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India Today
2 days ago
- Health
- India Today
From death certificate to marriage certificate: Journey of HIV-positive Indians
Tarun (name changed), a Mumbai resident, was diagnosed HIV-positive and was only given 30 days to live. He defied the prognosis, and has been living with the virus for 23 years now. But back in 2002, the news that someone had tested positive for HIV was nothing short of a death before the virus killed, social rejection and emotional distress killed those with has been leading a near-normal life for 23 years, thanks to advancements in antiretroviral therapy (ART), family support and peer individuals now have a lifespan that is close to that of uninfected people. It is now, more than ever, that they are seeking companionship for the long now 46, is healthy, married, and living what he calls "a full life". His wife, Anushka (name changed), is also HIV-positive. Together, they are parents to a biological daughter, who is HIV-negative, and an adopted must be noted that India had an estimated 23.48 lakh people living with the virus in 2019 – the third-highest burden of HIV in the world – according to a National AIDS Control Organisation (Naco) India Today Digital spoke to said the country today has around 2.5-3 million HIV-positive people, roughly a third of whom fall in the marriage bracket of 21-35 years."Today, more HIV-positive people are getting married compared to a decade ago," Anjali Gopalan, founder and executive director of The Naz Foundation (India) Trust, told India Today Digital."HIV-positive individuals are now even marrying HIV-negative people," said Gopalan, whose organisation has extensively worked with issues related to HIV/AIDS and sexuality for over three MK, advocacy officer with Mumbai-based Humsafar Trust, a support group for people living with HIV (PLHIV), also said that marriages among HIV-positive people are on the rise as compared to a decade HIV-positive individuals, even the way of finding partners is seemingly online matrimony platforms like and have emerged. Matrimony major recently launched a section for HIV-positive brides and experts and HIV-positive individuals told India Today Digital that most people from the community seeking partners do so offline, primarily through annual meet-ups organised by Naco. Experts said even the World Health Organisation (WHO) plays a small role in the the coming up of online matrimonial platforms and Jeevansathi's exclusive section is a signal of a positive shift in India's HIV/AIDS JOURNEY FROM DEATH CERTIFICATE TO MARRIAGE CERTIFICATETarun, a chef returning from a cruise-liner job, was diagnosed with HIV during a routine check-up in and scared, he hid the diagnosis from his mother for nine months. By the time she found out, the doctor had given him 30 days to live. But his mother's support kept him he stuck to medication, a healthier lifestyle and diet, and regular check-ups, Tarun's immunity and outlook improved. He left his job as a chef, fearing a simple kitchen injury could stir a panic about HIV transmission, and took up work at a call centre years passed, he became a peer counsellor day, he was asked to speak with an HIV-positive woman from Raipur who had faced abuse from her in-laws after losing her husband to AIDS. He didn't expect that this woman, by the end of counselling, would become his friend, and ultimately his might have found his life partner by chance while counselling, but most HIV-positive people find their spouses either at meet-ups or the matrimonial sites that have come COUPLES AND SAFE CHILDBIRTHThe journey of Tarun and Anushka, both HIV-positive individuals, helps us understand some of the struggles that such couples marriage, childbirth is where they faced the next big challenge."When we planned to have a baby, many hospitals turned us away because we were both HIV-positive," Tarun said. "The discrimination came from everyone – receptionists, ward boys, nurses, and even doctors."The couple were wrongly told they couldn't have an HIV-negative child."If the mother is HIV-positive, she is placed on lifelong antiretroviral therapy (ART) to suppress the virus to undetectable levels. With proper adherence, this reduces the risk of transmission to the baby to less than 1%," Dr Rashmi Singh, a Delhi-based medicine specialist, told India Today Digital."During childbirth, if the mother's viral load is under control, a vaginal delivery is also considered safe, but just to be sure, most gynaecologists recommend a C-section delivery," she the process after the baby is delivered, Singh said, "After birth, the infant is given preventive medication for several weeks, and is monitored through regular HIV testing up to 18 months of age."In cases where only the father is HIV-positive, Singh added, "Assisted reproductive technologies such as sperm washing followed by intrauterine insemination (IUI) or in vitro fertilisation (IVF) can be used. These methods ensure that the virus is not present in the sperm used for conception, preventing transmission to both the mother and child."MANAGING HIV WITHIN A MARRIAGEHowever, couples with HIV need to be extra careful about unprotected sex even if both are living with the told India Today Digital