Pediatric HIV/AIDS Care in Phnom Penh:

In August 2009, Cambodian Health Committee opened the Joseph P. Sullivan Outpatient Clinic for HIV Care of Children at the Pediatric Ward, at the Khmer-Soviet Friendship Hospital (KSFH) in Phnom Penh, Cambodia’s largest public hospital. The pediatric ward which was underused and in poor condition was also renovated at that time.

Impact:

1. Outpatient HIV care and treatment was initiated and provided to +586 children at the Sullivan HIV Pediatric HIV Clinic in the first years of it operation with a special focus on children with HIV and TB. The chief of pediatrics at the time, Dr. Sinet, had trained at the Maddox Chivan Children’s Center, which was one of teh first facilities to provide HIV drugs to children who need them.outstanding success of treatment measured in HIV viral load suppression and adherence with medicines.

2. 85,000+outpatient visits for HIV care for children living with HIV/AIDS were conducted at the Sullivan Center between 2009-2020. Outstanding success of treatment was measured in HIV viral load suppression and adherence with medicines.

3. 400+ children needing HIV treatment/year under the age of 18 received their routine and ongoing primary HIV care and medicines at the Sullivan Center per year between 2009-2020.

Outstanding success of treatment and adherence to the daily treatment was measured in HIV viral load suppression and increase in CD4+ T cell counts.

Dr. Vophorn, the lead CHC physician at the Sullivan HIV pediatric Clinic with a new patient .

4. From its first days of operation, a critical linkage was established between CHC’s Maddox Chivan Children’s Center (MCCC), and the Pediatric HIV Clinic at the Khmer Soviet Friendship Hospital (KSFH). The age-specific counseling program for children with HIV at different developmental ages that was developed at the MCCC and the MCCC counselors were integrated into the Pediatric HIV Clinic. And, social workers from the MCCC assist with medical counseling of children and social problems faced by any children and their families attending the clinic. There was a natural link for children whose families wanted them to participate in the MCCC activities, to join in the MCCC program.

5. National physicians who were working at the Pediatric Ward who had been trained in HIV treatment and care at the MCCC became leaders in HIV care of children at the new pediatric HIV clinic.

6. The Khmer-Soviet Friendship Hospital (KSFH)’s adjoining Pediatric Ward, which had been poorly functional before CHC opened the Sullivan HIV Pediatric Clinic, was renovated at the time that CHC built the adjoining HIV outpatient clinic in 2009.

The ward renovation enhanced in patient services for children living with HIV/AIDS or arriving at the ward for any reason and houses 20 beds and isolation rooms for children with infectious TB.

Vaccination activities were instituted and neonatal and intensive care facilities consistent with local standards of care were also updated.

Strengthening of the neonatal service on the renovated ward answered an important need of the hospital given that it has a very busy maternity service with +3,000 births/year that serves the poorest patients in the city.

Hospitalization of children living with HIV/AIDS

Waiting to see the doctor and counselor at the Sullivan Clinic

Dr. Isabelle, a French pediatrician who volunteered with Cambodian Health Committee providing mentorship at the Pediatric Ward is shown above examining a newborn brought from the adjacent Maternity Ward, while mentoring the pediatric care team in newborn examinations at the hospital.

An infant with a fever being admitted to the renovated Pediatric Ward at the Khmer Soviet Hospital for antibiotics and fever control.

Jaundiced newborns receiving UV light therapy on the pediatric ward after birth in the maternity ward of the Khmer-Soviet Friendship Hospital. Their grandmother is with them in teh upper left photo.

7. During COVID in 2021, all HIV care at the Khmer Soviet Friendship Hospital for adults and children, including the Sullivan Pediatric HIV Clinic, was merged with the National AIDS Program (NCHADS) National Clinic in Phnom Penh, which cares for +3800 persons living with HIV/AIDS. CHC follows these patients in partnership with the Cambodian National AIDS Program (NCHADS) team.

As they age out of pediatric care they join the 175 older teenagers and young adults who received HIV care from CHC at the Sullivan Pediatric HIV Clinic and who are now are treated in the adult NCHADS clinic by HIV staff with a focus on helping them stay adherent with their medications during their vulnerable time of life as teenagers and young adults who must take responsibility for their bodies and management of their HIV infection.

8. Thankfully, in 2026, pediatric HIV transmission has been significantly decreased and is very low in Cambodia due to screening for HIV before birth and treatment of HIV-infected pregnant mothers-to-be with AIDS drugs to prevent mother-to-child transmission of HIV.

It is therefore now rare for young children to present to any health facility with HIV/AIDS. As the 586 children who were treated at the Sullivan Pediatric HIV Clinic have grown into teenagers and young adults, they have joined adult HIV clinics after the age of 15 according to Cambodia Ministry of Health policy. A focus of CHC’s current work is to provide support for adherence of adolescent and young adults to lifelong HIV treatment in the pediatric and adults NCHADS HIV clinic.

Children with parents awaiting follow-up appointments at the Sullivan HIV Clinic for Children in 2020.

This boy and his father meeting with the medical counselor after they visit the doctor to reinforce taking daily HIV medications. She is using the counseling cards developed by Maddox Chivan Children’s Center/Cambodian Health Committee team.

Teens waiting for their appointment with the counselor and the doctor.

In the photo above left, Dr. Sinet, who was the chief of the pediatric ward at the Khmer Soviet Hospital, consults with pediatrician Dr. Ann Kao - - a US pediatrician from Massachusetts General Hospital in Boston, Massachusetts who was volunteering with CHC—about the baby Dr. Ann was holding in her arms.

The 12 month old baby girl named Sivy, was just discovered to be infected with HIV, and was brought to the pediatric ward by her mother; she weighed 12 pounds and had severe diarrhea, fever, and malnutrition and advanced AIDS.

Right top photo: the mother is holding her, accompanied by the baby’s 8 year old sister. Her mother had just learned in the adult HIV Clinic of the that she and Sivy’s father were both HIV positive. The mother was sent to the pediatric ward so her two daughters could be tested for HIV and the baby could be evaluated. The older sister was HIV negative. Unfortunately, the baby, was found to be infected with HIV from maternal-child transmission. She was now suffering with advanced AIDS disease and was hospitalized in very serious condition on the Pediatric Ward to receive fluids and antibiotics for her diarrhea and for therapeutic feeding for her malnutrition.

General Pediatrics Hospitalization and Care at the newly renovated Pediatric Ward

A 3 year old boy having a blood test to test his CD4+ T cell count and HIV viral load to evaluate the efficacy of his treatment for HIV and his immune system.

Left: H.E. Mam Bun Heng, the Cambodian Minister of Health awards CHC Executive Director at the time, Dr. Sok Thim, with the Gold Medal for Reconstruction of Cambodia on behalf of Prime Minister Hun Sen on the occasion of the opening of the renovated pediatric ward and the Sullivan Pediatric HIV Clinic in August 2009 (photo below) at the Khmer Soviet Friendship Hospital and celebrating the NGO-Ministry of Health Partnership to treat Pediatric HIV.

Critical support Pediatric Care for Children living with HIV/AIDS and Pediatric Care at the Khmer-Soviet Friendship Hospital through the years has been provided by Jeanne Sullivan, Nancy and Steven Crown, Angelina Jolie, Mark Peters, Barbara and Peter Sereda, and Cathi and Albro Lundy.