Abstract
Introduction
Globally, by the end of 2022, there were 39 million people living with HIV (PLHIV), which included 37.5 million adults and 1.5 million children aged less than 15 years, approximately 16.7% (6.5 million) of whom were living in Asia and the Pacific. Among these PLHIV, an estimated 76% of all PLHIV are accessing antiretroviral therapy (ART). In Cambodia, 76,000 people had HIV, with 1,400 new infections. Approximately 64,931 individuals were accessing treatment; however, 11,000 remained unaware of their status. Key populations and their clients or partners accounted for 83% of new infections. Despite this, there is a significant gap in understanding the epidemiological characteristics of newly diagnosed cases and risk factors associated with HIV infection.
Methods
This cross-sectional study utilized existing data from the 2022 National Boosted Integrated Active Case Management (B-IACM) database provided by NCHADS, with 4242 cases after cleaning. We investigated the associations between HIV positivity and various factors. These factors included age group, sex, client type, risk behavior, geographical location, and province. The analysis employed chi-square tests to evaluate initial associations; then, multiple logistic regression analyses were performed to assess the main predictors of HIV. We used Stata 15 V. for data analysis.
Results
Close to 37.0% of PLHIV were in the 25-34 year age group. Men accounted for 76.2% of the sample. The non-key population represented 50.4%, and the key population accounted for 49.6%, mostly the MSM group. The odds of being HIV-positive for males were significantly greater than those for females, with AOR = 3.75 (95% CI: 1.55--9.07), p value of 0.003. Compared with the non-key population, the key population had an AOR = 8.47 (95% CI: 2.57-27.94) for HIV, with a p value <0.001. Those identified as having high-risk behaviors had AOR = 3.42 (95% CI: 1.42-8.21) and were more likely to be HIV than were those identified as having lower-risk behaviors (p value = 0.006). Compared with those tested in health facilities, individuals tested in community settings had lower odds of being positive for HIV (AOR = 0.13, 95% CI: 0.05–0.34). Finally, individuals from the plain region had an AOR = 5.80 (95% CI: 2.13-15.83), with a p value < 0.001.
Conclusion
The study revealed the main predictors of HIV in the B-IACAM data, including sex, client type, risk behavior, test place, and province/region. Men, key populations, high-risk behaviors, and testing context strongly correlated with increased HIV positivity. Additionally, residence in certain provinces or regions was a critical predictor. These findings provide insights into epidemiological characteristics that critically emphasize the importance of targeted interventions and customized public health strategies that cater to the distinct needs of these vulnerable populations.