that he and his wife planned their pregnancy under the close supervision of a gynaecologist, as he cannot have regular unprotected sex despite having his viral load under control. His semen could still affect his wife's CD4 count – a key indicator of immune health in people living with today, with ART, many people can restore and maintain normal CD4 Tarun's case, regular monitoring of both viral load and CD4 count helped guide safe family must also be noted that India's ART programme is one of the world's most cost-effective and accessible. First-line ART medicines can cost around Rs 1,500-Rs 2,000 per month at private institutions, but under Naco, the government provides them free of WITH HIV: BEYOND THE VIRAL LOADDespite being cost-effective today and offering a high chance of leading a normal life, living with HIV within a relationship still comes with its own set of emotional and practical serodiscordant couples, where only one partner is HIV-positive, the HIV-negative partner may have to make certain adjustments, especially around trust and physical intimacy, such as barely being able to have unprotected sex, and other lifestyle adjustments involving Foundation's Anjali Gopalan said, "When there is openness and honesty about one's HIV status, many couples are able to make it work. With the right support and counselling, people often choose to focus on the relationship and the bond they share, rather than the condition."Finding a partner, however, remains one of the biggest MK of the Humsafar Trust points out, "Most people living with HIV try to find a partner who is also HIV positive. Though marriage rates have improved, the success rate at community HIV melawas (fair, in Marathi) is still just 1-2%."Melawas are the Naco-organised community meet-ups held in Maharashtra. Similar meet-ups, known by different local names, are held annually in cities across India. Experts say these are typically low-key events, drawing around 100–150 attendees now married and actively involved in the HIV-positive community as a counsellor, says he attends the melawa across Maharashtra, to connect with others and offer common way people intending to get married meet is through word-of-mouth, especially via counsellors who interact with people living with HIV and often pass along information when they hear someone is looking for a partner."I have helped four couples get married by informally playing matchmaker," Tarun told India Today who has attended nearly every community meet-up in Maharashtra in the past several years, said, "Around 80% of those who turn up at these events are men. This gender disparity is one of the reasons why the success rate of melawas leading to marriage remains so low."Both Sumi MK and Tarun noted that even older individuals seek companionship and long-term relationships are often spotted at the community meet-ups. Online HIV matrimony portals offer some hope, but their reach is seemingly who helps facilitate such meet-ups, says, "Many people come from underprivileged backgrounds and aren't tech-savvy enough to maintain a profile. The emotional toll of living with HIV also means many don't always stay active on these platforms."Other social factors persist as well."Even within the HIV-positive community, people often seek partners from the same caste," Tarun added. "I once introduced two individuals from the Patil community, but the girl's parents insisted on the same sub-caste, and the match fell through."While stigma and practical hurdles remain, the journey of people living with HIV is no longer defined by fear or isolation. With stronger treatment options, growing awareness, and supportive communities, HIV-positive individuals are reclaiming their right to live, and love.- EndsMust Watch advertisement
Mail & Guardian
16-07-2025
- Health
- Mail & Guardian
SA gets R520 million to buy the twice-a-year anti-HIV jab – but there's a snag
Research indicates the anti-HIV jab, lenacapavir, protects women completely and works almost as well for men, transgender and nonbinary people. Photo: Marko Milivojevic/Pixnio South Africa has accepted an offer of just over $29 million (about R520 million) from the Global Fund to Fight Aids, TB and Malaria to buy the twice-a-year anti-HIV jab, lenacapavir, But there's a snag. The country isn't getting extra money from the fund to buy the medicine; it has to use cash from a grant that it has already been awarded and that was cut by 16% in June. Moreover, the fund, at this stage, won't tell the health department — or any of the other eight countries it has selected for early roll-out — how much they're paying lenacapavir's maker, Boitumelo Semete-Makokotlela, the chief executive of the country's medicine regulator, Bhekisisa it is aiming to have lenacapavir registered in South Africa before the end of the year. According to the health department's head of procurement, Khadija Jamaloodien, the lenacapavir funds from the Global Fund will become available in October, when the roll-out period of South Africa's next grant, known as Grant Cycle 7, kicks in. But roll-out — probably in early 2026 — can only start once Sahpra has registered the medicine, the country's essential medicines list committee has reviewed and recommended lenacapavir, procurement