Battle Against HIV Now Fought on Streets

On a hot, sunny morning last week, Kong Sothea Korn was surrounded by about 30 street children in a squatter village near the Phnom Penh railway station.

He was asking them questions, trying to figure out what the kids know about AIDS and how they can protect themselves.

The short answer was, they didn’t know much.

His colleague, Heng Chan Heng, said this wasn’t even the toughest crowd to reach.

Some­times, he said, “I have to deal with brothel gangsters, and it takes a very long time to get permission to talk to the prostitutes.”

The job they are doing is one of the most important in Cam­bodia today. They are peer educators, hitting the streets every day to give the poorest Cambo­dians health information that could save their lives.

What was different about this day was about a dozen journalists, from Phnom Penh as well as Europe, Asia and Australia, who watched intently and scribbled notes as the peer educators talked to the people.

The foreign journalists were in Cambodia as part of a tour  sponsored by the European Com­mission/UN Population Fund’s Reproductive Health Initiative for Asia.

And they got an earful on exactly why AIDS is so hard to fight.

“My friends say I am too traditional and a coward,” said Ouk Sophoan, 20. Why? Because he is a virgin. His friends sleep with fellow students and with prostitutes, he said, “and they use a condom only when they know a girl has a lot of partners.”

“We are housewives, and we don’t trust our husbands much,” said Si Sokunthea, a 36-year-old mother of four. Studies show that the housewives are right: many Cambodian men visit prostitutes, about 40 percent of whom are infected with AIDS.

And even when prostitutes know about AIDS and try to get clients to use condoms, their customers are often drunk and refuse.

It all adds up to bleak projections for Cambodia. With a population growth rate of 2.3 percent and a fertility rate of 4.6 percent, Cambodia’s population is expected to rise from 11.2 million now to 16.5 million by 2025.

About 43 percent of the population is currently under 18, ac­cording to UNFPA. Studies indicate that while premarital sex is “much more frequent than so far assumed,” those under 20 know even less about sexually transmitted diseases or birth control than other age groups.

Fully 80 percent of them, for example, think there is no way they can contract AIDS.

So UNFPA and the EC have joined forces in a reproductive health initiative, which will spend $25 million on 42 projects in seven Asian nations.

Young people are a special focus in four countries: Cam­bodia, Laos, Sri Lanka and Viet­­nam.

A 1999 study found that 90 percent of the then-180,000 AIDS victims in Cambodia were between 15 and 35 years old. (The estimated number of AIDS victims today is about 200,000).

Project officer Sarah Knibbs said RHI’s projects in Cambodia “give young people information and services to help them avoid reproductive health problems like HIV/AIDS, sexually transmitted diseases and unwanted sexual activity.”

Traditional Cambodian culture is sexually conservative. Young people—particularly young women—are not supposed to have sex before marriage. That makes it nearly impossible for sexually active adolescents to talk to their parents—or even health care professionals—about sex.

Add to that the social disruption of the war years, and “the social structure of Cambodian society has crumbled, leaving adolescents in poverty vulnerable to negative influences,” says a report prepared by tour organizers.

But at least some of them are getting the word. Twenty-year-old Reurn Sarun, visiting Phnom Penh from his home in Kom­pong Chhnang province, said he once worried he might contract AIDS from getting a haircut.

Now, he said, “I suggest that men use condoms.”




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