Taking prevention to the next level: Packaging PrEP with primary health care services as a pathway to achieving 2030 HIV prevention and universal health coverage goals

SAT015

Satellite

Other

Plaza Auditorium/Channel 4

23 July 11:30 - 12:30

Co-Chairs

Kimberly E. GREEN, PATH, Vietnam
Midnight POONKASETWATTANA, Asia Pacific Coalition on Male Foundation (APCOM Foundation), Thailand
Mitchell WARREN, AVAC, United States

Organizer

PATH, AVAC, World Health Organization, and IAS - the International AIDS Society

While annual new HIV acquisitions have declined by 32% since 2010, we remain far short of the 2025 prevention target, with a projected 1.2 million new acquisitions in 2025—three times the global target. To meet 2030 prevention goals, we need to make HIV prevention, including pre-exposure prophylaxis (PrEP), more relevant and accessible to those who need it by moving toward sustainably packaging PrEP within comprehensive primary health care. This session will spotlight real-world approaches to PrEP integration across service areas (from sexual and reproductive health and harm reduction to mental health and gender-affirming care) tailored for adolescents and youth, transgender people, and people who use drugs; model what integrated PrEP services could look like, including for next-generation PrEP products; and strategize how governments, funders, normative agencies, private sector, and communities can collectively shepherd in this new frontier of integrated, client-responsive PrEP services.

11:30 4 min	Welcome Kimberly E. GREEN PATH, Vietnam Midnight POONKASETWATTANA Asia Pacific Coalition on Male Foundation (APCOM Foundation), Thailand

11:34 5 min	Integrated person-centered primary health care: the pathway to universal health coverage Davina CANAGASABEY PATH, United States

11:39 5 min	What young people need when it comes to integrated health care and HIV prevention? Chilufya KASANDA Treatment Advocacy and Literacy Campaign, Zambia

11:44 7 min	Person-centered PrEP: Framing Vietnam’s approach to integrating PrEP and primary health care. Thi Thu Huong PHAN Viet Nam Administration of HIV/AIDS Control, Ministry of Health, Vietnam

11:51 27 min	Perspectives: How can we get there? Adamson NDHLOVU JSI USAID DISCOVER-Health, Zambia Heather-Marie SCHMIDT UNAIDS Asia-Pacific, Thailand Ashley VIJ USAID, United States Hasina SUBEDAR South African National Department of Health, South Africa Kimberly E. GREEN PATH, Vietnam Moupali DAS Gilead Sciences, United States Midnight POONKASETWATTANA Asia Pacific Coalition on Male Foundation (APCOM Foundation), Thailand Mitchell WARREN AVAC, United States

12:18 5 min	Call to Action Elizabeth ONYANGO Coast Sex Workers Alliance, Kenya Midnight POONKASETWATTANA Asia Pacific Coalition on Male Foundation (APCOM Foundation), Thailand

12:23 7 min	Wrap-up and closing Mitchell WARREN AVAC, United States

AUTHOR

Daniel Reeders

SUMMARY

Providing access to pre-exposure prophylaxis (PrEP) as part of comprehensive primary healthcare services can promote uptake in key populations and provide a pathway to universal healthcare.

HIGHLIGHTS

Moving from siloed to synergistic delivery of PrEP and primary care can make integrated person-centred care for PrEP users a model and pathway for efforts to expand universal health coverage. Davina Canagasabey (PATH) highlights the challenge: one-stop-shop models of care that offer differentiated service delivery — asking services to expand and diversify their care. Chilufya Kasanda (Treatment Advocacy and Literacy Campaign) argues young people need a package of sexuality education and sexual and reproductive health, mental health, substance use, and HIV services. Global funders need to support services to meet local community needs and priorities. Thi Thu Huong Phan (MoH, Viet Nam) describes care available from one-stop-shop services in Viet Nam, which includes viral hepatitis, mental health and gender affirming care; data show 27% of PrEP starters first present for non-HIV care. Ashley Vij (USAID) describes the need for integrated services that span a continuum of health promotion, disease prevention, intervention and care. Heather-Marie Schmidt (UNAIDS) notes the Global PrEP Appeal Survey (n=17,000) finds 60% of participants have unmet PrEP need. However, Mitchell Warren (AVAC) cautions: prevention is not just about products; they do not deliver themselves and cannot prevent HIV unless we build program infrastructure around them.

CRITICAL ASSESSMENT

The themes can draw more explicitly on well establish conceptual frameworks including those in the conception of Primary Health as formulated in the Alma-Ata Declaration (WHO, 1978). This envisions a whole-of-society response to health inequity, and it highlights the importance of community engagement and community ownership of PrEP implementation strategies. It also draws attention to the health equity questions that inevitably emerge when we offer new health services (Tudor Hart, 1971). Disciplines such as social epidemiology, health economics, and medical sociology have much to contribute to the conversation about integrated care.