Although HIV is not a “gay disease”, HIV transmission is highest among MSM (men who have sex with men), trans and gender non-conforming people.
In 2018, among the 480,000 people in Thailand living with HIV, the highest rate of HIV infection was among adults aged 15-49. Over the years, these numbers have steadily declined, but have not stalled by any means.
However, they can be stalled.
Approved by the FDA (the US’s Food and Drug Administration) in 2012, PReP (Pre–exposure Prophylaxis) is a daily medication that reduces the risk of HIV transmission by up to 99% when taken as prescribed.
PrEP distribution started in Thailand in 2014 through the PrEP-30 scheme program at Thai Red Cross. Here, people could buy Thai-manufactured generic PrEP for THB30 per day. The Tangerine Community Health Center, which is located inside of the Thai Red Cross in Bangkok, distributes PReP for free to transgender Thais.
Since then, the cost has come down to THB400 per month (at Thai Red Cross) and in 2018, the Ministry of Public Health began to scale up PrEP distribution in Thailand to make it nationally available high-risk HIV groups.
“We hope that other countries can learn from Thailand, so that they can move faster. Don’t wait too long. Delayed roll-out of PrEP means more new HIV infections and slower progress to ending AIDS.”Panumard Yarnwaidaskul, Deputy Director-General, Department of Disease Control, Ministry of Public Health
The fact is, HIV prevention is available in Thailand and has been so for years, yet there remains a problem: we’re still not talking about it.
In Thailand, the gay community is aware of PReP, yet there is still confusion about where to get it, how to use it properly and what it actually means if someone is “Negative, on PReP”. This is a designation an individual can choose when listing their HIV status on gay-dating & hookup apps.
According to a doctor at a local HIV clinic, which provides PReP, the issue is stigma- people are slut-shamed for taking it. If they’re taking PReP, it must be because they have a lot of sex with a lot of people and/or that they’re taking PReP, so that they can have the thrill of unprotected sex whenever they want.
Consequently, we’re not talking about the fact that we can eliminate HIV transmission, simply because we’re too busy shaming each other for being proactive about our sexual health.
Suck. Fuck. Test. Repeat.
In addition to decreasing the HIV transmission rate in Thailand, PReP is also driving us towards more openness in discussing sex and our sexual health in general, starting with regular testing.
The Thai Red Cross, like most distributors of PReP, require HIV and syphilis testing every three months to continue prescribing the medication. This is because PReP is only effective for HIV prevention, therefore it is important for everyone taking PReP to get tested regularly. If someone is already HIV-positive, they will be treated with antiretroviral medications (ARVs).
Everybody’s doing “it”
PReP is not a party drug or something to be taken just because you want to have multiple sexual partners. It is a life-saving preventative medication that needs to be talked more about now, not later. Openly, freely and without shame.