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2nd Asia-Pacific Regional Consultation on PrEP Implementation

Tue 19 Jun 2018 ข่าวสาร

Thai Red Cross AIDS Research Centre (TRCARC), FHI 360 LINKAGES program, funded by United States Agency for International Development (USAID), in collaborated with World Health Organization (WHO) organized the 2nd Asia- Pacific Regional Consultation on PrEP Implementation. Using antiretrovirals (the AIDS drugs) to prevent people from being infected by HIV (the AIDS virus) has been proved successful since 2010. Several studies after that confirmed its efficacy if subjects did take the drug. The US Food and Drug Administration (FDA) approved its use among homosexuals and intravenous drug users who were at risk in 2012. Pre-Exposure Prophylaxis (PrEP) was recommended in the 2014 Thai Treatment and Prevention Guidelines resulting in the fee for PrEP service at the Thai Red Cross Anonymous Clinic in December 2014, followed by several government- led and community-led PrEP demonstration projects in Thailand.

Although WHO recommended the use of PrEP in its 2015 Guideline, not very many countries in the Asia-Pacific region implemented it. Several large-scale PrEP programs were started in many developed countries in 2016, building the interest in the Asia-Pacific region. As a result, the 1st Asia- Pacific Regional Consultation on PrEP implementation took place in Bangkok last January, supported by USAID. Many pilot projects across the region have taken place after this first meeting. The 2nd Asia-Pacific Regional Consultation on PrEP implementation this year was to follow-up on the progress made during last year as a result of the first Asia-Pacific Regional Consultation on PrEP implementation.

The objectives of this conference aimed for updating on the status of PrEP Implementation in the Asia-Pacific region and set out regional goal; exploring and sharing experiences on alternative ways to create demand for PrEP in the region by looking at the 3P’s: Potential PrEP Users, Providers, and Policy Makers; and documenting PrEP service delivery models in the region for scaling up PrEP among key populations.

The 2nd Asia-Pacific Regional Consultation on PrEP Implementation brought approximately 170 key representatives across the Asia Pacific region from the HIV/AIDS programmatic sectors, international development agencies, United Nations family, and community-based organizations on a most timely topic of common interest: that is, the fast-changing landscape of HIV prevention in this region. Increasing number of PrEP implementation programs in the Asia Pacific region reflects the growing empowerment of populations at risk for HIV and their providers and the gradual introduction of PrEP into the national HIV strategic plans of the countries in this region in order to support those who engage in risky behaviors to stay negative.

For Thailand, in order to achieve the goal of ending AIDS, PrEP was included in the National Guidelines on HIV/AIDS Treatment and Prevention, launched in October 2014. This was followed quickly by the establishment of the first fee-based PrEP service which costs 1 USD per day at the TRCARC in December 2014. In 2015, the country piloted Community-Led and Government-Led PrEP programs in 3 provinces which were subsequently scaled up to 10 provinces in 2016 and 2017. As of today, we have almost 4,000 PrEP users in Thailand in various PrEP implementation programs and services. Excitedly, the National Health Security Officer program has now planned to include PrEP services for populations at high risk for HIV infection under their health insurance scheme, starting next fiscal year.

The discussion today highlighted alternative ways countries have been using to create demand for PrEP by looking at the 3Ps, a concept proposed by WHO Global PrEP Coalition, which looks at PrEP demand creation by Potential PrEP Users, Providers, and Policy Makers. In addition, participants also learned from real-world PrEP implementing experiences from the United Kingdom, Thailand, Vietnam, Taiwan, Malaysia, India, and the Philippines. Key factors to success and how PrEP programs could be tailored to suit different key populations were shared. Finally, PrEP targets were set for countries in our region and next steps were identified for countries to pursue their efforts to achieve those targets.

The consensus from the conference was that PrEP was an indispensable component in ending AIDS. In addition to early testing and rapid treatment of infected individuals, prevention package containing PrEP should be offered to those HIV-negative high-risk individuals. Pilot or demonstration projects should be scaled up to a level and with a pace that can end AIDS on time. In addition, it was expected that country would invest more in PrEP while international funding would gradually transit out. Best practices learned from this meeting should be adapted to other countries in the region both among policy/program implementers, PrEP providers, and PrEP users. International development agencies would facilitate this best practice sharing process and monitor the progress to report back at the Third Consultation meeting next year as a mean to accelerate the regional response.

Download the Second Asia Pacific Regional Consultation on PrEP Implementation here

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