XVIII International AIDS Conference

Abstract

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The socio-economic impact of HIV in Cambodia at the household and national levels

J. Cercone1, E. Pinder1, S. Hean2, C. Men2, K. Moriarty3, S. Ammassari3

1Sanigest Internacional, San José, Costa Rica, 2Center for Advanced Studies, Phnom Penh, Cambodia, 3UNDP/UNAIDS Cambodia, Phnom Penh, Cambodia

Background: Cambodia has made impressive progress in increasing access to antiretroviral treatment (ART) and promoting preventive measures to address HIV's challenges. In the context of UNDP-UNAIDS' regional initiative, this household survey evaluates the socio-economic impact of HIV in Cambodia.
Methods: This quasi-experimental designed study of 2,623 “cases” (HIV households) and 1,349 “controls” (non-HIV households) applies multivariable analysis and propensity score matching to determine HIV's effect on households, including inter alia impacts on: poverty, employment, human capital accumulation, health status and health expenditure, as well as household coping mechanisms, stigma and gender equality.
Results: HIV has a significant impact on household consumption, asset accumulation (53% HIV+ households vs. 80% non-HIV own their house) and produces greater impoverishment (65% vs. 52% are in debt). HIV-households require more health care (62% vs. 53% sick in previous 4 weeks), have reduced nutritional status (58% vs. 39% hungry in previous year) are less able to maintain employment, face increased discrimination, and children have increased barriers to education (30% vs. 22% children missed a school day in previous year). HIV households also face significant gender-related challenges as widows face more discrimination (11% vs. 6% widowed). Overall, HIV has significant impact on macro-economic growth and the labor market, leading to declines (approximately 2%) in GDP.


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Conclusions: These results, comparable with UNDP´s studies in India, Vietnam, and China, highlight areas where support programs should focus to alleviate the burdens facing PLWHA and focus public policies on prevention and treatment of HIV to avoid its potentially devastating effects on Cambodia's economy.


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