From: Bangkok Post
Community-based and non-governmental organisations have easier access to population groups with a higher risk of HIV infection in Thailand and must be encouraged to provide counselling and care to them, academics say.
Speaking at the 18th Bangkok International Symposium on HIV Medicine yesterday, Praphan Phanupak, director of the Thai Red Cross Aids Research Centre, urged for community-based organisations to be allowed to play a greater role in the detection of HIV cases and treatment of infected patients.
During the past two years, Dr Praphan has led a Test and Treat pilot programme in several communities, located in six provinces across the country, and worked with local communities and organisations such as Service Workers in Groups (Swing) and Rainbow Sky.
According to a study, community-based organisations have more luck convincing people with a higher HIV infection risk to get tested and treated if found seropositive.
“They are in a better position to reach and recruit the individuals at risk,” he said, due to their better access and closer, far-reaching ties.
Data suggests that homosexual men, transgenders and sex workers have higher HIV incidence rates than other groups. This incidence rate must be higher than 3% for the population group to be considered as one at risk of Aids infection.
“It’s important to meet the communities where they are and meet their needs,” said Deborah Birx, the Coordinator of the United States Government Activities to Combat HIV/Aids.
People working in civil society groups have better access and know those communities, Ms Birx argues. She says their voice is more important than ever in battling against HIV.
Dr Praphan urged the government to look at how these community-based organisations can be empowered to provide HIV counselling, and if they can be allowed to carry out HIV tests in their centres rather than have people at risk go to a medical facility.
They could even give preventive PrEP (pre-exposure prophylaxis) medicine to certain groups while they engage in high risk behaviours.
The challenge is to find money for these groups so they can play a bigger role, as state regulations currently do not allow them to be funded by the government budget, and ensure they can provide high quality care that draws the public’s confidence.
Community workers, most of whom have already been trained for HIV counselling, must be prepared to conduct tests and administer PrEP medicine, he says.
Dr Praphan also asked if Thailand could give out free PrEP treatment to groups at risk, although it would require a change in the social mindset.
“Some people may think we are spending state budget on people who engage in risky behaviours,” he said, explaining a month’s dose of PrEP costs only between 650 baht and 900 baht.
“Giving out PrEP treatment is a cost-effective way to prevent HIV rather than waiting for people to become infected.”
According to UNAIDS, in 2014 there were 445,642 people living with HIV in Thailand, 7,902 new infections, and 19,390 HIV-related deaths.