Understanding Better PrEP and its Delivery from Vietnam’s Achievements

By April 10, 2024 SKPA

Dr Tashi Dendup
Sr. Health Program Manager
Save the Children International, Bhutan Office

Pre-exposure prophylaxis (PrEP) has emerged as an effective intervention for HIV prevention. The WHO recommends multiple PrEP options as part of combination prevention approaches. The uptake of PrEP into national guidelines and implementation of PrEP services is gradually increasing in many countries.

In Bhutan, although PrEP is included in the recent national guidelines, it is not yet provided as an intervention formally, especially for high-risk groups. The general awareness of and interest in PrEP currently appears to be low in the country. Bhutan’s response to HIV is geared toward ending the HIV epidemic by 2030 and Bhutan’s Ministry of Health has set the national targets of 95-100-95. The recent allocative efficiency analysis recommends providing PrEP to sex workers and other high-risk groups.

As part of the SKPA-2 Program, Bhutan plans to conduct a demonstration study and gradually roll-out PrEP in the country. To ensure the successful implementation of the demonstration project and scale-up, a team from Bhutan including officials from Bhutan’s National HIV/AIDS Control Program and key population-led organizations undertook a study visit to Vietnam from 4 to 8 March 2024. The learning visit supported through the SKPA-2 program was coordinated by the Lighthouse Social Enterprise of Vietnam. 

Given the significant milestones achieved by Vietnam in the PrEP program, Bhutan sought to explore these successes in depth and gain a comprehensive understanding of Vietnam’s PrEP program. The visit was aimed at learning Vietnam’s successes in rolling out PrEP, community engagement, advocacy, and demand generation.

The delegation had the opportunity to meet with the Director General and officials from the Vietnam Administration of HIV/AIDS Control, where delegates were introduced to the national PrEP strategy and management at different levels of the health system. Subsequent meetings with WHO Vietnam, UNAIDS Vietnam, PEPFAR program partners, and several clinics including those run by community organizations provided a holistic view of the program.

While Vietnam’s PrEP model may not be wholly replicable in Bhutan’s health system – given the differences in context and health systems – the team observed that strategies from Vietnam’s PrEP program were noteworthy. Some of these include the need to conduct targeted sensitization programs to raise awareness of PrEP and dispel prevalent myths immediately, consider diverse communication strategies to increase demand and ensure active and meaningful engagement of the community from the onset. Bhutan will also need to include the provision of adequate affirming information on PrEP as an important strategy that can help increase PrEP uptake and retention. Additionally, Bhutan could consider adopting Vietnam’s One-Stop-Shop model for delivery of HIV and related services by expanding the list of services provided currently. 

This study tour has provided valuable insights into the PreP program and its delivery, and Bhutan needs to tailor its approach to account for local challenges. These learnings and the broader understanding gained through the study visit will surely help take forward PrEP in Bhutan.

 Published on: 08-Apr-2024

About the Contributor

Dr Tashi Dendup

Sr. Health Program Manager
Save the Children International, Bhutan Office

Dr. Tashi Dendup works as a Sr. Health Program Manager with Save the Children Bhutan. He holds a PhD and a master’s degree in public health. Dr. Tashi previously worked for Bhutan’s Ministry of Health for around 10 years. He also worked as a public health consultant providing technical assistance to government and international organizations in Bhutan.

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