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Expanded Record  (Item 6 of 30 from Meeting Abstracts)
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Learning by doing: developing effective outreach programmes in Cambodia.

Seng SW, Mean CV, Net SS, Godwin P, Wienrawee P; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14;13:abstract no. TuPeD3552.

S.W. Seng, NCHADS, 170 Sihanouk Boulevard, Phnom Penh, Cambodia, Tel.: +855 23 722 515, Fax: +855 23 722 515, E-mail:

Issues: In 1995, the Cambodian Ministry of Health, with WHO support, established an outreach programme to provide awareness and education about HIV/AIDS to commercial sex workers. Under the governments World Bank loan project, this was provisionally funded through 1997/8, and some 10,000 sex workers in some 800 establishments were reached. In 1997 an internal evaluation of the impact of the programme was conducted by the National AIDS Programme, which, however, revealed disappointingly low levels of condom use. In 1998 an external evaluation was therefore conducted, which concluded that while the project had been successful in imparting knowledge about HIV and AIDS to commercial sex workers, little behavioural change had been achieved as a result of the outreach activities; specifically the coverage of the programme was sporadic, the methods of education were didactic, and the target group too limited. The programme was, however, still considered a critical part of the National Strategy. The Ministry therefore undertook a major re-design exercise. Description: A multi-disciplinary team was formed within NCHADS, supported by an external consultant. The team spent three months interacting with provincial staff and NGOs, training and helping provinces to conduct social mapping exercises of commercial sex services (CSS) locally, and identify objectives, targets and structures for the re-designed programme. The programme concluded quickly that the context of commercial sex services was much wider than simply the formal brothels, and that workers in commercial sex services were of many different kinds, with many different needs. The objectives were broadened significantly, aiming to make commercial sex services safe and healthy, for all concerned. Specifically it was recognised that this means that workers in commercial sex services should be well-informed about HIV, AIDS, STD, reproductive health, and aware of and able to seek proper services in these areas; they should have access to and use condoms on all occasions, should not be subject to violence or cooercion, and should be exposed to other job alternatives. It was quickly recognised also that the target groups to be reached extended far beyond the sex workers themselves, and included brothel managers and owners, agents and middlemen, non-brothel-based sex workers, clients, and the local administration. This had significant implictions for just how outreach activities would be conducted. Finally, the outreach programme was identified as a critical element in the introduction of the 100% condom-use policy, a priority core of the National Strategy, providing the support, extension and on-going education the 100% CU policy requires. The provinces are now starting to implement this new programme. Conclusions: This history demonstrates how a good pilot project, carefully evaluated and flexibly learned from, combined with determined Government action and serious commitment, and cooperation and collaboration from a wide variety of partners in the country, can establish unusual, innovative, strategic and exciting policy and programme responses from Government.

Publication Types:

  • Meeting Abstracts


  • Acquired Immunodeficiency Syndrome
  • Behavior
  • Cambodia
  • Coitus
  • Condoms
  • HIV Infections
  • HIV Seropositivity
  • Health Education
  • Humans
  • Learning
  • Organizations
  • Pilot Projects
  • Program Evaluation
  • Reproductive Health
  • Safe Sex
  • Sex Workers
  • Sexual Behavior
  • Sexual Partners
  • Sexually Transmitted Diseases
  • education
  • organization & administration

Other ID:

  • GWAIDS0002116

General Notes:

  • Meeting held in: South Africa

NLM Unique ID: 9870004
UI: 102239609
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Last Updated: May 20, 2014