Last week in Siem Reap, MPact and the International Treatment Preparedness Coalition organized a workshop about mobilizing demand among gay and bisexual men and transgender people for Pre-Exposure Prophylaxis, also known as PrEP. Considered one of the most important scientific breakthroughs of this decade, PrEP is a pill that is safe to use and can prevent HIV with up to 99% efficacy, if taken as directed.
Gay, bisexual and transgender communities from seven countries (Cambodia, Indonesia, Vietnam, Kyrgyzstan, Tajikistan, Ukraine, and Jamaica) came together to learn about PrEP and PrEP progamming within a comprehensive sexual health framework grounded in principles of community empowerment and sex positivity. They developed and received peer feedback on 21 community-led interventions for the roll-out and scale-up of PrEP programs in their regions. A subset of these interventions will receive funding support by MPact and ITPC for pilot-testing in the coming months. The participants went through a highly competitive selection process from a pool of over 180 applicants.
Access to PrEP is incredibly different for people in different parts of the world– some of the participants operate in areas where PrEP is not yet available or legally registered, others had already begun the start-up of PrEP interventions in their countries but were working to get into the hands of more people. However, in all countries, gay and bisexual men and transgender people continue to experience stigma and discrimination in healthcare settings and in some settings, are criminalized and denied basic human rights.
Taking into all these complex layers and factors into account, the workshop asked participants to think critically about how to get PrEP into the hands of key populations and the communities who need it most. Is PrEP accessible? Is it affordable? Is it acceptable? Is it appropriate?
Throughout the week, MPact worked to help bust commonly held myths about PrEP and discussed the basics of PrEP, including approaches for non-daily use and concurrent use with hormones or recreational drugs. The workshop also created a space for challenging frequent arguments from community members, healthcare providers and policy makers that come up in the context of PrEP – that it encourages irresponsible sexual behavior, that its side effects are dangerous and unknown, and that its use can lead to an increase in the acquisition of STIs. These discussions helped ground participants’ understanding in facts and the science that many participants knew their communities had questions about and needed more in-depth information.
In addition to learning the “WHAT” i.e. the basics about PrEP and the building blocks of PrEP programming from start-up to scale-up pertinent to each country context, the workshop gave opportunities to have a rich strategic exchange about the “HOW”. How do we impact the decisions of policy makers? How do we train and sensitize healthcare providers? How can we empower peer educators and outreach workers to get evidence-based information to their communities? How can social media tools and campaigns be used to mobilize queer communities to access accurate information about PrEP and PrEP-related services?
Ultimately, participants took away the key message of the workshop: PrEP is much more than just a pill, neither is it a silver bullet! PrEP is an important sexual health tool within a network of strategies available for queer communities and works best when communities are empowered to take their sexual health back into their own hands — to have pleasurable and informed sex without shame, without stigma, and without fear.