processes are in place and health workers and clinics have all they need to hand the drug safely to patients. Two studies released last year showed the medicine In fact, Ending Aids as a public health threat means reaching a stage where fewer people are getting newly infected with HIV than the number of people with HIV who are dying (increasingly for other reasons than HIV, for example old age). According to the The Global Fund money for South Africa is, however, not nearly enough to put two to four million people a year in South Africa on the lenacapavir jab (see price explanation below) — and even if it was, the country's health system won't be able to roll the medicine out that fast, scientists and policymakers say. Will the US help to pay for the jab? The fund's offer follows the body's announcement on July 9, that it has the 'ambition' to finance enough lenacapavir for two million HIV-negative people — in the low- and middle-income countries it supports — over the next three years. But fulfilling this ambition The US government's Aids fund, Pepfar, And, although some activists say it's still possible for the US administration to come on board (lenacapavir is The Global Fund's offer, however, is a way to get branded, 'bridging' doses from Gilead to South Africa while the world waits for cheaper generics to become available around 2027. 'We now stand at a moment of reckoning and a moment of choice,' Mitchell Warren, the executive director of the international advocacy organisation, Avac, told Bhekisisa at the 'While a lot of the choices over the last six months have been made by an American politician [Donald Trump] who doesn't care about the pandemic or science generally, our choice is to make decisions based on the science that we all now know. Which is that lenacapavir is our most potent opportunity.' Countries have to budget just under R600 per dose Jamaloodien, however, cautions further discussions with the Global Fund and Gilead will be needed about the governance around the pricing of the product. 'We have a transparent pricing system, guided by the In a Global Fund letter sent in early July to the nine early roll-out countries — South Africa, Zimbabwe, Eswatini, Lesotho, Zambia, Mozambique, Kenya, Uganda and Nigeria — the fund asked the governments to budget for $60 (about R1 076) per patient a year ($30, or R576, per six-monthly dose), to buy lenacapavir. But in the document, which Bhekisisa has seen, the fund makes it clear that the amount 'reflects the country contribution only, to be used for budgeting purposes, and should not be considered the product price'. Jamaloodien has confirmed that the health department did receive such a letter. The letter also states that the gap between the price that the fund pays Gilead per patient a year and the $60 that countries will pay for with their Global Fund grants, will be covered by private sector funding, which Bhekisisa will be paid for by a $150 million (about R2.68 billion) donation of the UK-based Furthermore, says Jamaloodien, South Africa's letter instructs the country to submit its first order, for planning purposes, by 30 September under an 'agreed procurement mechanism'. Why does Gilead not want to talk about LEN's price? Lenacapavir, also referred to as LEN for short, was registered for HIV prevention — also called PrEP — by the US medicines regulator, the Food and Drug Administration The US is the only country in which LEN has been registered so far as PrEP. For low- and middle-income countries such as South Africa, Gilead said it will have a 'not-for-profit' price such as the one they negotiated with the Global Fund, but isn't allowing the fund to make it public. Several scientists and activists at the HIV science conference, have, however, told Bhekisisa the rumoured not-for-profit price that Gilead has negotiated with the Global Fund is $100 per person a year, and Avac, But neither Gilead or the Global Fund have confirmed this amount. If South Africa budgets for $60 per person a year, the $29.2-million that Global Fund says we can use to buy lenacapavir, translates to putting and keeping about 400 000 people on the medicine over three years (Global Fund grants run for three years at a time). Gilead argues because the not-for-profit price is based on the actual cost of making lenacapavir, and shipping it to countries, it can't declare that cost. 'Gilead doesn't publicly disclose manufacturing costs for any of our medications,' Caroline Almeida, Gilead's head of public affairs, told Bhekisisa in Kigali. But activists don't buy this argument. 'Gilead's secrecy will obstruct civil society activism for lower drug prices and keep prices high in middle-income countries [such as South Africa] where Gilead negotiates prices directly,' the Avac has identified 16 top lenacapavir markets, of which South Africa is — by far — the largest because of the country's high number of new HIV infections. The country's And But for LEN to be affordable, activists argue, Gilead needs to be open about its price. 'Such secrecy undermines the power of buyers to negotiate affordable prices and violates the human rights of all people to access information and lifesaving tools,' activists said in Warren concludes: 'Pricing transparency has been a long-standing challenge, as companies try to balance their commercial pricing and marketing strategies with their global public health strategies. We clearly need a new model or compact for pricing that helps break the cycle of small thinking and limited impact.' This story was produced by the . 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TimesLIVE
