At the same time, others who were open about their sexual orientation might not be having sex with anyone at all, meaning they should not be included in epidemiological models of populations at risk from the virus.
Sophea, a tall Phnom Penh university student with masculine good looks and wavy hair, says he never identifies himself as part of the MSM community due to family and social discrimination. Yet inside, he said, he feels more like a girl.
"Before I discovered I was a man who loves other men, I was never interested in girls. But when I’m close to other men, I always feel warm and calm," he said.
"Nowadays, I have a partner and we live together like lovers despite the lack of stability. As a man, I feel that loving men is natural and my sense tells me to not tell this to any girls."
At the same time, however, some people note that some "real men" in Cambodia tend to act effeminately, copying they way girls speak and using lots of cosmetics.
Dr Phan Sotheavuth of Medecine de l’Espoir Cambodge (MEC) said men preferred men not for environmental or societal reasons but for psychological factors.
"Changes in hormones, which vary with the food we eat daily, and the natural favoritism of young boys for feminine things like clothes are also factors," he said.
Leng Mony Thach, president coordinator of the National Chaktomok MSM Network, said he believed genetic factors from birth were important.
"There are two kinds of MSM, long-hair MSM who have long hair and resemble girls, and short-hair MSM who look like normal men and have sex with both women and men," he said. referring to the terms used by epidemiologists working in Cambodia in recent years.
The National Chaktomok MSM Network estimates the MSM community at around 18,700 men in 17 provinces, excluding those who have not disclosed their sexual behavior.
Keo Rothana, who has short hair, said he used to live with his wife and daughters but could not stop having clandestine sex with male partners
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