The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62138

Kannitha Kong, MD, RACHA, EngenderHealth, House #160, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia, 855 23 213724, kkannitha@racha.org.kh

As Cambodia’s HIV/AIDS epidemic progresses, infection rates among rural women has risen to two percent or higher. The key high-risk group in rural communities are migrant couples, i.e., husbands migrate to obtain temporary employment as an unskilled laborers. Many of these migrant men have sex with commercial sex workers. Low condom use results in their infection, bringing HIV/AIDS to rural communities when they return. Condom promotion among rural Cambodian couples is very problematic. Using condoms means a lack of trust, a powerful concept in intimate relationships in Cambodia. Even when a wife knows her husband is unfaithful, she “trusts” that he will use a condom. Husbands resist because it means he cannot be “trusted”, he acknowledges his unfaithfulness, or he does not “trust” his wife’s faithfulness. RACHA and the MoH initiated a risk assessment program targeting migrant couples. Outreach facilitators discuss high-risk behaviors, promote self-assessment of risk, demonstrate correct condom use, and encourage couples to discuss condom use. Both husband and wife are contacted. Key messages include condoms’ dual purpose, and protecting family security especially by husbands. Follow-up meetings reinforce messages. Couples using condoms serve as peer educators targeting other migrant couples. HIV+ villagers also discuss how they became infected. RACHA also organizes village shops to stock condoms. Results are encouraging, roughly 30 percent of couples accept condom use after initial contacts. The program taps an “unmet need”, i.e., couples are aware they might be at risk of infection, and the program helps them to realize this and take action.

Learning Objectives:

This session will enable participants to:
• identify individuals at high risk of HIV/AIDS infection in rural communities, and
• develop culturally appropriate interventions to enable rural people to assess their risk of infection and change behaviors.

Keywords: HIV/AIDS, Rural Communities

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.