16-07-2025
- Health
- TimesLIVE
SA gets R520m to buy the twice-a-year anti-HIV jab — but there's a snag
South Africa has accepted an offer of just over $29m (about R520m) from the Global Fund to Fight Aids, TB and Malaria to buy the twice-a-year anti-HIV jab, lenacapavir, that research shows could help to end Aids in the country, says health department spokesperson Foster Mohale. But there's a snag. The country isn't getting extra money from the fund to buy the medicine; it has to use cash from a grant that it has already been awarded and that was cut by 16% in June. Moreover, the fund, at this stage, won't tell the health department — or any of the other eight countries it has selected for early rollout — how much they're paying lenacapavir's maker, Gilead Sciences, for the product. Boitumelo Semete-Makokotlela, the CEO of the country's medicine regulator, the South African Health Products Regulatory Authority (Sahpra), told Bhekisisa it aims to have lenacapavir registered in South Africa before the end of the year. According to the health department's head of procurement, Khadija Jamaloodien, the lenacapavir funds from the Global Fund will become available in October, when the rollout period of South Africa's next grant, known as Grant Cycle 7, kicks in. But rollout — likely in early 2026 — can only start once Sahpra has registered the medicine, the country's essential medicines list committee has reviewed and recommended lenacapavir, procurement processes are in place and health workers and clinics have all they need to hand the drug safely to patients. Two studies released last year showed the medicine completely protects young women from contracting the virus and works almost as well for men, transgender and gender-nonbinary people. In fact, a modelling study shows that if between two and four million HIV-negative people in South Africa use the jab every year over the next eight years, the medication could end Aids as a public health threat by 2032. Ending Aids as a public health threat means reaching a stage where fewer people are getting newly infected with HIV than the number of people with HIV who are dying (increasingly for other reasons than HIV, for example old age). According to the latest Joint United Nations Programme on HIV and Aids (UNAids) report, which was released last week, 170,000 people got newly infected with HIV in 2024, while there were 53,000 Aids-related deaths. The Global Fund money for South Africa is, however, not nearly enough to put two to four million people per year in South Africa on the lenacapavir jab — and even if it was, the country's health system won't be able to roll the medicine out that fast, scientists and policymakers say. Will the US help to pay for the jab? The fund's offer follows the body's announcement on July 9, that it has the 'ambition' to finance enough lenacapavir for two million HIV-negative people — in the low- and middle-income countries it supports — over the next three years. But fulfilling this ambition will depend on whether the governments of wealthy countries give enough money to the Fund in its next replenishment round. The US government's Aids fund, Pepfar, was originally going to help to pay to roll out lenacapavir in poorer countries. And, though some activists say it's still possible for the US administration to come on board (lenacapavir is mentioned in President Donald Trump's budget proposal for the next financial year, but is understood to be only for pregnant and breastfeeding women), it's not clear at all how this might happen after the Trump administration's drastic cuts to funding for HIV projects in countries including South Africa this year. The Global Fund's offer, however, is a way to get branded, 'bridging' doses from Gilead to South Africa while the world waits for cheaper generics to become available around 2027. 'We now stand at a moment of reckoning and a moment of choice,' Mitchell Warren, the executive director of the international advocacy organisation, Avac, told Bhekisisa at the 13th conference on HIV science in Kigali this week. 'While a lot of the choices over the last six months have been made by an American politician [Donald Trump] who doesn't care about the pandemic or science generally, our choice is to make decisions based on the science that we all now know. Which is that lenacapavir is our most potent opportunity.' Countries have to budget just under R600 per dose Jamaloodien, however, cautions further discussions with the Global Fund and Gilead will be needed about the governance around the pricing of the product. 'We have a transparent pricing system, guided by the Public Finance Management Act. Even if we procure medicine with Global Fund money, we have to follow the same rules that the Treasury requires us to follow with tenders, which includes revealing the price at which the medicine is bought,' Jamaloodien says.
