title: Improving prevention and care for HIV and sexually transmitted infections among men who have sex with men in Cambodia: the sustainable action against HIV and AIDS in communities (SAHACOM).
abstract: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia.
  
  
  
  We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang and Siem Reap provinces. A two-stage cluster sampling method was employed to select the study sample for structured interviews.
  
  
  
  The midterm and endline samples were similar. The average number of sexual partners in the past three months decreased significantly from 6.2 to 4.0 (p = 0.03). The proportion of MSM who reported paying for sex with men in the past three months also decreased significantly from 19.0 % to 9.7 % (OR = 2.0, 95 % CI = 1.3-3.0). No significant change was found in condom and lubricant use in all types of relationships. Regarding STIs, 28.1 % of MSM at midterm reported having at least one STI symptom in the past three months compared to 6.1 % at endline (OR = 4.6, 95 % CI = 2.9-7.4); out of them, 14.1 % of MSM at midterm sought treatment compared to 20.7 % at endline (OR = 2.6, 95 % CI = 1.1-6.9). The proportion of MSM who reported using illicit drugs in the past three months also decreased significantly from 12.2 % to 5.1 % (OR = 2.4, 95 % CI = 1.4-4.2). However, the proportion of MSM who reported having been tested for HIV in the past six months decreased significantly from 94.1 % to 77.1 % (OR = 2.9, 95 % CI = 1.8-3.6).
  
  
  
  Findings from this study indicate that the SAHACOM was effective in improving sexual behaviors and related health outcomes among MSM under the project. However, it could not increase condom use and HIV testing rates among this key population. Tailored intervention programs are needed to improve condom use and HIV testing among MSM in Cambodia.
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia. siyan@doctor.com.|Center for Global Health Research, Public Health Program, Touro University California, 1310, Club Drive, Vallejo, CA94592, USA. siyan@doctor.com.
authors: Siyan
authors: S
authors: Yi
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia.
authors: Sovannary
authors: S
authors: Tuot
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia.
authors: Pheak
authors: P
authors: Chhoun
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia.
authors: Khuondyla
authors: K
authors: Pal
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia.
authors: Chanrith
authors: C
authors: Ngin
authors: KHANA Center Population Health Research, No. 33, Street 71, Tonle Bassac, Chamkar Mon, Phnom Penh, Cambodia.
authors: Sok Chamreun
authors: SC
authors: Choub
authors: Center for Global Health Research, Public Health Program, Touro University California, 1310, Club Drive, Vallejo, CA94592, USA.
authors: Carinne
authors: C
authors: Brody
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control; D002160:Cambodia / Q000453:epidemiology; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data; D017280:Condoms / Q000706:statistics & numerical data; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D058996:Quality Improvement; D011787:Quality of Health Care; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cambodia; Community-based interventions; HIV; Men who have sex with men (MSM); Sexually transmitted infections (STIs); Sustainable Action against HIV and AIDS in Communities (SAHACOM)