Page 13 - EPREP book

Executive Summary

HIV pre-exposure prophylaxis monitoring and process evaluation for Thailand’s National PrEP
roll-out under the Universal Health Coverage (UHC) for fiscal year 2020

Background and significance

HIV Pre-exposure prophylaxis (PrEP is the use of antiretroviral medications among
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uninfected HIV individuals at high risk to prevent HIV infection. The two antiretroviral drugs
combination of 200 mg emtricitabine (FTC and 300 mg tenofovir disoproxil fumarate (TDF)
)
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have been recommended by the World Health Organization (WHO for the use as PrEP in
HIV/AIDs before potential HIV risk exposure as an additional measure to prevent HIV infections.

In Thailand, PrEP has been implemented as an additional measure for HIV prevention among

key population since 2014. These include men who have sex with men (MSM), transgender
women, HIV-serodiscordant couples, and people who injects drugs (PWIDs). PrEP service in

Thailand can be categorized into three different models include the followings:

1.Facility-based or hospital-based model where PrEP service is provided at local

hospitals. Hospitals that are PrEP service centers would receive direct funding from the
National Health Security Office (NHSO) to run HIV related services including HIV Voluntary

Counselling and Testing (VCT), HIV testing, PrEP and ARV clinics.
2. CBOs reach-recruit to hospitals where staff working under community-based

organizations (CBOs) help in reaching and recruiting potential PrEP clients as well as referring

them to nearby hospitals that are PrEP service centers. PrEP is offered at hospital settings.
3. Key-Population-Led Health Service clinics (KPLHS) where PrEP service is delivered at

KPLHS supported by KP-community health workers (KP-CHWs). This type of service delivery
is available in some provinces in the country.

In 2020, the National Health Security Office (NHSO) launched a pilot project in providing
PrEP service for 2,000 PrEP initiators in 51 PrEP service centers. In this regard, the national

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monitoring and evaluation (M&E framework has been adopted in order to evaluate on this
early implementation. As a part of M&E process, this study aims to evaluate the PrEP services

under this UHC pilot project delivered to identify significant gaps and issues concerning PrEP

cascade and reflect “real world” feasibility of PrEP use as well as issues hindering the retention
in PrEP services among key populations. The findings from this evaluation project would be

รายงานการประเมินผลการด าเนินงาน PrEP ภายใต้ชุดสิทธิประโยชน์สปสช.ปีงบประมาณ 2563[x]