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IAS 2013: A Global HIV Perspective, Spotlight on Cambodia

About 4,700 AIDS researchers, scientists, clinicians, community leaders, program implementers and others have gathered in Kuala Lumpur, Malaysia for the 7th International AIDS Society's Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013). This is the largest open scientific HIV conference in the world. As with any global conference, this one takes a big picture look at HIV across the globe.

The major themes are the a progress report on the benefits of earlier treatment, the major biomedical interventions for prevention (pre-exposure prophylaxis and treatment as prevention), HIV vaccine progress, and HIV diagnostic testing to identify infection earlier and continue to close the window of negativity during HIV seroconversion. Another important theme is a review of strategies to eliminate AIDS - the so-called "End of AIDS" or "Stop AIDS" movements. How realistic is this? Take a look:

The first plenary session of the conference proved to be an eye opener. Mean Chhi Vun, Director of the Cambodia National Center for HIV, Dermatology and STIs, and advisor to the Ministry of Health, presented the Cambodia 3.0 initiative. Cambodia 3.0 is being implemented to achieve the 3 ambitious goals of having no new HIV infections, no deaths and no HIV stigma in the country by 2020.

Through a partnership with the US-based William (Bill) Clinton Foundation, Cambodia has universal access to antiretroviral therapy. From 1998 to 2001, early interventions focused on HIV and STI prevention in sex work settings began to slow transmission, and HIV prevalence among 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. Cambodia's 2011 population = 14.3 million.

“Cambodia 3.0” builds on the progress to date, achieved in large part as the result of universal access and the Clinton partnership. Impressive results for a medium sized country where the average per capital income is about US$2000/ year.

Reference: Chhi Vun, M. Achieving Universal Access and Moving towards Elimination of New HIV Infections in Cambodia. Presented July 1, 2013 at IAS 2013 in Kuala Lumpur, Malaysia. Oral Abstract MOPL01.

Source: Reporting from Kuala Lumpur for the PRN News: Bill Valenti, MD