Page 273 - 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

1.1 Background and significance

Thailand is among the countries with highest HIV prevalence in Asia and the Pacific region
with an estimated of 480,000 people living with HIV (PLWH) in 2018 accounting for 9% of the

region’s total HIV infected population [1]. Despite the fact that the prevalence has been declining
over the past decades due to successful early treatment and prevention programs, HIV remains
a significant public health issue of the country. HIV acquisition is disproportionately high among

certain key populations (KPs) including transgender women (TGW), men who have sex with men
(MSM), heterosexual HIV-1 serodiscordant couples, sex workers (SWs), and people who injects

drugs (PWIDs). To achieve the country ambitious goal in stopping AIDs endemic in the country
by 2030, a number of strategies including scale-up screening for early HIV treatment and HIV
prevention are crucial to pave the way for the disease eradication.

HIV Pre-exposure prophylaxis (PrEP) is the use of antiretroviral medications among
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) have

been recommended by the World Health Organization (WHO) for the use as PrEP before potential
HIV risk exposure [2]. In Thailand, PrEP has been implemented as an additional measure for HIV

prevention among key population since 2014. 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.

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