Cambodia Must Focus on MSM Population to Combat Spread of HIV, UNAIDS Official Says

Cambodia must focus on its "hidden" population of men who have sex with men, including those who also have sex with women, to combat the spread of HIV in the country, UNAIDS Cambodian coordinator Tony Lisle said recently, IRIN/Reuters AlertNet reports. Although Cambodia has made significant gains in the fight against the disease, it still has an HIV/AIDS prevalence of 1.6%, the highest in the region, according to UNAIDS estimates. A study conducted by Family Health International in 2004 among 1,306 MSM in the country found that there were four times as many "masculine acting" MSM -- who are locally called "short-haired" MSM and have sex with one another -- than transgender MSM -- who are called "long-haired" MSM and have sexual partners from both groups. In addition, a recent survey conducted by the Cambodian National Centre for HIV/AIDS Dermatology and STDs in three provinces -- Phnom Penh, Batdambang and Siem Riep -- found that 58% of MSM surveyed reported having sex with female partners in the previous year. Of the 58% of MSM who reported having sex with a female partner, almost 25% said they had sex with a female commercial sex worker, and 16.6% said they had sex with casual female partners in the previous month. A recent report conducted by Therapeutics Research, Education and AIDS Training found that "short-haired" MSM are more likely to receive money for sex -- 20% regularly and 41% occasionally. The report also found that misconceptions persist among MSM concerning HIV transmission and that male sex workers often are unable to negotiate condom use and generally do not use lubricant. According to UNAIDS, fewer than one in 20 MSM in Cambodia have access to HIV prevention and care services. Although the government has begun to acknowledge MSM in its HIV prevention programs, nongovernmental organizations and community-based organizations have only begun recently implementing programs to reach the population, according to government researchers. "When you have a very dense network, and when you have crossovers in the network between males and females, in the presence of high risk of [sexually transmitted infections] and in the presence of low condom usage, then you have a potential for an explosive epidemic," Lisle said. Sear Young Tan of the National MSM Network -- which aims to eliminate stigma and discrimination against MSM and promote equal access to HIV information and services -- said educating "short-haired" MSM must be an integral part of the country's HIV prevention efforts (IRIN/Reuters AlertNet, 1/30).

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