poipet town – Chao Chuon’s 10-year-old twin sons chased each other around the 14 beds in Poipet’s small AIDS clinic last week, eight of which were occupied by emaciated bodies linked to intravenous drips.
The stark white room behind the public health center had been the boys’ playground for a week, since tests confirmed that Chao Chuon, 44, and her husband Suon Sopheap, 45, were both HIV-positive.
Since then, the dream of a better life that brought the couple and their five children to this border town from Koh Kong province two years ago has crumbled.
Too ill to work, Suon Sopheap lost his construction job and Chao Chuon stopped carrying sweet pork across the Thai border to sell in Aranyaprathet town. Her 13- and 15-year-old sons from a previous marriage have left school to search through the trash piles punctuating Poipet’s rocky, dusty roads.
“I do nothing now,” Chao Chuon said. “I stay at the hospital. My children are scavengers now and sell garbage to support me and my husband.”
With a large population of transient workers and an abundance of drugs and brothels to comfort those far from home, Poipet has long been seen as an epicenter of the AIDS epidemic.
On one front, the fight against AIDS here has been successful. Infection rates are reaching a plateau among groups traditionally at high risk from the disease, such as sex workers, police officers and the military.
Although new infections among those groups have stabilized,
the prevalence of HIV/AIDS—
meaning the number of people that actually have the disease—is rising. And it is families like Chao Chuon and Suon Sopheap’s that are bearing the brunt of the epidemic’s new wave.
“The mode of transmission has moved from high risk groups to the general population—from husband to spouse,” said Dr Mean Chhi Vun, director of the National Center for HIV/AIDS, Dermatology and STI.
For many of Poipet’s workers, sex for cash is a fact of life.
“They go away from [their] wife. This is a normal, natural need. They have sex,” Mean Chhi Vun said.
In 2002, the most recent year for which figures from the Ministry of Health are available, 37.4 percent of sex workers in Banteay Meanchey province were HIV positive, provincial health director Dr Chhum Vannarith said, compared to 32.6 percent of sex workers nationwide.
Since the ministry’s 100 percent condom use campaign was launched in 1998, up to 95 percent of brothel patrons report using condoms on their visits, Mean Chhi Vun said.
Other countries with high HIV rates have faced the transition in the epidemic from small groups to the general population. Those that have not adjusted their outreach efforts have seen an “explosion” in infection rates, said Lea Spring Dooley, a field support specialist with the NGO CARE Cambodia’s health program.
“We need to look at this as something that is impacting the country, not just pockets,” she said.
At the Poipet health center, which opened a Voluntary Confidential Counseling and Testing center in May 2003 with the sponsorship of the US Centers for Disease Control, housewives far outnumber sex workers among women who seek testing, laboratory section chief Suon Sophal said.
One year ago, up to 60 percent of the 50 to 60 HIV tests given each month came back positive, Suon Sophal said Wednesday. Today, 160 to 170 people seek tests each month and only 10 to 20 percent test positive.
Pregnant women who come to the center for pre-natal care are also encouraged to get tested, he said. More than 100 expecting mothers have been tested this month alone, and infection rates among that group has remained steady at about 2 to 3 percent.
Suon Sopheap believes that he contracted HIV from his first wife, who he divorced before marrying Chao Chuon two years ago. He swore he never paid for sex, and Chao Chuon said that she believes him.
“Maybe I will leave the hospital next week, but I’m not sure,” she said, as her children lay beside her. “I’m waiting for my husband and my health to get better.”
