amfAR and WHO Support Pilot Study Investigating PrEP in the Philippines

Enrollment has started for a pilot project that brings pre-exposure prophylaxis (PrEP) to the Philippines in an effort to curb the rapid spread of HIV infection among men who have sex with men (MSM) and transgender individuals. The project, known as PrEPPY (PrEP Pilipinas), will evaluate community-based, peer-driven delivery of PrEP services for MSM and transgender women at high risk for HIV in Manila. The Philippines is among the first countries in Asia introducing PrEP -- an HIV prevention drug.
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Project PrEPPY is a multi-agency collaboration led by an international team of experts from government, academia, and multilateral and nongovernmental organizations, including the World Health Organization (WHO) Regional Office for the Western Pacific, the Research Institute for Tropical Medicine (RITM), and LoveYourself, an LGBT community organization based in Manila, with support from amfAR, The Foundation for AIDS Research.��
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"Efforts to address the burgeoning HIV epidemic in the Philippines are inadequate, and there is now an urgent need to take more effective measures to reduce HIV transmission among vulnerable populations," said amfAR CEO Kevin Robert Frost. "We're excited to be a part of this unique partnership in deploying an important tool in our arsenal against HIV, especially among MSM."
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While HIV prevalence in the Philippines is low compared to other countries, it is experiencing a sharp rise among key affected populations and within certain urban areas. The Philippines' Department of Health estimates that the country is seeing approximately 26 newly diagnosed cases of HIV per day, with over 9,264 cases reported in 2016.
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"The HIV epidemic in the Philippines is expanding at an alarming rate. We must explore every option that can prevent further transmission -- PrEP is one promising additional method in our prevention arsenal," said Gundo Weiler, M.D., WHO Country Representative.�
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Eighty-five percent of all new HIV infections are among MSM and men who have sex with men and women. Some of the main factors fueling the HIV epidemic among MSM in the Philippines include social stigma and legal barriers that have previously limited access to condoms and HIV testing and counseling for those under the age of 18.�
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"Current national HIV prevention policies are not tailored to address the specific needs of those who are most vulnerable right now, even though four out of five people with HIV in the Philippines are MSM," said Chris Lagman, Deputy Director of LoveYourself and co-principal investigator of the study.

"We need innovative solutions on how to stop HIV from spreading in our communities, and Project PrePPY will be the country's first major effort to spread awareness about PrEP and how it works, and to encourage MSM to consider using it," added co-principal investigator Rossana Ditangco, M.D., head of the AIDS Study Group at the RITM, Philippines Department of Health.

PrEP is a WHO-recommended prevention intervention whereby HIV-negative individuals at substantial risk for HIV take daily oral antiretroviral drugs. Evidence to date shows that when used properly in tandem with other HIV prevention tools such as condoms and regular counseling and testing, PrEP can reduce the chance of HIV infection among higher-risk individuals by up to 90 percent. It was first approved by the U.S. Food and Drug Administration in 2012 but has yet to be funded by national health or insurance programs in most countries.

A total of 200 HIV-negative MSM and transgender women at risk of infection will be offered free oral PrEP at LoveYourself's two clinics in Metro Manila. The two-year project will include the integration of HIV prevention services, including routine HIV and sexually transmitted infection testing, intensive patient education on PrEP, treatment preparedness and adherence support, as well as peer support.

Results from the pilot study will inform national policies and guidelines on the potential for scale-up and wider implementation of PrEP as an HIV prevention option in the Philippines.

"PrEP is an important additional HIV prevention tool, especially for subgroups of MSM who are at high risk of HIV infection," said Ying-Ru Lo, M.D., Coordinator, HIV, Hepatitis and Sexually Transmitted Infections Unit, Division of Communicable Diseases at WHO Regional Office for the Western Pacific. "The Philippines is among the first countries in Asia to introduce PrEP, showing their commitment to step up HIV prevention for MSM and address the worsening HIV epidemic among MSM in the Philippines."