As COVID Delays HIV Targets, Experts Emphasize Implementing Effective Prevention Strategies in India

Chennai (Tamil Nadu) / Mumbai (Maharashtra) [India], December 11 (ANI/NewsVoir): As a follow up to the World AIDS Day and to commemorate the Human Rights Day 2020, on December 10, Centre for Sexuality and Health Research and Policy (C-SHaRP) and The Humsafar Trust (HST) hosted a virtual event to understand how far India has come in terms of adopting HIV pre-exposure prophylaxis or PrEP recommended by World Health Organisation (WHO).
The discussion comes at a time when COVID-19 is having a devastating impact on all 17 Sustainable Development Goals (SDGs) and threatening the achievements already made for HIV prevention in the country.
The event focused on Pre-Exposure Prophylaxis (PrEP), a highly effective medicine for preventing HIV and emphasised on the relevance of human health rights - having the right and access to affordable medicines to protect one's health.
Speakers and panellists discussed the current status and way forward on scaling up PrEP programmes in India. Nearly all speakers agreed that there is an urgent need to generate awareness with accurate information and to understand the demand for PrEP - a step to ending global and national goal of ending HIV by 2030. Further, it was highlighted that ending stigma related to HIV and prevention of the virus must be high prioritised.
"PrEP has been shown to be highly effective in protecting against HIV when taken consistently in multiple studies and real-world settings. The keys to optimal PrEP implementation are having clinicians who are knowledgeable about the medications, who can provide culturally competent counseling, and informed consumers, who understand that adherence is the cornerstone of PrEP's benefit. Providers and consumers also need to have a broader understanding of sexual health, since PrEP does not protect against other sexually transmitted infections," said Dr Kenneth H Mayer, Professor, Harvard Medical School, while explaining the best practices on PrEP
WHO and Centers for Disease Control and Prevention, U.S.A have released guidelines on PrEP; however, India is yet to formally release a national PrEP guideline.
"PrEP is an important integrated tool for larger prevention of HIV. I don't know why there should be any reservation to PrEP; which is a medicine-based prevention, if there is no reservation to use of condoms; which is a barrier-based prevention? Private sector is usually quick and innovative in implementing science-based practices as compared the government; which has to consider a lot more issues and sometimes act in knee-jerkism!," said Dr Ishwar Gilada, President, AIDS Society of India, while commenting on the status.
"There are gaps in implementing PrEP which we need to address. We need to look at delivery models; social-behavioral research needs to be done to understand acceptability, adherence and sustainability; community awareness strategies need to be developed, community voices need to be included and demand generation has to be there," said Dr Seema Sahay of Indian Council of Medical Research - National AIDS Research Institute (ICMR-NARI), while expressing the Indian research outlook.
Further, she added that it is essential to be prepared for interruptions such as COVID to ensure delivery is not affected.
Most importantly, voicing the community's needs, Abhishek Desai said, "I think as the conversation around PrEP is opening up in India, my suggestions to policymakers would be to increase accurate information, accessibility and affordability. I would push policymakers to view this from the lens of how do we make this (PrEP) a public conversation whether it is about normalising PrEP just as condoms are today normalised or how do we move this conversation to a broader spectrum who may or may not come under high risk and how to we move this conversation beyond privileged gay men."
In line with other speakers, Dr N. Kumarasamy, Chief and Director of Infectious Diseases Medical Centre VHS added, "India needs Biomedical HIV prevention in the form of PrEP. Science shows this works. Implementing PrEP will facilitate ending HIV in India."
The event was titled 'PrEP-ing India - Update on HIV Pre-exposure Prophylaxis and Way Forward' and was an interactive virtual session for 1.5 hours, with Dr Venkatesan Chakrapani from C-SHaRP and Ms. Shruta Rawat from the Humsafar Trust moderating a vibrant discussion on how PrEP should be accorded more seriousness in the research community as well as in government initiatives in the coming years.
A key consensus from the event was that PrEP be introduced in the national programmes quickly as an option to reduce one's HIV risk and be made accessible to at-risk marginalized communities.
Centre for Sexuality and Health Research and Policy (C-SHaRP) is a not-for-profit research agency and provides technical support to government, non-governmental and community organizations, and multi-/bi-lateral agencies. The organization formulates and evaluates effective, inclusive and community-centred policies and programmes, and conducts research on sexuality, sexual and reproductive health and HIV. It influences national health-related research agenda and health-related policies for marginalised communities in relation to sexuality, sexual and reproductive health, and HIV through community-based collaborative research studies and policy research.

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The Humsafar Trust (HST) was founded in April 1994 to reach out to LGBTQ+ communities in Mumbai Metro and surrounding areas. It currently has offices in Mumbai and Delhi The HIV interventions of HST are supported by National AIDS Control Organization (NACO) and Mumbai District AIDS Control Society (MDACS) to provide health services to over 8500 Men who have sex with men (MSM) and Transgender communities every year through Public Health Care delivery systems, its In-house clinics, and via internet outreach.
HST organizes advocacy workshops for health care provides, law enforcement agencies, judiciary, legislators, politicians and political parties, Government bodies, media, student community to sensitize them on the issues of Gay, bisexual and other MSM, and trans people. On average, HST provides outreach services to over 10000 LGBTQ plus communities in Mumbai alone.
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