HIV rates among MSM stubbornly high: study

The HIV infection rate among the men who have sex with men (MSM) population has increased over the past six years, according to a new study, which estimates Cambodia’s total MSM population is 50 percent higher than previous counts.

Published late last month in the American Journal of Epidemiology and Infectious Disease, the study embarked upon the most comprehensive study of Cambodia’s MSM community to date, spanning 11 provinces and Phnom Penh. Its authors found that the infection rate has increased from 2.1 percent in 2010 to 2.3 percent today, nearly four times Cambodia’s overall prevalence rate of 0.6 percent.

UNAIDS country director Marie-Odile Emond acknowledged in emailed comments that the rate had gone up, but noted that infection rates among MSM communities in many other cities in the region are far higher. “While it remains too high and obviously we have not managed to bring it further down, this remains relatively low,” she wrote.

The study estimates Cambodia’s MSM population at 31,000, up from a 2008 estimate of 21,300. The study’s lead author Dr Siyan Yi attributed the jump to improved methodology, while Emond said that only 65 percent of those men were either reach- able or not at risk of infection.

Yi said more needed to be done to educate those 31,000 men on safe practices such as condom use – less than 70 percent of respondents to the study reported having always used a condom while having sex in the previous month.

UNAIDS’s Emond agreed that while prevention strategies have shown successes in Cambodia, efforts needed to be increased.

“Prevention has been a good investment and certainly paid off,” she wrote. “This clearly needs to be sustained . . . to reach MSM groups who may not be reached by messages or might relax their safe behaviour.”

Both Emond and Yi said that stigmatisation of MSM by health-care providers is an impediment to prevention strategies. “This can be a barrier to health care and HIV education,” Yi said.

Their comments were echoed by the founder of the human rights NGO CamASEAN, Srorn Srun, who has worked with MSM in all 25 provinces. He said yesterday that discrimination is rife among health-care providers.

“Health-care providers always ask, ‘How do you have sex with men?’ rather than trying to treat them,” Srun said. “They are destroying the privacy of MSM.”

Health Ministry officials did not respond to requests for comment.