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PrEP in Taiwan
PrEP Implementation: Examples From Taiwan 

Released: July 07, 2025

Expiration: July 06, 2026

Stephane Wen-Wei Ku
Stephane Wen-Wei Ku, MD
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Key Takeaways
  • Community-led and alternative access models in the Asia-Pacific region can help fill gaps in pre-exposure prophylaxis (PrEP) access.
  • Continued support from the government and public health agencies is key to increasing PrEP uptake and successful PrEP implementation on a wider scale. 

Access to affordable tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) remains a major barrier to pre-exposure prophylaxis (PrEP) scale-up in the Asia-Pacific region. Unlike Thailand and Vietnam, where generic TDF/FTC is available, countries like Taiwan, Singapore, Japan, and South Korea only have brand name TDF/FTC, which is rarely covered by national health insurance schemes. Apart from finding a solution to the cost, the endorsement of public health agencies in the form of national guidelines and policies supporting PrEP use among key populations is also key to successful PrEP implementation.

Taiwan’s Pilot PrEP Project
In 2016, Taiwan Centers for Disease Control (CDC) launched the first government-funded PrEP program in Asia—a pilot PrEP project—aiming to enroll 1000 participants in 5 hospitals. However, the pilot project came to a halt because of opposition by religious conservatives in 2017, resulting in enrollment of less than one third of the target number of participants. The only silver lining is that preliminary results showed an excitingly low HIV seroconversion rate (0.3%) among those enrolled.

Fortunately, to expand PrEP coverage, the Taiwan CDC has implemented scale-up programs since 2018, providing government-funded TDF/FTC to young adults, serodiscordant couples, sex workers, and people with sexualized drug use. The programs were rolled out with integrated sexual health services including HIV self-testing, one-stop testing and treatment, mpox vaccination, and chemsex interventions. Apart from infectious disease specialists, urologists, family medicine doctors, and psychiatrists who work with clients engaging in chemsex were also included as eligible PrEP prescribers in these programs.

This approach seems to help. As of December 2024, approximately 8500 people have enrolled in government-funded PrEP programs at 113 hospitals and clinics throughout Taiwan.

Although PrEP uptake among at-risk populations from CDC-funded programs has gradually increased, the number of users remains relatively low. One barrier to access is the enrollment criteria of these programs. Enforcement of the enrollment criteria means that people who do not meet them cannot get access to affordable PrEP via these programs.

“Out-of-Pocket” PrEP
One alternative source of generic TDF/FTC is the “gray market” on the Internet or pharmacies in the neighboring countries such as Thailand. In many high-income Asian-Pacific countries like Taiwan, these alternative ways to obtain PrEP are used by men who have sex with men who do not have access to generic TDF/FTC.

Other alternative PrEP sources that I have observed are community-based organizations and Taiwanese healthcare professionals providing “assisted PrEP access.” That is, they help clients with necessary laboratory tests before purchasing PrEP online, providing mandatory documents such as prescriptions and diagnosis certificates for importing generic TDF/FTC for personal use, and scheduling clients for regular follow-up appointments to ensure adherence and safety.

These alternate methods of obtaining PrEP certainly help increase uptake, but as it is unclear how many people are obtaining PrEP via these methods, it is difficult to estimate the true scale of current PrEP use in Taiwan. 

The Future
Recently, generic TDF/FTC from Taiwanese and Canadian pharmaceutical companies and long-acting injectable cabotegravir for PrEP have become available in Taiwan, although the cost of both remains high compared with those same drugs from Thailand and India. It is of great interest to the HIV care community how the introduction of generic TDF/FTC will reshape the PrEP market domestically, in addition to how it will affect public health policies in the future. The Taiwan CDC is also considering the addition of cabotegravir to the government-funded PrEP options for cisgender women and transgender populations, pending price negotiations.

Finally, a highly effective, long-acting lenacapavir just received approval from the FDA as a PrEP injectable taken every six months. Following this approval, we truly hope that all stakeholders will work together to make these options more accessible and affordable to facilitate PrEP delivery to those in need in our region.

Your Thoughts
How does your experience with providing PrEP compare with the experience of healthcare professionals in Taiwan? Are there similar barriers and facilitators of PrEP? Leave a comment to join the discussion!

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