HIV forum urges more PrEP options

[reader]

From Bangkok Post

PrEP medication options for HIV prevention should be diversified to ensure people have more choices to meet their requirements, a recent forum as told.

Nittaya Phanuphak, executive director of the Institute of HIV Research and Innovation (IHRI), said PrEP takers need to have more choices in protecting themselves from contracting HIV/ Aids. While oral PrEP has proved to be effective in HIV prevention, there are certain limitations, as ingesting it orally on a daily basis may prove inconvenient during work hours or if people have a demanding lifestyle.

Furthermore, when prescribing PrEP, a medical checkup -- such as having a blood status check or following up on HIV infections with a doctor -- is required and many people do not have time to visit hospital, she said. As a result, many people take their medicine inconsistently, which leads to a higher risk of HIV/ Aids infection. With inconsistent blood checkups, these people also do not have the chance to know their blood status, she said.

"The options in HIV prevention we have today are limited. Thailand should provide more diversified PrEP options to meet people's lifestyles and their needs, such as investing in injectable PrEPs or exploring other HIV prevention options like intravaginal rings for women.

"Such diversification requires policymakers, funders and the state to help make it happen. They need to consider that such choices must be available and accessible inclusively, and affordable for all,'' she said.

Dr Nittaya spoke to participants during a forum entitled the "Community Forum: From Options to Choice". Held by her office, it was aimed at discussing Pre-Exposure Prophylaxis or PrEP options to ensure more inclusive HIV/Aids prevention and protection for all people in the country.

Targets for getting people to take PrEP pills have fallen short, and other options are not as readily available. PrEP is a medicine that people who do not have HIV can take to prevent themselves from contracting HIV/Aids when they may be at risk of being in contact with the virus.

Thailand has had a national PrEP rollout since 2015, and this medicine is included in the social welfare system, which Thais can access for free. As of now, only the daily oral intake PrEP available is in Thailand; long-acting injectable PrEP like Cabotegravir and Lenacapavir have proven to be more effective and convenient in HIV prevention, but are not available under the healthcare system.

Government Pharmaceutical Organisation (GPO) director of supplies and products, Rachaneekorn Jevprasesphant, said various processes are needed to make a new medicine, including licensing and pricing.

She said that when it comes to the local production of medicines, sourcing ingredients and formula development should be taken into account. Then the GPO has to conduct research, which can take around two years, followed by drugs registration which can take around a year. So, making a drug locally can take three years altogether.

IHRI project manager Rina Chan-amnuaysuk said having various options on offer helps to guarantee people's safety while having sex.

She said Thailand had set the goal of 144,054 PrEP takers by 2022; however, at that time, there were only 31,790 people who had taken PrEP.https://www.bangkokpost.com/thailand/general/2912520/hiv-forum-urges-more-prep-options
 

[reader]

From The Nation

Upholding human rights is key to ending the AIDS pandemic

Ahead of World AIDS Day (1 December), UNAIDS urges leaders to protect the human rights of everyone living with, and at risk of, HIV. Only then can the world meet the goal of ending AIDS as a public health threat by 2030. A new report, “Take the rights path to end AIDS”, notes that despite huge progress made in the HIV response, human rights violations are leading to the denial or limitation of access to HIV services.

“When there is impunity for gender-based violence, when people can be arrested for who they are, when a visit to health services is dangerous for people because of the community they are from—the result is that people are blocked from HIV services that are essential to save their lives and to end the AIDS pandemic,” said Winnie Byanyima, Executive Director of UNAIDS. “To protect everyone’s health, we need to protect everyone’s rights.”

Globally, every minute a person dies due to AIDS. Almost quarter of the estimated 39.9 million people living with HIV are still not accessing life-saving treatment. And in at least 28 countries, new HIV infections are on the rise. It is imperative that HIV prevention, testing and treatment programmes can be reached without fear by all who need them.

The criminalisation and stigmatisation of marginalised communities continue to block access to life-saving HIV services. In the 2021 Political Declaration on Ending HIV and AIDS, countries committed to ensure that by 2025 less than ten per cent of countries have punitive laws and policies and less than ten per cent of people living with HIV (PLHIV) and key populations experience stigma and discrimination. (The key populations are communities at higher risk for HIV, including men who have sex with men, people in prisons and other closed settings, people who use drugs, sex workers and transgender people.)