Scoop
07-07-2025
- Health
- Scoop
Cambodia Is 2nd Asian Country To Rollout Long-Acting Injectable HIV Prevention Option
Press Release – CNS In Cambodia, the first two long-acting and injectable cabotegravir PrEP doses were given to a female sex worker and a transgender person, said Patricia Ongpin, UNAIDS Country Director for Cambodia, Lao PDR and Malaysia. After Thailand, Cambodia becomes the second Asian country to rollout long-acting and injectable options to protect oneself from getting infected with HIV. United Nations health agency (formally known as World Health Organization or WHO) had first issued its guidelines in 2022, asking countries to deliver long-acting injectable Pre-Exposure Prophylaxis (PrEP), using cabotegravir medicine, as part of comprehensive approach to HIV prevention. PrEP is a medicine for HIV-negative people to reduce their risk of getting infected. According to the WHO, long-acting injectable cabotegravir PrEP is a safe and highly effective prevention option for people at substantial risk of HIV infection. In Cambodia, the first two long-acting and injectable cabotegravir PrEP doses were given to a female sex worker and a transgender person, said Patricia Ongpin, UNAIDS Country Director for Cambodia, Lao PDR and Malaysia. Know more about long-acting injectable cabotegravir PrEP Long-acting injectable cabotegravir PrEP is an intramuscular injectable, long-acting form of PrEP. * First 2 injections are administered 4 weeks apart * Followed thereafter by an injection once every 8 weeks. This long-acting injectable PrEP with cabotegravir (CAB- LA) has shown in scientific studies to be safe and highly effective among cisgender women, cisgender men who have sex with men, and transgender women who have sex with men (studies include two randomised controlled trials, HPTN 083 and HPTN 084). These studies found that use of long-acting CAB-LA PrEP, resulted in a 79% relative reduction in HIV risk compared with oral PrEP, where adherence to taking daily oral medication was often a challenge. WHO clearly states that both daily oral PrEP and long-acting injectable PrEP are highly effective. Choice matters Expanding the range of science- and evidence-based HIV prevention options, so that people can choose what works best for them, is very important if we are to empower people towards health seeking behaviour, as well as progress faster towards ending AIDS, she said. 'Evidence is very clear on what works in HIV prevention. But what we need to know is that one size does not fit all. So we really have to understand that a combination of HIV prevention options must be made available in the market for people to choose from – based on their daily life, personal choice, and what they are comfortable with,' said Patricia Ongpin, in an exclusive interview given to CNS in the lead up to 13th International AIDS Society Conference on HIV Science (IAS 2025) – the largest global gathering on HIV science this year. She was also a speaker at IAS 2025 Affiliated Independent Event on the theme: 'Strengthening competencies and capacities in Global South to end AIDS, end TB, and deliver on SDGs.' 'Cambodia is a leader in the HIV response for many reasons. It currently has an HIV prevalence among the general adult population of 0.5%. In 2024, it was estimated that there were 76,000 people living with HIV, 1200 new infections (which roughly translates to 3 new HIV infections a day) and 1000 AIDS related deaths that year in Cambodia,' said Patricia. 'This represents roughly a 45% reduction in new HIV infections as compared to 2010.' Nepal is the only country in Asia Pacific region (and among 4 in the world) to record a decline of over 75% in new HIV infections since 2010, said Eamonn Murphy, UNAIDS Director for Asia Pacific at the 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025). Cambodia on track to achieve 95-95-95 targets for 2025 95-95-95 targets for 2025 refer to ensuring that at least 95% of people living with HIV know their HIV-positive status, 95% of those who know their status are receiving lifesaving antiretroviral therapy, and 95% of those on therapy are virally suppressed. According to WHO, those people with HIV who remain virally suppressed have ZERO risk of transmitting HIV to anyone else. So, HIV treatment also works as prevention. Not just rich nations like New Zealand, but also low- and middle-income countries like Nepal, Cambodia and Thailand in Asia and the Pacific region are meeting some of the 2025 HIV-related targets. 'Cambodia is on track to achieve the 95-95-95 HIV-related targets. In 2024, Cambodia had 92% of all people living with HIV who knew their status. Nearly 100% of all those who knew their HIV positive status were on lifesaving antiretroviral treatment, and 98% of those on treatment were virally suppressed. So, this is a fantastic achievement and we are really hoping that Cambodia can achieve the 95-95-95 targets on time for 2025,' said UNAIDS' Patricia Ongpin to CNS (Citizen News Service). She added: 'This is a very strong health response in Cambodia. and it also reflects its strong political commitment, community-led response, and adoption of innovations. But it is not just a health response, it is essentially a multi-sectoral response from Cambodia. This includes provision of social protection for people living with HIV and female entertainment workers, to social protection schemes that allow them access to free healthcare and covers their other out-of-pocket expenses or reimbursements.' Patricia was referring to Health Equity Funds in Cambodia – a social health protection government scheme designed to enable poor people to access free healthcare at public facilities. They aim to improve access to healthcare and reduce financial burdens, particularly for those most vulnerable. 