A patient receives consultant before taking HIV preventive measures in Hà Nội. —VNA/VNS Photo Tạ Nguyên
Hoàng Đình Cảnh, deputy head of Việt Nam Administration of HIV/AIDS Control (VAAC) under the Ministry of Health (MoH), speaks to the press on the ministry’s plan to expand pre-exposure prophylaxis (PrEP) service to all provinces and cities nationwide
Why does Việt Nam want to expand PrEP availability?
As we know that HIV prevalence in Việt Nam has changed in recent years. The rate of HIV infection among injection drug users and female sex workers has decreased while the rate of HIV infection among men who have sex with men (MSM) and transgender women (TGW) is still high, especially in big metropolitan areas. The main cause is unsafe sex in these groups. Given that there is currently no vaccine available, antiretroviral (ARV) drug treatment is considered an effective solution.
PrEP is the preventive treatment for people at high risk of HIV infection.
PrEP has been used by numerous countries for many years. This method doesn’t replace an HIV vaccine but is the simplest way which has been shown to reduce up to 90 per cent of HIV risk among MSM through clinical trials.
The World Health Organisation recommended that PrEP should be supplemented to those at high risk of HIV infection with the combined HIV prevention package.
Acknowledging the effectiveness of HIV prevention of PrEP and the long-term benefits of using ARV to HIV-infected people, the VAAC has piloted the provision of PrEP for MSM and TGW in HCM City. It will provide evidence and information on the feasibility of PrEP’s implementation in Việt Nam.
PrEP is currently provided at 26 provinces and the MoH plans to expand to all cities and all provinces to put an end to the HIV epidemic in the country.
Could you please explain more about PrEP and the benefits of PrEP for people who are not infected with HIV?
PrEP means that a person with a high risk of HIV infection receives antiretroviral drugs (ARV) every day and will be protected from HIV infection.
In Việt Nam, PrEP drugs are offered free through sponsored programmes and projects. It is a combination of two types of drugs - Tenofovir and Emtricitabine. When taken daily, the level of ARV in the blood can prevent the HIV virus from invading or prevent it from replicating in the body.
Studies have shown that PrEP is highly effective in preventing HIV transmission (up to 90 per cent) if taken daily.
Hoàng Đình Cảnh, deputy head of Việt Nam Administration of HIV/AIDS Control under the Ministry of Health. Photo Phunuvietnam.vn
In your opinion, who can use PrEP and who should not use it?
The Ministry of Health has advised the following people use PrEP to prevent HIV transmission: men who have sex with men, transgender women, sex workers, injection drug users and partners of HIV carriers who are not yet treated with ARV or who are on treatment but have more than 200 copies of HIV per millilitre of blood.
Those who cannot use PrEP including HIV-positive, people with signs or symptoms of acute HIV infection, people with kidney problems or those allergic to the drug, and people exposed to HIV in the past 72 hours. Because not all people can use PrEP, it is necessary for a person to be consulted, examined and tested by a doctor before deciding to use it.
What should a person do when they want to use PrEP?
When a person is regularly exposed to high risk of HIV infection such as unsafe sex (not using condoms) and unsafe injecting (sharing needles and syringes), he or she should go to facilities which provide PrEP service.
Then, the doctor will consult to know whether the client is at high risk of HIV infection or not. All personal information of the client is kept confidential. If the client is at high risk, the doctor will ask them to take an HIV test. If they are infected with HIV, they will need HIV/AIDS treatment.
If the client can use PrEP, the doctor will prescribe and guide the usage.
PrEP does not interact with other drugs so it is safe to take them together. Most PrEP users have no serious side effects. However, a small number of people may experience some side effects such as nausea, diarrhoea, dizziness and headache.
Normally, these side effects will stop after one to two weeks. It is necessary to call or see a doctor right away if these symptoms persist and affect the client's activities. — VNS