PHNOM PENH – Nearly half of new HIV cases have been among 15-24 year olds, despite good progress after decades reducing infections, especially among those most at risk.  

This raises concern among advocates, who are calling for proactive solutions from authorities and full participation from the young people.

Since the mid-1990, Cambodia has tried to achieve the UNAIDS target of 95-95-95, meaning 95 percent of people affected by HIV knowing their status; 95 percent of people living with HIV (PLHIV) being treated; and that 95 percent of the treated PLHIV have suppressed viral load, achieving the U=U status (meaning that the virus cannot be transmitted as it is undetectable).

The latest data from the National AIDS Authorities (NAA) shows infections fell to 1,200 in 2024, down 45 percent from the 2010 figure and 90 percent from that in 1990.

Transmission from mothers to babies was reduced to only 6.9 percent as 97 percent of pregnant women received prevention treatment in a timely manner.

The country has achieved a 92-100-98 target but is struggling to reach to people who are not aware of their status or are hiding their condition. Cambodia was at 89-98-98 in 2023.

Resolving a new challenge

NAA chairman Eang Moly said achieving the first 95 goal is not difficult for Cambodia, but the challenge is to reduce AIDS to fewer than 200 cases by 2028.

This is partly due to about 44 percent of cases in 2024 being among the young people aged 15-24 while a majority of cases were among men who have sex with men (MSM).  

Young people are another concern for the stakeholders, along with MSM, transgender people, those working in entertainment, and those injecting drugs.   

To lower infections further, Cambodia plans to issue the injectable pre-exposure prophylaxis (PrEP), starting with people with multiple sexual partners. However, HIV advocates suggested the authority consider their identity confidentiality and reaching out to a wider population through peer-to-peer approach.  

The number of infections among young people was largely due to a decrease in their basic knowledge about HIV/AIDS, NAA said.

The report on “Sexual and Reproductive Health of Adolescents and Youth in Cambodia” in 2016 shows that HIV is one of the sexual and reproductive health concerns among young people due to the lack of sexual and reproductive health information and knowledge, youth friendly services, poor education attainment, and disadvantages of rural youngsters who moved to urban areas for work.

Information about the sexual and reproductive health of adolescents and youth was limited, while the available resources were generally related to subpopulations, the report says.   

Normalize Sexual Health Conversations, Advocate Says

HIV advocates and NAA say talking about sexual health in daily conversation is a problem among the young population, prompting all stakeholders to put more effort into catching their attention, especially through social media.

Patricia Ongpin, country director of UNAIDS in Cambodia, Laos, and Malaysia, said Cambodia has made good progress in this area as the country is focusing more on young people’s knowledge and attitudes.

“A key strength of Cambodia’s approach lies in its use of differentiated interventions, particularly through digital platforms in addition to physical outreach,” she said.  

Often, the young can get information and engage in services of HIV prevention, testing and treatment through these platforms, which are additional approaches to reinforce the knowledge on the existing education in the curriculum for young people at an appropriate age.

Last month, the NAA promised to provide $100,000 to UNAIDS Cambodia to continue its work for a year.

UNAIDS has promoted youth-friendly services, HIV awareness through in-person and digital platforms to engage and inform them of available HIV services, and improve access to essential tools.

Through the UN Joint Team on HIV, the UNAIDS also implements Comprehensive Sexuality Education into schools. She said, “this equips students with accurate, age-appropriate information on HIV prevention and sexual health, empowering them to make informed decisions.”

When lack of information challenges and sexual health topics are not normalized, Seum Sophal, HIV advocate of the Health Action Coordinating Committee, said the country should integrate lessons on healthy sexual relationships for students entering secondary education.   

Sophal suggested the country learn from other countries, where youth advisory groups are established to influence aligning the policy direction, ensuring their voices and contribution to the outcomes.  

“Cambodia could institutionalize such bodies at various levels of governance, or use the current existing structure like FoNPAMs and DFoNPAMs to support the role of HIV intervention in the long-term,” Sophal said.

A study suggested by Sophal, entitled “HIV Knowledge and Attitudes Among Cambodian Adolescents” which was issued in 2020, finds that young people’s knowledge and attitude to HIV are of particular interest because they involve sexual experimentation and may relate to high-risk sexual behaviors, and they will be less likely to engage in those if they know about HIV.

Involving 463 high school students, findings showed that most had low knowledge of HIV, particularly in transmission, prevention, symptoms and testing. It suggested education on HIV in schools.

Citing the Cambodia Demographic and Health Survey in 2021–2022, Sophal said only about 23% of 15 to 24 year old had comprehensive knowledge of HIV/AIDS, which was down from 38% in 2014 and 44% in 2010 when the disease was still a hot public health topic.  

Despite reducing infections and educating people at the same time, stakeholders and the public still have not normalized conversations related to HIV or sexual relationships.

To normalize open conversation on HIV and sexual relationships, Sophal wanted the stakeholders to highlight education on HIV treatment and the U=U campaign.

“This will increase the understanding of treatment effectiveness and the U=U message, which has the potential to reduce fear and stigma,” Sophal said.

The advocate called for caution when promoting those messages through media campaigns, as some could portray them incorrectly.

Otherwise, the messages might cause “negative stereotypes, or focus solely on risk groups, rather than normalizing it as a public health condition,” Sophal said.