PrEP Implementation in the Asia-Pacific Region: Opportunities, Implementation and Barriers

December 2016 - Combination Prevention

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Zablotska, I., Grulich, A.E., Phanuphak, N., et al. Journal of the International AIDS Society (October 2016), 19(Suppl 6): 21119, doi: 10.7448/IAS.19.7.21119.

This review summarized advances, opportunities, and challenges in implementing pre-exposure prophylaxis (PrEP) in 12 countries in the Asia-Pacific Region. Men who have sex with men (MSM) experience HIV at 5–15 times higher rates than the general population. HIV incidence among female sex workers (FSWs) has decreased, but remains elevated. Prevention interventions for MSM and FSWs, including HIV testing services (HTS), condoms, and needle exchanges, have been largely inadequate. PrEP may be a viable option, given the concentrated epidemic in the region. Awareness of PrEP is generally low, but acceptability is high among those with knowledge of the approach; and PrEP clinical trials and demonstration projects involving MSM and transgender people are underway in several countries. Access to PrEP by key populations is limited by lack of knowledge, education, and availability, or by cost and stigma and discrimination; and use of HTS, which acts as a conduit to PrEP services, is very low among MSM. The World Health Organization has released guidance on administering PrEP among key populations; some countries in the region are developing their own guidance and policy documents. Community advocacy projects in Australia and Thailand are increasing awareness and demand, but further advocacy by communities is required to build awareness of the need for PrEP in the region, especially among MSM and FSWs. 

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