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National AIDS Authority and United Nations jointly launch report on the Socioeconomic Impact of HIV at the Household Level in Cambodia

Friday, 26 August 2011

Kingdom of Cambodia

Nation-Religion-King

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National AIDS Authority

Press Release

National AIDS Authority and United Nations jointly launch report on the

Socioeconomic Impact of HIV at the Household Level in Cambodia

PHNOM PENH, Thursday 25 August 2011: The report on the Socioeconomic Impact of HIV at the Household Level in Cambodia will be officially launched at 8:00am tomorrow [Thursday 25 August 2011] at the Intercontinental Hotel in Phnom Penh, highlighting the economic and social challenges faced by HIV-affected households in Cambodia, while drawing attention to the need for HIV-sensitive national social protection mechanisms.

While Cambodia has made remarkable progress in halting and reversing the national HIV epidemic and scaling up access to antiretroviral therapy and treatment for opportunistic infections, the report found HIV continues to have a profound impact on Cambodian households.

“The study highlights the extreme vulnerability of HIV-affected households to economic shock,” United Nations Resident Coordinator Douglas Broderick said.

“Findings indicate HIV-affected households face decreased income, combined with increased medical expenses, which sees households turn to poverty-inducing coping mechanisms such as depletion of savings and assets and increased indebtedness, with negative impacts in relation to food security and psychosocial wellbeing, as well as on the status of women and the education of children.

“Such findings underscore the importance of scaling up HIV-sensitive social protection programs and ensuring poverty-reduction interventions reach the poorest and most vulnerable members of society.”

Based on data collected through a national survey of 4,172 households (2,623 HIV-affected and 1,549 non-affected), the report examines the individual and household-level impacts of HIV, as well as impacts on population and macroeconomic growth.

The report highlights a range of individual and household-level impacts including:

• Changed household structure: HIV-affected households were twice as likely to be headed by a widow (34% versus 17%). More than one third of HIV affected households cared for an child orphaned by AIDS.

• Decreased income for people living with HIV: 27% of respondents reported they lost their job (or other source of income) since being diagnosed with HIV. For those who kept their job, income levels were 47% lower than before diagnosis. In general, HIV-affected households earned 25% per capita less than non-affected households.

• Decreased income for caregivers: Over 25% of people living with HIV had a caregiver, and 18% of caregivers reported they left their jobs in order to assume caregiving duties. Those who retained their employment, saw a 50% reduction in income.

• Delayed diagnosis leading to depletion of savings and assets: 25% of PLHIV received their diagnosis after a prolonged illness. This increased out-of-pocket expenses as individuals (a) sought care before realising they were eligible for publically-funded HIV programs (b) were likely to require greater medical attention as they had not been accessing HIV treatment. Accordingly, more than 33% of HIV-affected households reported having sold assets or borrowed money prior to diagnosis. An additional 12% used savings to pay for care prior to diagnosis.

• Increased debt: 65% of HIV-affected households had at least one loan, compared with 53% of non-affected households. HIV-affected households were less likely to be in debt for constructive reasons such as improving their dwelling or investing in agricultural production. HIV-affected households were more likely to have sourced their loan from a moneylender (26% versus 21%) and to have paid higher interest rates (5.4% versus 4.3%).

• Food insecurity: 51% of HIV-affected households reported being hungry and not having enough food to eat in the previous year, compared to 35% of non-affected households.

• Increased child labour: Children in HIV-affected households were more likely to have a job than those in non-effected households. Twice as many girls in HIV-affected households worked as girls in non-affected households (10% versus 5%).

• Increased school absence and grade repetition: Enrolment levels among HIV-affected and non-affected households were statistically equal (86% and 85% respectively). However, HIV-households were more likely to state that children were not enrolled due to financial reasons (21% versus 15%). Children (aged 5-9 years) in HIV-affected households were more likely to have missed more than 10 days of school in the previous year than children in non-affected households (15% versus 8%). Girls in HIV-affected households were 30% more likely to have repeated a grade.

• Stigma and discrimination: 23% of women reported experiencing verbal abuse in the previous year as a result of their HIV status (compared with 16 % of men), while 7% reported experiencing physical threats or abuse as a result of their status (compared with 4 % of men).

• Psychosocial impacts: 65% of PLHIV reported low self-esteem, 49% report feeling ashamed of their status, 47% % felt they should be punished, and 16% reported having suicidal thoughts in the previous year.

In addition, the report predicts the national HIV epidemic will be responsible for an overall decline in GDP of 16.5 % between 1993 and 2020. However, the report estimates high coverage of antiretroviral therapy (96.7% of eligible adults and children) successfully averted 21,497 labour force deaths between 2003 and 2009 and reduced GDP losses by $100 million per year over the same period, thereby demonstrating the cost-effectiveness of universal treatment coverage.

This is the largest and most comprehensive study ever conducted on the socioeconomic impact of HIV in Cambodia. Findings will be used to strengthen existing HIV prevention, treatment, care and impact mitigation strategies, introduce new evidence-informed interventions and ensure resources are utilised effectively and efficiently.

The report was produced by the National AIDS Authority and the United Nations in Cambodia, in collaboration with Sanigest Internacional and the Centre for Advanced Study.

For further information, please contact: Mr. Ker Munthit (Khmer): +855 11 905 261, This e-mail address is being protected from spambots. You need JavaScript enabled to view it or Ms. Casey McCarthy (English): +855 17 996 540, This e-mail address is being protected from spambots. You need JavaScript enabled to view it