MSM communities call for national PrEP strategies to prevent new HIV infections

27 April 2016 (Bangkok) – Pre-exposure prophylaxis (PrEP), the daily medication that prevents HIV infections, is efficacious and has real potential to help global and local efforts to reach prevention targets in Asia, according to the meeting report of “PrEPARING ASIA”, the region’s first and biggest, as well as the world’s first community-led, consultation on the rolling out of the medication. The report calls for PrEP to be included in national HIV prevention strategies, particularly for men who have sex with men (MSM) in Asia.

“The HIV epidemic is out of control for MSM in Asia, and current prevention strategies are just not enough to reduce HIV infections required to achieving HIV prevention targets, including ending the HIV epidemic by 2030,” said Midnight Poonkasetwattana, APCOM’s Executive Director. “We have seen that PrEP works very effectively to reduce HIV infection rates, particularly for those key populations that are most at risk, such as young MSM; but awareness about PrEP continues to be low, and a strategic country-level PrEP roll out should be planned wherever possible.”

The World Health Organization (WHO) recommends that PrEP be available as part of national complementary HIV prevention strategies for most at risk populations, including MSM and transgender populations. WHO estimates that the use of PrEP globally could reduce HIV incidence amongst MSM by 20-25%, averting up to 1 million new infections over 10 years. PrEP, however, needs to be integrated with sexual health services such as regular HIV testing, kidney screening, adherence support and screening for sexually transmitted infections (STIs) and side effects.

The findings from the PrEPARING ASIA report are based on discussions from a community-led regional consultation meeting with 129 participants from 23 countries, held in Bangkok, Thailand on 23-25 September 2015. The meeting, organized by APCOM and supported by UNAIDS, WHO, UNICEF, the USAID LINKAGES Project managed by FHI 360 , UNDP and the Multi-Country South Asia Global Fund HIV Programme, the Thai Red Cross Society, Isean HIVOS Program, and Malaysian AIDS Council, demonstrates how the Asian MSM communities, who are the key affected population, can lead the way in finding, programming and implementing effective tools for HIV prevention. MSM community and service organisations are already actively supporting PrEP roll-out in countries like Indonesia, the Philippines, Thailand and Vietnam.

“APCOM’s PrEPARING ASIA meeting underscored the continuing importance of communities in the HIV response. For PrEP to be accessible and successfully implemented in the region, the central role of communities will be key: providing information, raising awareness, creating demand, supporting delivery and adherence and working in partnership with providers to make services inclusive, acceptable and effective,” said Dr Rachel Clare Baggaley, Coordinator HIV Key population & innovative prevention (KPP), World Health Organization.

With the release of the PrEPARING ASIA report and its recommended advocacy and roll-out strategies, including specific roll-out action plans for six countries, there are now more resources and guidance available to assist countries in adding PrEP to their HIV prevention strategies. The results of the PrEPARING ASIA consultations are already beginning to appear.

“The consultation quickly stimulated interest in PrEP in numerous countries. Within weeks of the consultation, FHI 360 received requests from several countries asking how they could start PrEP,” reported Stephen Mills, PhD, MPH, Technical Director, Asia-Pacific Region, FHI 360.

APCOM is confident that the release of the consultation report will even further stimulate interest and action on PrEP as a key HIV prevention tool. Where support is needed, APCOM, along with all of its technical and community partners, can provide any technical assistance necessary to community advocates, HIV policy makers, program planners, community representatives and health workers.

“We need to capitalise on the opportunities offered by PrEP to end HIV by 2030,” urged Mr. Poonkasetwattana. “Let us not miss this chance.”

The full report can be found online at https://www.apcom.org/PrEPARINGASIA