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Author: Lao Xianliang
2020-12-01 00:29
Last update date: 2020-12-01 00:29
Today (December 1) is World AIDS Day. There is no cure for this infectious disease and no effective vaccine. However, there has been drug treatment, which makes the infected person undetectable and non-infectious. There is also a preventive drug "PrEP" .
In general, PrEP requires daily medication. Hong Kong only approves the registration of patented drugs. The monthly drug fee is nearly 6,000 yuan. The high price of the drug makes many people go to Thailand to see a doctor and buy drugs.
Gay gay Billy came to Thailand to buy medicines four years ago. The cost of air tickets and hotels is only 500 yuan a month. He criticized the high cost of medicines in Hong Kong and the lack of supporting measures such as physical examinations for overseas buyers.
The Research Center for Infectious Diseases of CUHK has carried out a three-phase study of PrEP since 2017 to explore how to implement PrEP in Hong Kong. Professor Li Ruishan in charge said bluntly that the Hong Kong government's support is far behind other regions. It is hoped that the government will start with testing and education before experimenting. Funding drugs to specific groups of people.
PrEP special report:
AIDS prevention medicine PrEP｜The price of medicines in Hong Kong is high, most people buy medicines in Thailand and return to Hong Kong without support
AIDS prevention drug PrEP | CUHK research indicates that it can help HIV spread in Hong Kong and benefit Thailand's promotion effect
Only Truvada, a registered PrEP patent drug in Hong Kong, costs 188 yuan per pill.
(Photo by Ou Jiale)
The principle of PrEP is to use drugs for the treatment of HIV (AIDS virus) to prevent infection, but it is different from the treatment dose. It needs to be taken for a long time and on a regular basis. The user must be free of HIV infection, otherwise the infected person will develop resistance to the drug. No therapeutic effect.
The price of medicine in Thailand is only 5% in Hong Kong, which is derived from "PrEP tourists"
The PrEP drug "TDF / FTC" was approved for use by the U.S. Food and Drug Administration (FDA) in 2012. The patented drug brand name is "Truvada". It is produced by the pharmaceutical company Gilead Sciences and is priced according to the economic level of different countries or regions. Tablets are 188 yuan, 30 tablets per bottle. Only patented drugs approved for registration in Hong Kong cost nearly 6,000 yuan per month for daily medication, which is not included in the public medical drug list.
The proprietary medicines of the Thai Red Cross or private clinics are about 300 Hong Kong dollars per bottle. There are also sub-factory medicines with slightly different ingredients approved by the Thai government at about 150 Hong Kong dollars per bottle.
Because of the low price of medicines and the low prices of prescriptions to foreigners, Thailand has gradually become a PrEP prescription center in Southeast Asian countries, with a group of "PrEP tourists" from different countries.
Billy has been fighting for gay rights for many years. In 2016, he started to see a doctor in Thailand to buy PrEP.
(Photo by Luo Junhao)
Thailand one-stop service with air ticket is only 500 yuan per month
Billy Leung, an independent translator, has lived in the UK and Canada and has been following PrEP information.
In 2016, I went to the Thai Red Cross Clinic to see a doctor and purchase PrEP for the first time.
“It’s too expensive to buy in Hong Kong. It requires a private doctor’s prescription and a consultation fee. I can’t afford it at 7,000 to 8,000 yuan a month. When I go to Thailand to take medicine for six months, it’s only 3,000 yuan each time I go to Thailand. ."
Billy described Thailand as a "one-stop service." First see a doctor, do a sexual behavior questionnaire, test HIV, liver and kidney function, more than an hour later, the results will be obtained, no problems can get the doctor's prescription drugs.
However, the Thai Red Cross stipulates that drug users who are not resident in Thailand must provide a physical test report of HIV and liver and kidney function every three months to confirm that they are not infected with HIV and have no side effects.
No PrEP supporting test in Hong Kong
He went to Thailand because of the high prices of medicines in Hong Kong, but Billy encountered a lot of trouble even when he returned to Hong Kong.
The comprehensive treatment center of the Department of Health that provides services and treatment to HIV-infected and AIDS patients only has HIV tests and no liver and kidney function tests.
Billy met a doctor familiar with PrEP in a public outpatient clinic. He was soon able to do three types of tests. However, many of his friends were cold-eyed by the doctors and it was difficult to complete the required examinations in one go. "Hong Kong uses the current method to arrange tests. It’s very time-consuming and troublesome to go to different places for testing and write a letter to fetch the report after two weeks."
This year because of the new coronavirus epidemic, countries have closed customs. Like many "PrEP tourists", Billy can no longer go to Thailand to buy medicines. He said that because of the epidemic, he reduced sexual activities and changed his daily medication to on-demand medication. 2+1+1" plan (see separate draft for details).
Only a few people buy medicines at regular prices locally
In the 2017 Hong Kong AIDS Risk and Prevalence Survey of Men Who Have Sex with Men (PRiSM), 3.6% of the respondents who had received HIV testing and did not have a positive result were taking or had taken PrEP.
