The first case of HIV was detected in Cambodia in 1991, after which prevalence increased steadily to a high of 2.4% in 1998. A timely and appropriately targeted national response led to a decline in prevalence to 0.8% in 2010. Projections show that HIV prevalence is expected to decline further to 0.6% after 2010. Although Cambodia is one of the poorest countries in the world, the extraordinary HIV prevention and control efforts implemented by the Royal Government of Cambodia and its partners have helped to reduce the spread of HIV.
The majority of new HIV infections in Cambodia are contracted through heterosexual transmission, largely in the sex trade and entertainment industry. Women constitute a growing proportion of people living with HIV, and now represent more than half of the people living with HIV nationwide. It is estimated that half of new infections are in married women, with one third in infants as a result of mother-to-child transmission.
Significantly however, a low prevalence rate in the general population masks far higher prevalence rates in certain populations, for example in women engaged in entertainment work in venues such as karaoke bars, massage centres, and beer gardens. Men who have sex with men and people who use drugs are also highly vulnerable, marginalised and disproportionately affected by HIV in Cambodia. Currently, the highest proportions of new infections are among married women (43%) and through mother to child transmission (30%).
Cambodia started providing antiretroviral therapy at Government health services in 2003, and now an estimated 90% of those in need are receiving it (UNAIDS 2009). Broader access to ART is significantly improving the health and survival of people living with HIV, but agencies involved in the response to HIV also need to recognise and address their more complex needs beyond health in terms of livelihoods, food security, social integration and education. For children orphaned or made vulnerable by HIV and AIDS, there are particular challenges in providing holistic support and protection.