The HIV/AIDS epidemic in Cambodia is often described as having reached a mature stage. The rapid infection of the most at risk populations, and the initial surge in HIV prevalence, has peaked. However, high prevalence pockets remain among sex workers and their clients. One-third of new infections occur from mothers to children and half of current infections are now among married women. Condom negotiation within marriage is rare and men often have multiple sexual partners. High poverty rates in Cambodia’s mostly rural population also have an influence on HIV/AIDS, as men leave their families temporarily for work in high transmission areas.
The annual number of deaths among people living with HIV/AIDS (PLHIV) now exceeds the annual number of newly infected individuals. Despite this stabilization, there are an estimated 123,100 PLHIV in Cambodia – 22,000 who are expected to develop serious AIDS-related illnesses – and more than 77,000 children under 15 who have been orphaned by AIDS. Fifty Cambodians die each day due to the consequences and complications of AIDS. As a result, some at risk families further regress into poverty.
PLHIV face multiple challenges such as stigma and discrimination, lack of adequate income and poor living conditions. Over 6,000 people have started anti-retroviral treatment (ART) and require assistance to sustain their treatment and to re-enter the workforce. The children of PLHIV, including children whose parents and family members are HIV+ but who are themselves not HIV+, suffer many of the same vulnerabilities as do their families. Orphaned and vulnerable children (OVC) often have few opportunities for education, lose inheritances to which they are entitled, and, in many situations, are simply abandoned.
Goals
To achieve the project's objectives, Pact places PLHIV at the center of all activities in its implementation through and with NGO partners. Pact's work with PLHIV and OVC includes:
Partnerships with six local NGO partners, eight Provincial Cambodian People Living with HIV/AIDS Networks (P-CPN+) and a trained cadre of PLHIV to organize community-based forums that target the reduction of HIV/AIDS stigma and discrimination.
The Appreciative Participatory Approach (APA) to guide PLHIV at-risk families to develop and prepare plans for the future of their children.
Living wills developed by PLHIV that are filed with local government to secure the inheritance rights of their children.
Children Support Committees and Community Volunteer Networks of PLHIV that monitor the implementation of PLHIV plans for their children and manage donations from collection boxes in Buddhist temples and public places for the benefits of OVCs.
Capacity building and institutional support for sustainable organizational development.
IEC/BCC materials related to care and support for PLHIV and their caregivers.
Objectives
With funding support from Pfizer Foundation since November 2002 and USAID, Pact Cambodia's HIV/AIDS Program address the above issues through the followings objectives:
Increase participation and involvement of PLHIV in project design and implementation
Empower PLHIV to advocate for their rights and gain support from their communities in reducing HIV/AIDS stigma and discrimination
Increase community support to decrease social vulnerabilities and increase coping mechanisms for orphans and vulnerable children affected and infected by HIV/AIDS
Improve the livelihood of people affected and infected by HIV/AIDS through micro-enterprises
Support and strengthen the institutional capacity of the project's partners
Achievements to Date
PLHIV Project:
1- Organizational Development and Capacity Building
Pact has worked over several years to build the institutional capacity of its NGO partners and PLHIV on strategic planning, proposal writing, report writing, organizational assessment, personnel and administrative management, financial management, IEC materials development skills, development of independent governance structures, communication and facilitation skills, Advocacy and Negotiation Skills and Inheritance Rights and Children's Future Plan. The organizational development and capacitybuilding enables NGO partners to better address the need of their target groups in term of reduction of HIV/AIDS stigma and discrimination, decrease social vulnerabilities of OVC and promote better care and support for PLHIV and the reduction of HIV/AIDS epidemic in Cambodia.
2-Community Forums With technical assistance from Pact and in collaboration with local authorities, PLHIV organized and facilitated 39 Community Forums with more than 9,750 individuals in the eight provinces of Siem Reap, Kampong Thom, Battambang, Pursat, Sihanouk Ville, Takeo, Kampong Cham and Kandal.
The Community Forums focused on awareness raising and generating community responses to reduce HIV/AIDS stigma and discrimination. Participants at the Community Forums included home care providers, local authorities, PLHIV, monks, community members and health center staff. The forums provided an opportunity for community members to discuss attitudes and behavior reflective of stigma and discrimination against PLHIV, develop an awareness of the HIV/AIDS law and listen to PLHIV share their experiences. The forums served as a catalyst for commitments by local communities to reduce stigma and discrimination that are monitored and supported by a small group of local citizens and PLHIV.
3-IEC Materials Development by and for PLHIV and their Caregivers
In collaboration with the CPN+ and the HACC, Pact facilitated the development of the IEC/BCC materials designed by and for People Living with HIV (PLHIV) in Cambodia. More than 417,435 copies of the seven booklets, one 2004 calendar and two posters have been published and 372,253 distributed that addressing issues of self care/home-care, antiretroviral (ARVs) and opportunistic infections (OIs) treatment, the rights of PLHAs, planning for children future and stigma and discrimination.
Orphan and Vulnerable Children (OVC)
4- Inheritance Document
Pact's OVC program is unique to the Cambodia context in that it assist poor PLHIV families to establish living wills that ensure inheritance rights for their children. The OVC planning also integrates children affected and infected by HIV/AIDS into the community and the local school. Pact's OVC program is implemented through sub-grants to six local NGOs in five provinces in southern Cambodia. More over 345 PLHIV families now have plans for the future of their children and over 300 inheritance documents have been prepared and filed with the appropriate authorities.
Implementing NGOs Partners
Cambodian People Living with HIV/AIDS Network (CPN+)
Kondal CPN+ (KDCPN+)
Kompong Cham CPN+ (KCMCPN+)
Takeo CPN+ (TKCPN+)
Battambong CPN+ (BTBCPN+)
Siem Reap CPN+ (SRCPN+)
Kompong Thom CPN+ (KTMCPN+)
Porsat CPN+ (PSCPN+)
Sihanouk Ville CPN+ (SHVCPN+)
Women Organization for Modern Economy and Nursing (WOMEN)
Cambodian Development and Relief Center for the Poor (CDRCP)
Association of Farmer Development (AFD)
Rural Economic Development Association (REDA)
Khmer Women's Cooperation for Development (KWCD)
Phnom Srey Association for Development (PSAD)
Address: Phnom Penh Centre Building A 3rd
floor, Cnr. Sihanouk & Sothearos Blvd or PO Box 149,
Phnom Penh, Cambodia Phone: (855)-23-217-855 Fax: (855)-23-217-856 Email: pact@pactcambodia.orgGlobal site: www.pactworld.org
