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Integrating PrEP

CME

Integrating PrEP in Asia

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: June 09, 2025

Expiration: June 08, 2026

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Gain-Framed Counseling Increased PrEP Uptake Among Transgender Women in Thailand

Next, I will review strategies to improve PrEP delivery for key populations by meeting these people where they are.  

I find that a crucial method to facilitate PrEP discussions and make these conversations easier is to maintain a positive tone while counseling patients from key populations.

One way to do this is with gain-framed counseling. When using gain-framed counseling, HCPs should emphasize the positive gains from using PrEP, namely protection from HIV, and encourage patients to think of taking PrEP as a healthy behavior.4

Gain-Framed Counseling Increased PrEP Uptake Among Transgender Women in Thailand

Gain-framed counseling has shown to increase PrEP uptake among transgender women at the Tangerine Clinic in Thailand, especially for clients who did not perceive HIV risks by themselves.4

Key Population-Led Health Services Fill Gaps in Thailand

Among the most successful models for PrEP delivery in the Asia Pacific region are key population-led health services (KPLS). This delivery service model fills the gaps in conventional medical services by improving accessibility, availability, acceptability, and quality of healthcare.5

KPLS improve accessibility by providing PrEP delivery at hotspots, holding more flexible service hours, and providing 1-stop service.5

Services availability are improved by integrating PrEP with hormone monitoring, STI treatment and prevention, legal consultation, and harm reduction.5

Furthermore, staff members at KPLS are members of the community who provide nonjudgmental, stigma-free services and contribute to a greater feeling of acceptability.5

Finally, KPLS are dedicated to improving quality of sexual healthcare, with trained staff who meet national standards and strong linkage with public-health sectors.5

The success of this model is best illustrated by the increase in PrEP uptake in Thailand. PrEP use more than doubled since the introduction of KPLS, despite COVID-19 challenges. In 2023, approximately 80% of PrEP users in Thailand obtained PrEP from KPLS.6,7

Partnering With Community PrEP Navigators in the Malaysian Public Sector Enhances Access

Another great example of improving PrEP delivery by meeting people where they are is the PrEP Gov project and partnership with community PrEP navigators in Malaysia.

PrEP Gov aims to overcome barriers to PrEP through community engagement and integration with primary healthcare. This includes forming a PrEP navigator network to assist people in managing their PrEP usage and PrEP advocacy to reduce stigma and discrimination against key populations.8-12

The left slide of the slide depicts themany roles of PrEP navigators, and the right side displays other digital resources regarding PrEP delivery and integrated HIV and STI services. 

In which of the following settings do you integrate PrEP counseling?