The Hong Kong government is interested in making a highly effective HIV prevention drug available at the moment, says the non-government charity AIDS Concern.
The decision comes at a time when over 8,000 people had reported being HIV-positive in Hong Kong for the past 32 years. Last year, the government received 692 new cases of HIV infection, which is the second highest annual record since 1984.
What is this drug?
The drug, known as pre-exposure prophylaxis (PrEP), is a type of antiviral medication that allows the user to build up resistance against HIV (Human Immunodeficiency Virus) if ingested on a daily basis.
When HIV enters a person’s body, it can render the person’s immune system extremely defenceless against even the smallest infection, causing AIDS (Acquired Immune Deficiency Syndrome) if without treatment.
The World Health Organisation (WHO) under United Nations has recommended PrEP to people at high risk of contracting HIV. However, the organisation added that it is still a challenge to make these drugs available outside the clinical trial setting.
According to the report published by WHO, PrEP is a highly effective prevention drug when user strictly adheres to the habit of taking it daily. Most users do not show drug resistance against PrEP, apart from those who already have suffered from undetected, acute HIV infection.
Today, the only commercially available PrEP is a brand of a drug called Truvada, which is manufactured by the pharmaceutical company Gilead Science.
“Truvada is the only HIV treatment which has been put through big medical trials to see whether it works as a prevention treatment… It’s possible that some other treatments may also work as [PrEP], but we don’t yet have the evidence to show that,” said Andrew Chidgey, chief executive of local charity AIDS Concern.
Who should be taking PrEP?
Centers for Disease Control and Prevention (CDC), the leading national public health institution under the Untied States government, recommends PrEP to the following people:
- HIV-negative people who regularly have sex with an HIV-positive partner.
- Heterosexual people who regularly have unprotected sex with people of unknown HIV status.
- Injecting drug user
The statistics from Hong Kong government supports this recommendation. From 1984 to 2016, homosexual men who are ethnically Chinese have the highest HIV-infection rate in Hong Kong, according to the Virtual AIDS Office.
PrEP should not be given to people who are HIV-positive because it is a prevention drug and not a post-infection treatment drug. People must test for their HIV status before being given PrEP and should continue having tests every six months while using it.
When is it coming to Hong Kong?
PrEP is not available in Hong Kong’s public health system at the moment.
“[AIDS Concern] has advocated quite sometimes to the government that PrEP should be made publicly available, but we agree it needs to be introduced carefully,” said Chidgey.
The Advisory Council on AIDS, a government-appointed body that has been addressing the AIDS epidemic for the past 26 years, will be publishing a report this summer which describes its next strategy on HIV prevention.
“We are hoping that [the report] will say positive things about the potential for PrEP intervention in Hong Kong,” said Chidgey, whose organisation had submitted PrEP-related data to the Council. “We have also discussed the possibility of having trials in Hong Kong, and the government officials have been interested,” he added.
The chief executive of AIDS Concern said that if a PrEP program is implemented in Hong Kong, it should be made available through HIV clinical services, namely Kowloon Bay Integrated Treatment Centre, Queen Mary Hospital, and Princess Margaret Hospital.
“I think [PrEP] could be quite game-changing,” said Chidgey.
How to acquire PrEP in Hong Kong?
Today, the public health system does not subsidise HIV prevention methods other than condoms. Most of the funding goes to treatment, which only helps people after they had contracted the virus for life.
According to AIDS Concern, Hong Kong citizens have three options of accessing PrEP:
- Getting a drug prescription from a private doctor after consultation.
- Travelling to Thailand to purchase the drug and transport it back to Hong Kong.
- Buying the drug online.
A PrEP prescription from private doctor costs approximately HK$8,000 to HK$10,000 each month in Hong Kong, which is relatively unaffordable.
While it is legal for citizens to carry PrEP back to Hong Kong from Thailand, there is a limit to how much dosage they can carry.
Currently, the risk of purchasing PrEP online is high as there is no authority to ensure quality control, which puts the buyer at risk of consuming potentially dangerous substances.
Editor: Sara Furxhi
Copy Editor: Vincent Choi
Online: Tan Yu Lynn