Cambodia Is 2nd Asian Country To Rollout Long-Acting Injectable HIV Prevention Option
PrEP is a medicine for HIV-negative people to reduce their risk of getting infected.
According to the WHO, long-acting injectable cabotegravir PrEP is a safe and highly effective prevention option for people at substantial risk of HIV infection.
In Cambodia, the first two long-acting and injectable cabotegravir PrEP doses were given to a female sex worker and a transgender person, said Patricia Ongpin, UNAIDS Country Director for Cambodia, Lao PDR and Malaysia.
Know more about long-acting injectable cabotegravir PrEP
Long-acting injectable cabotegravir PrEP is an intramuscular injectable, long-acting form of PrEP.
* First 2 injections are administered 4 weeks apart
* Followed thereafter by an injection once every 8 weeks.
This long-acting injectable PrEP with cabotegravir (CAB- LA) has shown in scientific studies to be safe and highly effective among cisgender women, cisgender men who have sex with men, and transgender women who have sex with men (studies include two randomised controlled trials, HPTN 083 and HPTN 084). These studies found that use of long-acting CAB-LA PrEP, resulted in a 79% relative reduction in HIV risk compared with oral PrEP, where adherence to taking daily oral medication was often a challenge.
WHO clearly states that both daily oral PrEP and long-acting injectable PrEP are highly effective.
Choice matters
Expanding the range of science- and evidence-based HIV prevention options, so that people can choose what works best for them, is very important if we are to empower people towards health seeking behaviour, as well as progress faster towards ending AIDS, she said.
"Evidence is very clear on what works in HIV prevention. But what we need to know is that one size does not fit all. So we really have to understand that a combination of HIV prevention options must be made available in the market for people to choose from - based on their daily life, personal choice, and what they are comfortable with," said Patricia Ongpin, in an exclusive interview given to CNS in the lead up to 13th International AIDS Society Conference on HIV Science (IAS 2025) - the largest global gathering on HIV science this year. She was also a speaker at IAS 2025 Affiliated Independent Event on the theme: "Strengthening competencies and capacities in Global South to end AIDS, end TB, and deliver on SDGs."
"Cambodia is a leader in the HIV response for many reasons. It currently has an HIV prevalence among the general adult population of 0.5%. In 2024, it was estimated that there were 76,000 people living with HIV, 1200 new infections (which roughly translates to 3 new HIV infections a day) and 1000 AIDS related deaths that year in Cambodia," said Patricia. "This represents roughly a 45% reduction in new HIV infections as compared to 2010."
Nepal is the only country in Asia Pacific region (and among 4 in the world) to record a decline of over 75% in new HIV infections since 2010, said Eamonn Murphy, UNAIDS Director for Asia Pacific at the 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025).
Cambodia on track to achieve 95-95-95 targets for 2025
95-95-95 targets for 2025 refer to ensuring that at least 95% of people living with HIV know their HIV-positive status, 95% of those who know their status are receiving lifesaving antiretroviral therapy, and 95% of those on therapy are virally suppressed.
According to WHO, those people with HIV who remain virally suppressed have ZERO risk of transmitting HIV to anyone else. So, HIV treatment also works as prevention.
Not just rich nations like New Zealand, but also low- and middle-income countries like Nepal, Cambodia and Thailand in Asia and the Pacific region are meeting some of the 2025 HIV-related targets.
"Cambodia is on track to achieve the 95-95-95 HIV-related targets. In 2024, Cambodia had 92% of all people living with HIV who knew their status. Nearly 100% of all those who knew their HIV positive status were on lifesaving antiretroviral treatment, and 98% of those on treatment were virally suppressed. So, this is a fantastic achievement and we are really hoping that Cambodia can achieve the 95-95-95 targets on time for 2025," said UNAIDS' Patricia Ongpin to CNS (Citizen News Service).
She added: "This is a very strong health response in Cambodia. and it also reflects its strong political commitment, community-led response, and adoption of innovations. But it is not just a health response, it is essentially a multi-sectoral response from Cambodia. This includes provision of social protection for people living with HIV and female entertainment workers, to social protection schemes that allow them access to free healthcare and covers their other out-of-pocket expenses or reimbursements."