'So, a holistic approach in Cambodia's HIV response has helped the country to become a leader in achieving the 95-95-95 HIV-related targets for 2025, in the hope that it can indeed end AIDS soon after,' said Patricia. 1st ever rollout of long-acting injectable PrEP in Cambodia Patricia shared that long-acting injectable cabotegravir PrEP was launched in the second half of June 2025 in Cambodia. 'A feasibility and acceptability research study was done last year in consultations with communities, so that we can know how will it be perceived by the people who are intended to use it. The government is working hand-in-hand with civil society organisations and communities so that there is more demand generation for long-acting injectable cabotegravir PrEP, and also to stem other challenges like hesitancy etc.' She had a meeting with Cambodian Director of HIV programmes and learnt that the uptake of long-acting injectable cabotegravir PrEP is 'pretty good right now, where we have both: people who are switching from oral PrEP to long-acting injectable PrEP, and also new initiation of PrEP in general.' One dose of long-acting injectable cabotegravir PrEP costs US$36 Thanks to the Global Fund to fight AIDS, TB and Malaria (The Global Fund), long-acting injectable cabotegravir has become possible for eligible people in Cambodia. Treatment for people living with HIV is lifesaving and revolutionary as it has made HIV akin to any other chronic disease. It has been proven that those who are on treatment and remain virally suppressed, live healthy and normal lifespans – comparable to those without the virus – and there is zero risk of any further HIV transmission from them. But oral HIV treatment has to be taken daily without fail. This could be challenging given the fact that HIV treatment is lifelong. Long-acting injectable cabotegravir along with Rilpivirine (CAB/RPV LA) is also available as treatment for people living with HIV who have suppressed viral load (once every two months). But it is not yet rolled out in Cambodia yet. Dapivirine vaginal rings in Cambodia: next breaking news? 'Right now, we have cabotegravir as a PrEP (HIV prevention option), injected once every two months. However, it is likely that soon Cambodia may rollout dapivirine vaginal rings for HIV prevention,' said Patricia of UNAIDS. Dapivirine vaginal ring (developed by International Partnership for Microbicides and acquired by Population Council), is the world's first female-controlled, long-acting, non-systemic, microbicide product that substantially reduces the risk of getting infected with HIV. Thus, it is also referred to as a PrEP ring. The dapivirine vaginal ring is a flexible silicon ring that slowly releases the HIV prevention drug dapivirine into the target cells and substantially reduces the risk of her getting infected with HIV. Any HIV-negative woman, who is at risk of acquiring the infection, can herself put the ring in her vagina, leave it in place for a specified period and then replace it by herself. Patricia informs that Cambodian government began considering dapivirine vaginal rings and long-acting injectable cabotegravir, roughly at the same time. 'So, Cambodia is in the final process of settling down the standard operating procedures (SOPs) and training. We are hoping that in the next month or two, dapivirine vaginal ring will also be added to the range of combination HIV prevention options people can choose from. We hope this would reduce the number of new HIV infections in Cambodia.' Public health warrants infection prevention but would we sustain it? UNAIDS' Patricia Ongpin puts the spotlight on sustainability of HIV prevention as well as global AIDS response in context of competing priorities. 'It is a real issue,' she rightly points out. She calls on governments to have optimal political commitment which should match the services, legal reforms and policy harmonisation, policy framework, health and development financing, and systematic integration which are critical if we are to end AIDS by 2030. 'Multi-sectoral approach towards ending AIDS is key,' she said. Health financing varies between countries. For example, Malaysia has almost all (99%) of its HIV response domestically-funded, whereas Cambodia has roughly 36%, informs Patricia. IAS 2025 message of UNAIDS' Patricia Ongpin 'HIV is not over and we need to stand together in solidarity to support governments, communities, and development partners in making sure that HIV responses stay alive,' said Patricia. She called for ensuring effective collaboration between different partners, such as governments, communities and development partners – so that not only innovative financing can be fully harnessed, but we are also able to rollout all combination HIV prevention options along with other critical cog-in-the-wheels to end AIDS by 2030. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
