their clients, who in turn spread the virus to their wives and newborns.
In October 1998, the Ministry of Health, with the technical support of the World Health Organization (WHO), implemented a 100% condom-use programme in the sex industry in Sihanoukville in an effort to control the spread of the AIDS virus and other sexually transmitted diseases. Sihanoukville was identified as the most appropriate site to initiate the 100% condom-use programme because of the high prevalence of HIV infection and the good cooperation from the local authorities. Activities included the development and distribution of the provincial regulation on 100% condom-use, meetings with the authorities (policymakers, district governor and officers, police), owners of sex establishments, and sex workers.
A team from the Cambodian Ministry of Health and WHO visited Sihanoukville to evaluate the on-going100% condom-use programme yesterday. Preliminary data from the programme in Sihanoukville indicate an increase in the percentage of condom use among sex workers interviewed. The team reviewed the progress of programme implementation and identified areas where improvements could be made.
The 100% condom-use programme was inspired by the successful experience in Thailand which sought to empower commercial sex workers by enabling them to refuse sex without condoms, resulting in a slow-down in HIV transmission. In Thailand, condom-use in sex establishments increased from 15% in January 1989 to more than 90% in June 1992. This resulted to a decrease in the incidence of common sexually transmitted diseases from 6.5 per 1000 population in 1989 to 0.49 in 1996. It is estimated that Thailand's 100% condom use programme has prevented more than two million HIV infections from occurring.
The Cambodian project, funded by UNDP, is being monitored actively by the provincial monitoring team. Supporting the project are WHO and other programmes such as the sexually transmitted disease (STD) service project of the European Union and the condom social marketing project of Population Services International based in Phnom Penh.
Expressing all-out support for the programme, Dr Mam Bun Heng, Secretary of State of Health, said the Government of Cambodia is committed to controlling the spread of HIV and other sexually transmitted diseases. "The Government of Cambodia is fully committed to taking action to control HIV and other sexually transmitted diseases. The 100% condom-use programme in Sihanoukville seems to be working well. Many sex establishments are actively participating and there has been a rise in the distribution and use of condoms. We are pleased with these results, and have made plans to implement the programme in Battambang and the military. This year, we would like to extend the programme nationwide".
The Government of Cambodia and Sihanoukville authorities were strongly praised by the WHO team for initiating and managing the 100% condom-use programme. The WHO team, which visited Sihanoukville, noted that the investigation so far have shown that this programme can reduce STD in sex workers and can therefore help reduce HIV transmission in the province. Together with UNDP and other partners, WHO will continue its support to expand the project. The WHO team expressed hope that Cambodia's initiative will serve as a model for other countries in the Region.
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