Patricia was referring to Health Equity Funds in Cambodia - a social health protection government scheme designed to enable poor people to access free healthcare at public facilities. They aim to improve access to healthcare and reduce financial burdens, particularly for those most vulnerable.
"So, a holistic approach in Cambodia's HIV response has helped the country to become a leader in achieving the 95-95-95 HIV-related targets for 2025, in the hope that it can indeed end AIDS soon after," said Patricia.
1st ever rollout of long-acting injectable PrEP in Cambodia
Patricia shared that long-acting injectable cabotegravir PrEP was launched in the second half of June 2025 in Cambodia. "A feasibility and acceptability research study was done last year in consultations with communities, so that we can know how will it be perceived by the people who are intended to use it. The government is working hand-in-hand with civil society organisations and communities so that there is more demand generation for long-acting injectable cabotegravir PrEP, and also to stem other challenges like hesitancy etc."
She had a meeting with Cambodian Director of HIV programmes and learnt that the uptake of long-acting injectable cabotegravir PrEP is "pretty good right now, where we have both: people who are switching from oral PrEP to long-acting injectable PrEP, and also new initiation of PrEP in general."
One dose of long-acting injectable cabotegravir PrEP costs US$36
Thanks to the Global Fund to fight AIDS, TB and Malaria (The Global Fund), long-acting injectable cabotegravir has become possible for eligible people in Cambodia.
Treatment for people living with HIV is lifesaving and revolutionary as it has made HIV akin to any other chronic disease. It has been proven that those who are on treatment and remain virally suppressed, live healthy and normal lifespans - comparable to those without the virus – and there is zero risk of any further HIV transmission from them. But oral HIV treatment has to be taken daily without fail. This could be challenging given the fact that HIV treatment is lifelong.
Long-acting injectable cabotegravir along with Rilpivirine (CAB/RPV LA) is also available as treatment for people living with HIV who have suppressed viral load (once every two months). But it is not yet rolled out in Cambodia yet.
Dapivirine vaginal rings in Cambodia: next breaking news?
"Right now, we have cabotegravir as a PrEP (HIV prevention option), injected once every two months. However, it is likely that soon Cambodia may rollout dapivirine vaginal rings for HIV prevention," said Patricia of UNAIDS.
Dapivirine vaginal ring (developed by International Partnership for Microbicides and acquired by Population Council), is the world's first female-controlled, long-acting, non-systemic, microbicide product that substantially reduces the risk of getting infected with HIV. Thus, it is also referred to as a PrEP ring.
The dapivirine vaginal ring is a flexible silicon ring that slowly releases the HIV prevention drug dapivirine into the target cells and substantially reduces the risk of her getting infected with HIV. Any HIV-negative woman, who is at risk of acquiring the infection, can herself put the ring in her vagina, leave it in place for a specified period and then replace it by herself.
Patricia informs that Cambodian government began considering dapivirine vaginal rings and long-acting injectable cabotegravir, roughly at the same time. "So, Cambodia is in the final process of settling down the standard operating procedures (SOPs) and training. We are hoping that in the next month or two, dapivirine vaginal ring will also be added to the range of combination HIV prevention options people can choose from. We hope this would reduce the number of new HIV infections in Cambodia."
Public health warrants infection prevention but would we sustain it?
UNAIDS' Patricia Ongpin puts the spotlight on sustainability of HIV prevention as well as global AIDS response in context of competing priorities. "It is a real issue," she rightly points out.
She calls on governments to have optimal political commitment which should match the services, legal reforms and policy harmonisation, policy framework, health and development financing, and systematic integration which are critical if we are to end AIDS by 2030. "Multi-sectoral approach towards ending AIDS is key," she said.
Health financing varies between countries. For example, Malaysia has almost all (99%) of its HIV response domestically-funded, whereas Cambodia has roughly 36%, informs Patricia.
IAS 2025 message of UNAIDS' Patricia Ongpin
"HIV is not over and we need to stand together in solidarity to support governments, communities, and development partners in making sure that HIV responses stay alive," said Patricia. She called for ensuring effective collaboration between different partners, such as governments, communities and development partners - so that not only innovative financing can be fully harnessed, but we are also able to rollout all combination HIV prevention options along with other critical cog-in-the-wheels to end AIDS by 2030.
Shobha Shukla – CNS (Citizen News Service)
(Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)
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