Scoop
06-07-2025
- Health
- Scoop
Cambodia Is 2nd Asian Country To Rollout Long-Acting Injectable HIV Prevention Option
After Thailand, Cambodia becomes the second Asian country to rollout long-acting and injectable options to protect oneself from getting infected with HIV. United Nations health agency (formally known as World Health Organization or WHO) had first issued its guidelines in 2022, asking countries to deliver long-acting injectable Pre-Exposure Prophylaxis (PrEP), using cabotegravir medicine, as part of comprehensive approach to HIV prevention. PrEP is a medicine for HIV-negative people to reduce their risk of getting infected. According to the WHO, long-acting injectable cabotegravir PrEP is a safe and highly effective prevention option for people at substantial risk of HIV infection. In Cambodia, the first two long-acting and injectable cabotegravir PrEP doses were given to a female sex worker and a transgender person, said Patricia Ongpin, UNAIDS Country Director for Cambodia, Lao PDR and Malaysia. Know more about long-acting injectable cabotegravir PrEP Long-acting injectable cabotegravir PrEP is an intramuscular injectable, long-acting form of PrEP. * First 2 injections are administered 4 weeks apart * Followed thereafter by an injection once every 8 weeks. This long-acting injectable PrEP with cabotegravir (CAB- LA) has shown in scientific studies to be safe and highly effective among cisgender women, cisgender men who have sex with men, and transgender women who have sex with men (studies include two randomised controlled trials, HPTN 083 and HPTN 084). These studies found that use of long-acting CAB-LA PrEP, resulted in a 79% relative reduction in HIV risk compared with oral PrEP, where adherence to taking daily oral medication was often a challenge. WHO clearly states that both daily oral PrEP and long-acting injectable PrEP are highly effective. Choice matters Expanding the range of science- and evidence-based HIV prevention options, so that people can choose what works best for them, is very important if we are to empower people towards health seeking behaviour, as well as progress faster towards ending AIDS, she said. "Evidence is very clear on what works in HIV prevention. But what we need to know is that one size does not fit all. So we really have to understand that a combination of HIV prevention options must be made available in the market for people to choose from - based on their daily life, personal choice, and what they are comfortable with," said Patricia Ongpin, in an exclusive interview given to CNS in the lead up to 13th International AIDS Society Conference on HIV Science (IAS 2025) - the largest global gathering on HIV science this year. She was also a speaker at IAS 2025 Affiliated Independent Event on the theme: "Strengthening competencies and capacities in Global South to end AIDS, end TB, and deliver on SDGs." "Cambodia is a leader in the HIV response for many reasons. It currently has an HIV prevalence among the general adult population of 0.5%. In 2024, it was estimated that there were 76,000 people living with HIV, 1200 new infections (which roughly translates to 3 new HIV infections a day) and 1000 AIDS related deaths that year in Cambodia," said Patricia. "This represents roughly a 45% reduction in new HIV infections as compared to 2010." Nepal is the only country in Asia Pacific region (and among 4 in the world) to record a decline of over 75% in new HIV infections since 2010, said Eamonn Murphy, UNAIDS Director for Asia Pacific at the 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025). Cambodia on track to achieve 95-95-95 targets for 2025 95-95-95 targets for 2025 refer to ensuring that at least 95% of people living with HIV know their HIV-positive status, 95% of those who know their status are receiving lifesaving antiretroviral therapy, and 95% of those on therapy are virally suppressed. According to WHO, those people with HIV who remain virally suppressed have ZERO risk of transmitting HIV to anyone else. So, HIV treatment also works as prevention. Not just rich nations like New Zealand, but also low- and middle-income countries like Nepal, Cambodia and Thailand in Asia and the Pacific region are meeting some of the 2025 HIV-related targets. "Cambodia is on track to achieve the 95-95-95 HIV-related targets. In 2024, Cambodia had 92% of all people living with HIV who knew their status. Nearly 100% of all those who knew their HIV positive status were on lifesaving antiretroviral treatment, and 98% of those on treatment were virally suppressed. So, this is a fantastic achievement and we are really hoping that Cambodia can achieve the 95-95-95 targets on time for 2025," said UNAIDS' Patricia Ongpin to CNS (Citizen News Service). She added: "This is a very strong health response in Cambodia. and it also reflects its strong political commitment, community-led response, and adoption of innovations. But it is not just a health response, it is essentially a multi-sectoral response from Cambodia. This includes provision of social protection for people living with HIV and female entertainment workers, to social protection schemes that allow them access to free healthcare and covers their other out-of-pocket expenses or reimbursements." Patricia was referring to Health Equity Funds in Cambodia - a social health protection government scheme designed to enable poor people to access free healthcare at public facilities. They aim to improve access to healthcare and reduce financial burdens, particularly for those most vulnerable. "So, a holistic approach in Cambodia's HIV response has helped the country to become a leader in achieving the 95-95-95 HIV-related targets for 2025, in the hope that it can indeed end AIDS soon after," said Patricia. 