HIV

Hi all

Just a quick post, i wanted to share with you my experiences from Monday.
We went out on a trip to some villages in Kampong Speu province to do some home visits with HIV patients who had stopped receiving food from WFP because we had run out. We hope to start again in April.

Cambodia has one of the highest infection rates in Asia, currently I think at 2.6%. Current thinking (although it is disputed) is that in Asia the trend has been that HIV enters first the injecting drug user communities through sharing needles and then into the sex worker community (injecting drug users and sex workers can be one and the same of course). Then men visit sex workers, contract HIV and take it home and infect their wife. So when 1% of pregnant women start testing postive for HIV, the epidemic can be referred to as generalised, that is spread out of specific cliques and into the mainstream population. At that same time the HIV prevalence in the sub groups (sex workers, truckers, drug users) can be massive. [Yes sociologists castigate me for using concrete definitions of sub groups when we know they are porous].

So once it reaches generalised it pretty much means that the HIV rate can climb dramatically if something isnt done. Luckily, Cambodia took the initiative with public information campaigns and providing condoms and is starting to wind it back. But what is amazing is that HIV is prevalent even in far flung villages.

The village we went to had about ten people living with HIV/AIDS (PLWHA). WFP provides a monthly ration of rice, fortified salt and fortified oil to improve their nutrition. Improved nutrition means a better response to the anti-retorvirals and less susceptibility to seconday infections (people don't die from AIDS, they die from secondary infections that AIDS has made them susceptible to).

It was quite striking meeting these people, everyday mothers, woman and children that were infected by their male partners and fathers. With AusAID I had met with groups of positive injecting drug users in Nepal but this was different where there was no ''choice'' (inverted commas because I know that the drug users didnt want to catch HIV and were in extremely vulnerable positions, but these women didnt stick a needle in their arm).

Particularly striking was a seven year old girl we met that was born with HIV (either through blood at birth or breatfeeding after birth). You could see that she was being treated for skin infections (lesions that sometimes manifest on immnosuppressed people). We also met with several households of orphans and other vulnerable children whose parent/s had passes away due to AIDS.

Luckily most of these households were continuing to receive support from Home Based Care NGOs (a local NGO called WOSO in this case). They were having to work harder and their health was suffering but they werent starving. We hope we can resume HIV rations in April because for them, poor nutrition has the most immediate consequences.

I will try and post a happier one later :)