Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia\ncontinues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and\nimplemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to\ndetermine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who\nhave sex with men (MSM) in Cambodia.\nMethods: We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted\nin 2012 and 2014 in Battambang and Siem Reap provinces. A two-stage cluster sampling method was employed to\nselect the study sample for structured interviews.\nResults: The midterm and endline samples were similar. The average number of sexual partners in the past three\nmonths decreased significantly from 6.2 to 4.0 (p = 0.03). The proportion of MSM who reported paying for sex with men\nin the past three months also decreased significantly from 19.0 % to 9.7 % (OR = 2.0, 95 % CI = 1.3-3.0). No significant\nchange was found in condom and lubricant use in all types of relationships. Regarding STIs, 28.1 % of MSM at midterm\nreported having at least one STI symptom in the past three months compared to 6.1 % at endline (OR = 4.6, 95 % CI = 2.\n9ââ?¬â??7.4); out of them, 14.1 % of MSM at midterm sought treatment compared to 20.7 % at endline (OR = 2.6, 95 %\nCI = 1.1ââ?¬â??6.9). The proportion of MSM who reported using illicit drugs in the past three months also decreased\nsignificantly from 12.2 % to 5.1 % (OR = 2.4, 95 % CI = 1.4ââ?¬â??4.2). However, the proportion of MSM who reported having\nbeen tested for HIV in the past six months decreased significantly from 94.1 % to 77.1 % (OR = 2.9, 95 % CI = 1.8ââ?¬â??3.6).\nConclusions: Findings from this study indicate that the SAHACOM was effective in improving sexual behaviors and\nrelated health outcomes among MSM under the project. However, it could not increase condom use and HIV testing\nrates among this key population. Tailored intervention programs are needed to improve condom use and HIV testing\namong MSM in Cambodia.
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