Cost and performance of HIV/AIDS control through outreach program to direct female commercial sex workers in Cambodia

Abstract

The present study was undertaken to measure the costs and performance of outreach program to direct female commercial sex workers in Cambodia. The study consists of two parts, first is the review of all activities of the program in 20 provinces and 2 major cities in order to calculate the total costs incurred by the program within its first year of intervention, and second is the analysis of behavioral change of commercial sex workers based on data from a Behavioral Survey on commercial sex workers. The survey was conducted in five selected provinces, which represent five different regions of the country, and 480 CSWs were interviewed. The results of the study, which are presented in this paper, show that total costs of the program incurred for the first year was 372,543390 Riels (1$US=2720 Riels), 3945 CSWs were educated and 1,514,880 condoms were distributed by the program within the first year. Among 3945 CSWs educated, 50.4% of them reported always condom use with clients, and there are 12% different in 'always condom use' which is significantly related to the activities of the outreach program. Cost ratio analysis show that cost per CSWs educated was 94,434 Riels per year, cost per 1 condom distributed was 246 Riels, Cost per 1 CSWs increase in always used condom contributed by the outreach program was 78,952 Riels, cost per 1 percentage increase in' always condom use' was 3,104,528 Riels and the flow of fund was 74% from donor, 21% from government, and 5% from NGOs. In addition the analysis found that the outreach program to CSWs in Cambodia may not be sustainable without financial support from donor, unless partial cost-recovery for condom was applied. In other way is to integrate outreach program into other existing programs such as condom social marketing, STD treatment and counseling.