Providing harm reduction on the streets of Phnom Penh
At the moment there are only three NGOs providing harm reduction services in Phnom Penh, Cambodia, and only two of them have a NSP license to do syringe exchange – KHANA is one of them.26 Feb 2014
By Ivan Varentsov.
I would like to start by giving a general picture of HIV situation in the country as well as access to treatment and HR services.
The population of Cambodia is just over 15 mln. The estimated prevalence of HIV among the adult general population is 0.7% (UNAIDS, 2012). Estimated number of PLHIV is 76 000 (UNAIDS, 2012). 46 134 of them are on ART (2013, NCHADS). ARV-treatment is available for free and is accessible for those needed (even provided on a base of some licensed NGOs). Most-at-risk populations (MARPS) are entertainment workers (EW), drug users (IDU/DUs) and men who have sex with men (MSM).
The estimated number of people who use drugs in Cambodia is between 13 000 and 28 000. 10% of them are injection drug users (IDUs). Almost all of IDUs (1 085) live in PP. HIV prevalence among IDUs is high – 24,8 % (IDU size estimated study in Cambodia 2012 done by NCHADS, NACD, KHANA).
The most popular drug is methamphetamine. Heroin is used almost only by those IDUs living in PP (it is not affordable in regions) and also they often mix it with valium.
HR projects in Cambodia were started by non-governmental organizations (NGOs) in 2004 but NSP guidelines on HIV prevention among IDUs were issued only in 2006. At the moment there are only three NGOs providing HR services in PP and only two of them have a NSP license to do syringe exchange – KHANA is one of them.
The first and only methadone clinic in Cambodia was opened in Phnom Penh in July 2010. By the end of 2013 there were 136 people on methadone treatment (118 of them were Khana’s clients including 22 females).
According to estimates about 80% of all IDUs are HCV positive (56% among methadone patients).
There is no local Harm Reduction Network in Cambodia but there is an MSM network, PLHIV network (CPN+), network of NGOs working in HIV prevention and few others. But there is a peer support group of IDUs under KHANA program existing in PP and maybe when it becomes stronger it could give grounding for a HR network.