The Asia Pacific situation

In Asia and the Pacific, there are 17 AIDS-related deaths every hour and a new HIV infection every two minutes. From 2010 to 2023, new infections increased in Bangladesh (20%), Lao PDR (23%), Papua New Guinea (104%), Afghanistan (175%), Fiji (241%) and the Philippines (543%). Four of the six countries worldwide where infections have surged by more than 100% since 2010 are in this region.

“Instead of punishing marginalised communities, governments need to uphold their human rights and ensure they have the specific information and care they require,” said Eamonn Murphy, Regional Director of UNAIDS Asia Pacific and Eastern Europe Central Asia. “The HIV response is at a crossroads. What governments do now will set the trajectory for whether we end AIDS as a public health threat and achieve a sustainable AIDS response, or whether we fail to achieve this and pay a much higher price in terms of human life and financial costs in the future.”

There are legal barriers to the HIV response across Asia Pacific. Twenty countries criminalize HIV transmission, exposure or non-disclosure while 14 restrict the entry, stay or residence of people living with HIV. All but one country, New Zealand, criminalise some aspect of sex work. Seventeen criminalise same-sex relations and 28 criminalise drug possession.

The report features an essay by Dr Adeeba Kamarulzaman, President of Monash University in Malaysia, and former President of the International AIDS Society.

Continues at

https://www.nationthailand.com/blogs/health-wellness/40043762

 

[floridarob]

2 hours ago, reader said:

on a daily basis may prove inconvenient during work hours or if people have a demanding lifestyle.

wait until they get older and have to take blood pressure meds....🙄

[spoon]

 

40 minutes ago, reader said:

From 2010 to 2023, new infections increased in Bangladesh (20%), Lao PDR (23%), Papua New Guinea (104%), Afghanistan (175%), Fiji (241%) and the Philippines (543%)

Scary statistic indeed. I wonder if there is a breakdown of this by year, to see if advance of prep access has reduced the new infection rate.

[VancBCMan]

A recent article in Canada about HIV infections and prevention

Fewer people worldwide are getting HIV — so why are rates going up in Canada?

There were 2,434 new diagnosed cases of HIV in Canada in 2023, a 35% increase from the year before

Fewer people are being diagnosed with and dying of HIV/AIDS around the world. But progress is uneven, and only a few countries are on track to meet global targets set by the United Nations to end HIV as a public health threat by 2030, suggests a new study from The Lancet HIV medical journal.

Between 2010 and 2021, new HIV infections decreased globally by almost 22 per cent, a decline largely driven by the progress in sub-Saharan Africa. But in Canada, the opposite is happening. In 2023, there were 2,434 new diagnoses of HIV here: a 35 per cent increase compared to the year before. The number of new cases had been on the decline between 2016 and 2020. Despite the increase in infections, fewer people are dying of HIV in Canada.

Globally, HIV-related deaths have also declined between 2010 and 2021 by almost 40 per cent, say the authors of the Lancet report, noting that's thanks to antiretroviral treatment — usually a combination of drugs that stop the virus from reproducing. Most people who take the medications daily for a few months have so little virus in their blood it doesn't show up in tests and can't be transmitted to others.

"The biggest takeaway is, progress is possible, but it will require sustained focus," said Austin Carter, a research scientist at the Institute for Health Metrics and Evaluation at the University of Washington and one of the authors of the study.

The most dramatic improvements in both diagnoses and deaths were in sub-Saharan Africa. But the region still leads the world in mortality rates. "Some patients get tested too late, and HIV testing is not free countrywide," said Dr. Gertrude Komoyo, who works with Doctors Without Borders to care for patients with advanced HIV in Bangui, Central African Republic.

'The problem is that we forgot'

Canada is not the only country experiencing increasing HIV infections. It's a pattern other wealthy countries are also seeing, say researchers. 

"The story in high-income countries is that it's challenging to eliminate HIV," said Carter.

He says the numbers reflect a growth in high-risk populations — including men who have sex with men and those who inject drugs — as well as a declining interest in HIV care. 

Almost 40 per cent of the new diagnoses in Canada were after exposure to heterosexual contact; 36 per cent involved exposure to male-to-male sexual contact; 18 per cent involved injection drug use.

"The problem is that we forgot," said Dr. Rejean Thomas, who saw the worst ravages of the AIDS crisis in the 1980s at his clinic in Montreal's Gay Village.

 

Full article here: https://www.cbc.ca/news/health/hiv-infection-rates-canada-1.7397342