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HIV-Related Risk Behaviors in Cambodia and Effects of Mobility

Sopheab, Heng MD, MPH*; Fylkesnes, Knut Dr Philos; Vun, Mean Chhi MD, MPH*; O'Farrell, Nigel MD, MRCP

JAIDS Journal of Acquired Immune Deficiency Syndromes: January 1st, 2006 - Volume 41 - Issue 1 - p 81-86
doi: 10.1097/01.qai.0000174654.25535.f7
Epidemiology and Social Science

Objectives: To study HIV risk behaviors in different population groups, linkages to bridge populations, and to examine factors affecting such behaviors and links.

Methods: Ten population groups in 4 provinces were surveyed. Stratified random cluster sampling was used, and interviews were conducted to provide information on sociodemographic characteristics, mobility, and risk behaviors. The groups surveyed were female sex workers (FSWs), household men and women, youths in vocational training, and men with high-mobility occupations (fishermen, mototaxi drivers, police, military, casino workers, and deminers). The total number surveyed was 3848.

Results: The proportion reporting sex in the past year with FSWs differed sharply between male groups ranging from 20% to 51% in the high-mobility groups and 5% to 10% in the other groups. Noncommercial sex varied less by group. Consistent condom protection (always used condoms in the past 3 months) with FSWs was high (>85% for most groups). However, condom use was significantly less with noncommercial partners, a high proportion of whom complained about a lack of condom availability. For the different male groups, travel away from home >1 month in the past year was a strong independent determinant of both sex with FSWs and noncommercial sex. Casual sex was more common in young unmarried men. Women in the general population did not report casual sex, but 41% of them were “worried about being infected by their husbands.”

Conclusions: The results suggest mobility is a strong determinant of casual sex. Although FSWs may still act as an important bridge for HIV transmission in Cambodia, noncommercial sex is becoming increasingly important due to the relatively low condom use in such relationships.

From the *National Center for HIV/AIDS, Dermatology and STDs, Ministry of Health, Cambodia; †Centre for International Health, University of Bergen, Norway; and ‡Ealing Hospital, London, and London School of Hygiene and Tropical Medicine, UK.

Received for publication January 2, 2005; accepted June 6, 2005.

Supported by the Asian Development Bank through the project JFPR 9006 Community Action for Preventing HIV/AIDS: Responding to HIV/AIDS in the Greater Mekong subregion.

Reprints: Heng Sopheab, National Center for HIV/AIDS, Dermatology and STDs, Ministry of Health, 170 Preah Sihanouk Blvd., Boeung Keng Korng I, Phnom Penh, Cambodia (e-mail: pmerunit@online.com.kh).

© 2006 Lippincott Williams & Wilkins, Inc.