LEARNING November 1, 2015

PrEParing Pakistan, One Young MSM at a Time

A reflection piece of young PrEP advocate who attended PrEParing Asia

Sarmad Ali, a Youth Voices Count member from Pakistan, considers himself a PrEP advocate. With the grant from UNDP’s Multi-Country South Asia Global Fund HIV Programme (based at the UNDP Bangkok Regional Hub), Sarmad attended PrEPARING ASIA, along with other PrEP advocates from South Asia. Read below as he reflects his participation in Asia’s first and biggest regional consultation on the roll out of PrEP. 

“PrEPARING ASIA: A new direction for HIV prevention among MSM” was held at Amari Watergate Hotel, Bangkok, from 23 to 25 September 2015. More than a hundred PrEP advocates from more than 25 countries participated in the regional consultation meeting, and I was proud and excited to be part of the delegates.

The objective of the Consultation was to discuss effective methods in rolling out PrEP in Asian countries. I find this Consultation really prominent in tackling the HIV epidemic in our region. Why? Let me start by bringing up the stat that it is estimated that a total of 717 million young people aged 15 to 24, comprising 60 per cent of the world’s youth, live in the Asia-Pacific region; and within Asia Pacific region, HIV epidemics are concentrated among the MSM and transgender communities. Lo and behold, younger counterparts of these communities are the most vulnerable ones. 95 percent of all new infection among young people occur among the most at risk adolescent populations. According to UNAIDS Data, 610,000 young people (15-24) in 2013 are living with HIV in Asia-Pacific. In summary, the Consultation was too close to home for a young community advocate like me. I was born and have been living in Pakistan; and the increasing number of young MSM living with HIV in my home land is a bitter truth I’ve been witnessing.

The first day of the event was started by world’s latest researches on PrEP efficacy.  Numerous leading academicians and scientists shared their experience on PrEP studies. Understanding the (minor) side effects of PrEP and how it is utterly beneficial to equip young and at high-risk with PrEP were my two key learning points. My nightmare as a PrEP advocate was that, in ten years from now, what if the epidemic among young MSM would only worsen and all we could do was only looking back and saying “we should’ve given them PrEP.”

…PrEParing ASIA has made me able to understand much further about PrEP. Sure I also still have other extra questions, but I believe I can learn this along the way.

PrEParing Asia’s second day began with the experience of PrEP users in different countries. They told us how PrEP positively changed their lives. They were happy with their partners and enjoying sexual needs and desires with them without any fears. With a positive note, my fellow PrEP advocates friend from Pakistan and I then did a country group discussion to explore the current HIV epidemic among Pakistani MSM and how it could be improved by the integration of PrEP within our health system. The country group discussion was then followed by having representatives from each country shared their thoughts on the roll out of PrEP among the young MSM using local strategies.

My second day ended with a clinic visit organised by APCOM. I visited Thai Red Cross Clinic, Thailand’s leading gay-friendly clinic that’s been prescribing PrEP to hundreds of young MSM in the country. Under their PrEP30 initiative, a single of PrEP pill costed for only 30 Thai Baht, or roughly about one US Dollar. It sounded cheap at first, but after I multiplied it with 30 days – given the need to consume it daily, the monthly cost of PrEP would still be a bit of burden for many young Pakistani who still financially relied on their parents, let alone those who lived below poverty lines. Should PrEP be available in Pakistan, I believe that an initiative to subsidise the price of PrEP should be a prominent priority.

In summary, PrEParing ASIA has made me able to understand much further about PrEP. Sure I also still have other extra questions, but I believe I can learn this along the way. What’s important is that I’m more convinced than ever that this magic pill is the more effective, if not the best, HIV prevention tool in making our region achieve “Zero HIV” in 2030. I went back home with an ambitious advocacy plan. My goal was to promote PrEP to my fellow young MSM friends and encourage them to further spread the awareness. That way, we could slowly build a demand of PrEP locally. Last but not least, I’m crossing my fingers that Pakistan would hold its national PrEP consultation and I will see again some of the experts and fellow advocate friends I met in PrEParing Asia – but this time, with stories of the PrEP advocacy we have done to our peers.