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Author: Lao Xianliang
2020-12-01 08:00
Last update date: 2020-12-01 08:00
The HIV pre-exposure prophylaxis "PrEP" was recommended by the World Health Organization as early as 2014. As one of the important measures for the prevention and treatment of AIDS worldwide, the Chinese University of Hong Kong began researching the implementation of PrEP in Hong Kong in 2017. Up to now 300 to 400 people have participated in the plan.
Professor Li Ruishan, who is in charge of the research, pointed out that the study found that if the price of medicine drops to several hundred yuan a month, most people are willing to afford it. Both daily medication and on-demand medication are equally effective and should be left to users to choose.
The number of newly reported HIV infections in Hong Kong has declined in recent years. Li Ruishan believes that it has benefited from the promotion of PrEP in Southeast Asia. He also believes that the promotion of PrEP in the MSM community is more effective.
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
CUHK is conducting the third phase of the PrEP implementation study and is recruiting participants.
(Photo by Ou Jiale)
Both medication regimens are effective
PrEP is prevented by drugs that treat HIV. It needs to be taken regularly and for a long time. Studies in foreign countries for many years have proven that the drugs are effective.
Li Ruishan, a professor at the Stanley Ho Research Center for Infectious Diseases of CUHK, said: "Closeness is perfect. There are only one or two cases in which it is ineffective, that is, the medication is not used properly according to the guidelines. The second possibility is that you have just been exposed to a drug resistant virus. The possibility is very low, even lower in the Hong Kong environment."
What is an effective medication?
There are two regimens for PrEP. One is to take the medicine daily, which can be protected after seven consecutive days. Li Ruishan reminded, "The daily medicine is taken at the same time every day, not at 7 o'clock in the morning today, 8 o'clock tomorrow night, or 3 o'clock midnight the next day. "Another option is "2+1+1", "Take two pills 2 to 24 hours before sexual activity. If you take two pills at 6 o'clock today, take one pill at 6 o'clock tomorrow, and take one pill at 6 o'clock the next day." ."
Can accept hundreds of dollars a month for medicine
CUHK has conducted research on the use of PrEP in Hong Kong in three phases since 2017.
The first two stages have been completed and the targets are all men who have sex with men.
Li Ruishan, who is in charge of the project, pointed out that the study is not a repeat of foreign pharmacodynamic studies, but the purpose is to explore the feasibility of Hong Kong.
In the first phase of the study, 60 people were recruited. Each person did not need to pay more than 5,000 yuan a month for medicines, but only 700 yuan. After analyzing the compliance of the participants, the conclusion is that most people think that a few hundred yuan a month is acceptable of.
In the second phase of the study, the daily intake and the "2+1+1" regimen were compared, and it was found that the effects of the two regimens were the same, and the two regimens also have their own needs, so users should choose by themselves.
The number of newly reported HIV infections in Hong Kong has declined in recent years. Li Ruishan believes that it has benefited from the promotion of PrEP in Southeast Asia.
(Photo by Ou Jiale)
One person is infected with HIV without taking medication according to the guidelines
Li Ruishan said frankly that the study was divided into two groups. One of the group that first took daily medication and switched to on-demand medication was later infected with HIV. Li Ruishan described it as a painful lesson, "Is medication on demand more dangerous? We analyzed the data and contacted the confirmed person to investigate. We finally determined that he was infected with HIV during the daily medication phase. He also admitted that he had not taken the medication as instructed."
The Hong Kong gay community has been fighting for equality and anti-discrimination for many years.
(Data Picture / Photo by Lin Ruoqin)
Gay community promotion is more effective
The current plan is to carry out the third phase of the implementation research phase. Participants can take three bottles of medicine each time and choose to take the medicine daily or on demand.
Participants have also expanded from men who have sex with men to citizens of different genders.
Li Ruishan pointed out that there are women participating, but the number is very small, and they are not sex workers expected by the general public, which proves that different people have a need for PrEP.
CUHK's research is still recruiting participants, but Li Ruishan admitted that although anyone can participate, it is mainly to cooperate with AIDS and other institutions to identify the most needy people.
In Hong Kong, the HIV infection rate among men who have sex with men is 6.5%. Li thinks that it is more effective to promote PrEP in the gay community. “Don’t say that there is no crisis in sexual contact between men and women. They have a big crisis, but not a crisis. The Internet does not mean that PrEP will help them a lot. Men who have sex with men are in a circle, and PrEP can be implemented."
Benefiting from the promotion of PrEP in surrounding areas, the number of new HIV infections in Hong Kong has shown a downward trend
The Centre for Health Protection announces the number of new HIV infections every month. The number in Hong Kong has declined year after year after peaking in 2015. In 2019, a total of 565 people reported new HIV infections, which was 22% less than the 725 reported cases in 2015; new HIV infections in the first three quarters of this year 395 cases were reported, which was 9% less than the first three quarters of last year.
Comparing the numbers of HIV infections in foreign countries, Li Ruishan pointed out, “In recent years, HIV infections worldwide have declined. Hong Kong’s measures such as promoting U=U (the HIV virus index cannot be detected equals the risk of infection is negligible), encouraging HIV testing and receiving treatment to reduce transmission. Opportunities. On the other hand, although Hong Kong does not have PrEP, the transmission of STDs in Hong Kong has a lot to do with Southeast Asia. There is more and more PrEP in this region, and Hong Kong is also benefiting from this phenomenon."
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STD infection has no obvious change
In some countries or regions that promote PrEP, the number of HIV has decreased, but the number of sexually transmitted diseases such as syphilis has increased, which is related to the sexual behavior of PrEP users who do not use condoms.
However, Li Ruishan pointed out that the Hong Kong study found that STD infections had not increased, and that the condom use habits of participants before and after taking PrEP were significantly different, "depending on each person's original behavior and orientation."
CUHK Stanley Ho Research Center for Infectious Diseases Li Ruishan has been engaged in AIDS treatment and research for many years.
(Photo by Ou Jiale)
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01News
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
[Chemfun・1] Sex, methamphetamine, and AIDS are intertwined, people hope to get out of the negative label
[Chemfun·2] The field trip party discusses 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 Gay Chinese University
