Healthcare groups step up campaign amidst smallest decline in new HIV infections

A US$20,000 seed grant will champion stigma-free HIV care services in Hong Kong and Taiwan.

To counter the stigma associated with the human immunodeficiency virus (HIV), IAS – the International AIDS Society – and Gilead Sciences partnered last year to expand the Me and My Healthcare Provider campaign, which promotes best practices of stigma-free HIV care services by healthcare professionals in Brazil, Hong Kong, Mexico, and Taiwan. 

UNAIDS data shows that the decline in new HIV acquisitions in 2020 and 2021 was the smallest since 2016 and that new acquisitions are rising where they had been falling in APAC. This is why the IAS and Gilead Sciences decided to partner again to run the campaign.

This year, the campaign will expand to include seed funding for each nominated partner organisation in Hong Kong and Taiwan. From 15 November 2022 until 15 December 2023, partner organisations will co-design and implement local campaigns, as well as work with the 2023 Healthcare Champion pairs to enhance training activities for healthcare providers to promote stigma-free service delivery in their communities.

Dustin Haines, Vice President, General Manager, Asia 5, Gilead Sciences, said battling stigma and discrimination in HIV care would not be a one-size-fits-all approach. Rather, programmes would be locally based to better address the gaps in HIV care in their communities.

“The seed grants will support local organisations to tell relatable stories that other healthcare providers or persons living with HIV in the community can identify with, helping them understand what success [in stigma-free HIV service delivery] looks like,” Haines told Healthcare Asia. A seed grant gets a project started until it is able to secure other funding.

A trusted relationship between healthcare client and provider is among the “critical success factors” to counter stigma and discrimination, he said. 

“How the healthcare provider and the client communicate to build that trust ultimately helps break down some of that stigma that exists. Unfortunately, we do see [stigma] in many parts of the world and we do need to tackle that,” Haines explained.

Ling-Ya Chen, a 2022 Me and My Healthcare Champion and HIV case manager at National Taiwan University Hospital, agreed. She said governments and non-governmental organisations must help evaluate and investigate discriminative delivery of healthcare for people living with HIV so that it can be used as a reference for related cases happening in the future.

Support from powerful leadership, celebrities, healthcare departments and medical fields can also ramp up HIV prevention initiatives, Chen advised.

“The support from all these parties could make this [HIV prevention] policy doable, and they could also clarify the correct message to the public,” she said.

Promoting healthcare champions

IAS President Sharon Lewin said she was expecting two things from the programme. One is creating a public national campaign to honour healthcare champions and the second is working with these champions to improve training activities for other healthcare workers.

“What this programme is doing is promoting and celebrating champions of healthcare that deliver stigma-free care even in environments where stigma still occurs in healthcare,” Lewin said.

Haines said it would take more than one individual group to handle this heavy task, adding that society and government must have a role to play in breaking down stigma.

Lewin shared that HIV responses globally have become diverse. In Asia Pacific, pre-exposure prophylaxis (PrEP) is widespread in Thailand and Australia. PrEP is a type of medication that lowers the risk of acquiring HIV from sex by about 99% if taken correctly.

A 2018 UNAIDS report showed that Thailand introduced PrEP for HIV prevention to vulnerable groups in high-burden provinces. In Australia, all general practitioners are allowed to offer PrEP.

But for countries such as Pakistan and the Philippines, Lewin said the numbers of new HIV infections were alarming.

“Numbers of new infections are increasing in some countries, and access to effective prevention such as PrEP is virtually non-existent,” Lewin said.

Strides and obstacles in Taiwan HIV prevention

Chen shared some achievements in Taiwan on HIV prevention, including the distribution of take-home self-test kits. In 2015, the Taiwan Centre for Disease Control started to advocate PrEP in Taiwan, which eventually led to the launching of the official PrEP programme.

“More and more people who know about PrEP and have started taking it,” Chen said, adding that programme participants went from 300 annually in 2017 to more than 2,000 in 2022.

One of the issues in HIV prevention is how a person might not use condoms or PrEP when they have only one sexual partner. “For every time they have sex, there could be exposure to HIV under unprepared circumstances,” Chen said. 

Chen pointed out that some healthcare workers may still have misconceptions around the transmission of HIV. She cited an instance where a fellow healthcare worker discarded a pen that had been used by a person living with HIV because they were afraid that they would be exposed to HIV.