AIDS Care Training Commences in Cambodia
February 2007—Confronted with the most severe HIV/AIDS epidemic in Southeast Asia, Cambodia launched an anti-AIDS program in the 1990s that led to a significant drop in HIV prevalence, from a high of 3 percent in 1998 to 1.9 percent in 2003.
While aggressive prevention efforts were able to stabilize Cambodia’s epidemic, care and treatment of people with HIV/AIDS have now become necessary focal points of the country’s health-care agenda. In 2004 the Cambodian government launched a multi-faceted national program to support the continuing education of health-care workers involved in HIV treatment and care, organized by the country’s National Center for HIV/AIDS, Dermatology, and STDs (NCHADS) and supported in part by a grant from TREAT Asia.
While the larger Cambodian HIV education program was initiated two years ago, those elements supported by TREAT Asia were launched in March 2006 and will continue to be implemented over the next several months. TREAT Asia’s NCHADS program comprises the following six components:
National symposium—The first Phnom Penh Symposium on HIV Medicine was held 14–15 September 2006 and attracted more than 300 HIV clinicians and health-care workers. Attendees heard updates on important international developments in HIV treatment and addressed issues related to patient care, including management of opportunistic infections (OI), antiretroviral therapy (ART), and referrals to appropriate services. According to NCHADS Director Dr. Mean Chhi Vun, the symposium may become a semi-annual event in the future.
- Training—Six new teams of OI/ART specialists are being trained at district hospitals across Cambodia. Each team consists of two clinicians, two nurse counselors, a logistics officer, an X-ray technician, a lab technician, and a team leader. The focus of this training is on team-building and operational aspects of HIV inpatient and outpatient services. By November, two of the six teams had received training.
- Mentoring—After each of the six new OI/ART specialist teams have completed training and are starting to provide services, they will receive on-site mentoring from a clinical support team comprised of an experienced doctor, a nurse counselor, and an HIV-positive coordinator. Each mentoring group will provide four week-long consultations to each new team. This mentoring program will cover patient flow, OI prophylaxis and management, ART drug education, record keeping and data collection, adherence counseling, and community education activities.
- Site support—Training updates are being offered in 20 hospitals where OI/ART programs were established prior to TREAT Asia’s involvement. This continuing education program will be conducted by a site support team consisting of one or two experienced clinicians from a national or provincial hospital and one or two experienced nurse counselors; the support team is being sent to work with the OI/ART teams for one-week on-site trainings held twice per year.
- Regional workshops—Alumni of the national OI/ART training program are being offered regional workshops twice a year, at which participants are able to share experiences with HIV infection in adults and children. Discussions cover OI and ART clinical care, drug adherence, psychological support, clinic operation, and referrals. Health-care staff take turns attending the three-day workshops so that HIV care is not interrupted at each site.
- Training in epidemiology and biostatistics—With the objective of training leading Cambodian HIV/AIDS clinicians, a two-week course on the foundations of evidence-based medicine, with a focus on epidemiology and biostatistics, will be provided to a group of clinicians who are highly knowledgeable about HIV/AIDS treatment and care in Cambodia.