Among them, 73.2% spend less than 1,000 yuan a month to buy PrEP; 48% get drugs from overseas, followed by local private clinics (26%) and online purchases (22.8%).
In the 2018 "AIDS Prevention Project Indicators Survey" (HARiS), 2,000 men who have sex with men who are receiving services from non-governmental organizations were interviewed. 66.0% had heard of it but had not taken PrEP, and only 20 had taken it. However, the survey data for 2020 is being counted and will be released next year.
"PrEP" is mentioned in the "Hong Kong AIDS Advice Strategy 2017 to 2021" issued by the Advisory Council on AIDS. It points out that it is strongly recommended to conduct an implementation study in Hong Kong to obtain a number of important information, including the most suitable service delivery model, and contact with the target population. Methods, and achievable medication compliance.
Li Ruishan, CUHK Stanley Ho Research Center for Infectious Diseases, has been engaged in AIDS treatment and research for many years.
(Photo by Ou Jiale)
400 people from CUHK participating in research scholars lament Hong Kong's backward support
The Stanley Ho Research Center for Infectious Diseases of the Chinese University has also launched a research plan on PrEP in 2017. It has now entered the implementation research stage, hoping to design a PrEP service model suitable for high-risk individuals. So far, about 400 people have participated in the plan.
Professor Li Ruishan, who is in charge of the plan, has informally estimated that about 2,000 people in Hong Kong take PrEP, and local doctors may only prescribe PrEP for 1 to 2%, and most of the rest are purchased overseas.
He met with scholars in Singapore, Taiwan and other regions a few years ago to discuss the implementation of PrEP. Now other countries have large-scale projects funded by the government or in cooperation with NGOs. However, Hong Kong is still at the university research stage and the progress is far behind other areas.
"The Hong Kong government may be afraid of spending too much money, but in fact, no one wants to eat medicine and food. What can the government do? Don't restrict me to providing PrEP. It must be large-scale. Providing PrEP opinions can also be a good precedent."
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Care AIDS pushes PrEP supporting testing
Since last year, AIDS Care has provided low-cost PrEP testing services before and after taking PrEP, including doctor consultation, HIV, STD and liver and kidney function tests.
Project manager Li Qilong said that about 10% of service users surveyed by his organization are or have been taking PrEP, and the trend is also rising. It is hoped that people who are interested or are taking PrEP will have regular physical examinations.
Li Qilong believes that Hong Kong places more resources on treatment than prevention. "The Department of Social Health provides HIV tests. If you add liver and kidney tests, you can meet the physical examination of people taking PrEP. However, the Hong Kong government can't do it." He felt that reducing HIV infection. It is good for the overall health of Hong Kong in the long run. It also reduces the government’s financial burden. It is worth promoting PrEP.
Li Qilong, the project manager of AIDS Care, feels that the Hong Kong government is worth promoting PrEP, and reducing HIV infection is good for society.
(Photo by Huang Shuhui)
Taiwan subsidizes 1,000 people for affordable medication
The Taiwan government uses PrEP as one of the strategies to prevent AIDS. Although the original price of the patented drug is expensive, it has set up a government-led subsidy program with 1,000 places per year. Sexual partners are HIV-infected and people under 30, 1,000 yuan per month. New Taiwan dollars (approximately 272 Hong Kong dollars), including the cost of medicines, consultation fees and physical examinations.
No support from the Department of Health
However, there is not only no drug subsidy in Hong Kong, but also no physical examination package.
In response to the enquiry of "Hong Kong 01", a spokesperson for the Department of Health stated that the Department of Health is currently adopting the recommendations made in the interim statement issued by the Scientific Committee on AIDS and STDs in December 2016, "In the absence of an effective public Before the health policy, how to balance costs and benefits is one of the issues that must be addressed."
The Department of Health also admitted that its comprehensive treatment center mainly provides one-stop clinical treatment for HIV-infected and AIDS patients, and does not support people who purchase and take pre-exposure prophylaxis by themselves.
PrEP drugs are prescription drugs in Hong Kong and resale is illegal.
(APCOM)
Personal luggage can be brought back to Hong Kong for resale in reasonable quantities
Regarding the legal issue of purchasing drugs overseas, a spokesperson for the Department of Health pointed out that importing requires a permit, but it is exempt from carrying a reasonable amount of drugs for personal use in personal luggage.
Anyone who illegally possesses or sells drugs prescribed by a doctor is an offence, with a maximum fine of $100,000 and imprisonment for two years.
Extended reading "Chemfun series reports":
[Chemfun・1] Sex, methamphetamine, and AIDS are intertwined, people hope to get out of negative labels (with video)
[Chemfun・2] The field trip party explores space scholars: Harm reduction is not "advocacy"
[Chemfun・3] The Children's Groups Association will launch support services to make help seekers no longer alone
01News
[Chemfun・1] Sex, methamphetamine, and AIDS are intertwined, people hope to get out of the negative label
[Chemfun・2] The field trip party explores space scholars: Harm reduction is not "advocacy"
[Chemfun・3] The Children's Groups Association will launch support services to make help seekers no longer alone
AIDS Department of Health