1st ever rollout of long-acting injectable PrEP in Cambodia Patricia shared that long-acting injectable cabotegravir PrEP was launched in the second half of June 2025 in Cambodia. "A feasibility and acceptability research study was done last year in consultations with communities, so that we can know how will it be perceived by the people who are intended to use it. The government is working hand-in-hand with civil society organisations and communities so that there is more demand generation for long-acting injectable cabotegravir PrEP, and also to stem other challenges like hesitancy etc." She had a meeting with Cambodian Director of HIV programmes and learnt that the uptake of long-acting injectable cabotegravir PrEP is "pretty good right now, where we have both: people who are switching from oral PrEP to long-acting injectable PrEP, and also new initiation of PrEP in general." One dose of long-acting injectable cabotegravir PrEP costs US$36 Thanks to the Global Fund to fight AIDS, TB and Malaria (The Global Fund), long-acting injectable cabotegravir has become possible for eligible people in Cambodia. Treatment for people living with HIV is lifesaving and revolutionary as it has made HIV akin to any other chronic disease. It has been proven that those who are on treatment and remain virally suppressed, live healthy and normal lifespans - comparable to those without the virus – and there is zero risk of any further HIV transmission from them. But oral HIV treatment has to be taken daily without fail. This could be challenging given the fact that HIV treatment is lifelong. Long-acting injectable cabotegravir along with Rilpivirine (CAB/RPV LA) is also available as treatment for people living with HIV who have suppressed viral load (once every two months). But it is not yet rolled out in Cambodia yet. Dapivirine vaginal rings in Cambodia: next breaking news? "Right now, we have cabotegravir as a PrEP (HIV prevention option), injected once every two months. However, it is likely that soon Cambodia may rollout dapivirine vaginal rings for HIV prevention," said Patricia of UNAIDS. Dapivirine vaginal ring (developed by International Partnership for Microbicides and acquired by Population Council), is the world's first female-controlled, long-acting, non-systemic, microbicide product that substantially reduces the risk of getting infected with HIV. Thus, it is also referred to as a PrEP ring. The dapivirine vaginal ring is a flexible silicon ring that slowly releases the HIV prevention drug dapivirine into the target cells and substantially reduces the risk of her getting infected with HIV. Any HIV-negative woman, who is at risk of acquiring the infection, can herself put the ring in her vagina, leave it in place for a specified period and then replace it by herself. Patricia informs that Cambodian government began considering dapivirine vaginal rings and long-acting injectable cabotegravir, roughly at the same time. "So, Cambodia is in the final process of settling down the standard operating procedures (SOPs) and training. We are hoping that in the next month or two, dapivirine vaginal ring will also be added to the range of combination HIV prevention options people can choose from. We hope this would reduce the number of new HIV infections in Cambodia." Public health warrants infection prevention but would we sustain it? UNAIDS' Patricia Ongpin puts the spotlight on sustainability of HIV prevention as well as global AIDS response in context of competing priorities. "It is a real issue," she rightly points out. She calls on governments to have optimal political commitment which should match the services, legal reforms and policy harmonisation, policy framework, health and development financing, and systematic integration which are critical if we are to end AIDS by 2030. "Multi-sectoral approach towards ending AIDS is key," she said. Health financing varies between countries. For example, Malaysia has almost all (99%) of its HIV response domestically-funded, whereas Cambodia has roughly 36%, informs Patricia. IAS 2025 message of UNAIDS' Patricia Ongpin "HIV is not over and we need to stand together in solidarity to support governments, communities, and development partners in making sure that HIV responses stay alive," said Patricia. She called for ensuring effective collaboration between different partners, such as governments, communities and development partners - so that not only innovative financing can be fully harnessed, but we are also able to rollout all combination HIV prevention options along with other critical cog-in-the-wheels to end AIDS by 2030. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
