Official Press Release Day 2
Cambodia, Young People living with HIV and Legal Landscape Focus of Monday Plenary
Monday, 1 July 2013 (Kuala Lumpur, Malaysia)–With the estimated number of annual new HIV infections in Cambodia plummeting from 20,000 in the early 1990s to around 1,300 in 2012, a new initiative called Cambodia 3.0 is being implemented to achieve the elimination of new HIV infections in the country by 2020.
Mean Chhi Vun, Director of the National Center for HIV, Dermatology and STI and Advisor to the Ministry of Health, referred to the initiative in his opening plenary remarks in the first plenary session of the 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) taking place in Kuala Lumpur, Malaysia, June 30-July 3. Some 4,700 AIDS researchers, scientists, clinicians, community leaders, programme implementers and other participants have gathered for the event, the largest open scientific AIDS conference in the world.
“The South East Asian region and beyond can learn hugely important lessons from the Cambodian success story in dramatically turning around the HIV/AIDS epidemic,” said Françoise Barré-Sinoussi, IAS 2013 International Chair and International AIDS Society
President. “Cambodia is, in many senses, a proof of concept on how to effectively implement science on the ground in order to scale up treatment and prevention in a very poor country.”
“South East Asia has the body of evidence before it in terms of preventing and treating the HIV/AIDS epidemic,” said IAS 2013 Local Co-Chair Adeeba Kamarulzaman, Director of the Centre of Excellence for Research in AIDS (CERiA) and Dean of the Faculty of Medicine at University of Malaya in Kuala Lumpur.
“Malaysia has paved the way in harm reduction, Thailand has paved the way in safe sex, and Cambodia has managed to combine the two in addition to set in place systems that effectively channeled funding into the effective, on-the-ground rollout of antiretroviral therapy.”
Achieving Universal Access and Moving towards Elimination of New HIV Infections in Cambodia
In his opening plenary remarks, Mean Chhi Vun (Cambodia), Director of the National Center for HIV, Dermatology and STI and Advisor to the Ministry of Health, reviewed Cambodia’s response to HIV over the past two decades and the way towards elimination of new HIV infections in Cambodia. In the mid-1990s, Cambodia faced one Asia’s fastest growing HIV epidemics, fuelled by unprotected sex work, but within five years became one of the few countries to have reversed its trend.
From 1998 to 2001, early interventions focused on HIV and STI prevention in sex work settings began to slow transmission, and HIV prevalence among direct brothel-based sex workers decreased from 42% in 1996 to 14% by 2006. Rapid scale-up of HIV counseling, testing, care and treatment took place from 2001 to 2011. The expansion of the HIV Continuum of Care established community linkages to encourage HIV testing and counseling and early care and treatment at district-level hospitals. These efforts resulted in a decline of HIV prevalence from an estimated 1.7% in 1998 to a projected 0.7% in 2011, while the estimated number of annual new HIV infections plummeted from 20,000 in the early 1990s to around 1,300 in 2012. Building on the progress to date, a new initiative, “Cambodia 3.0”, aims to achieve the elimination of new HIV infections by 2020.
Teens to Grown-ups: Falling through the Cracks, Lost in the Crowd or Thriving Adult?
Linda-Gail Bekker (South Africa), Deputy Director of the Desmond Tutu HIV Centre and Associate Professor of Medicine, University of Cape Town, discussed the challenges facing young people living with HIV as they transition from complete dependence on care givers and paediatric health services to adult HIV care systems that emphasize self-reliance and individual accountability for adherence. With adult services perceived as intimidating and impersonal, there are reports of failed transition with consequences of poor adherence, treatment failure and loss to follow up.
This transition has been well described for other diseases, but HIV is unique as a chronic illness because of related stigma, the relationship to poverty, the fact that multiple members of one family may be living with or have died from HIV, and the association with sexual, intravenous and maternal transmission. While some resources are available and models of transition proposed, most have been in resourced environments, and there is little recognition of the need to transition adolescents to adult care in low- and middle-income settings. Consequently, very little published data is available and systems to track youth into adult care are inadequate and evaluation of this process and its limitations and successes are not being captured.
HIV, Law and Stigma
Rather than helping forward the goals set by the international community in slowing the spread of HIV, the current legal and regulatory terrain is actually working actively to undermine HIV prevention and treatment projects, according to Aziza Ahmed (United
States), Assistant Professor of Law, Northeastern University School of Law. Indeed, scientists, public health practitioners, and community members are often working in legal and policy environments that are structured to make good public health interventions fail, that stigmatize, and that marginalize the very populations programmes seek to aid.
Ahmed called upon delegates to not only produce knowledge about the HIV epidemic, but to accept the responsibility of creating a legal and policy landscape that enables the implementation of effective and high quality HIV care, treatment, and service programmes — a legal and policy environment that does not discriminate, that does not stigmatize, and does not marginalize the very people who need support and care.
The International AIDS Society (IAS) is the world’s leading independent association of HIV professionals, with over 16,000 members from more than 196 countries working at all levels of the global response to AIDS. The IAS members include researchers from all disciplines, clinicians, public health and community practitioners on the frontlines of the epidemic, as well as policy and programme planners.
The IAS is lead organizer of the IAS Conference on HIV Pathogenesis, Treatment and Prevention, which will be held in Kuala Lumpur, Malaysia, 30 June – 3 July 2013 and custodian of the biennial International AIDS Conference, which will be held in Melbourne, Australia, 20-25 July 2014.
The Centre of Excellence for Research in AIDS (CERiA) was established in 2007 to respond to the need to better understand the Malaysian HIV epidemic and to build local capacity in conducting HIV related research. Since its establishment it has become the
leading Centre in Malaysia conducting HIV related research in various fields including epidemiology, social behavioural, clinical and laboratory based research.
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