HIV-negative individuals whose intimate partners are HIV-positive can now avoid contracting the virus without having to use contraceptives such as condoms. The health ministry in collaboration with Save the Children has introduced an oral medication for HIV-negative individuals. In the first phase of the pilot programme, key populations including men having sex with men, sex workers, transgender individuals, and people who inject drugs residing in Thimphu and Paro are being given the medication. The initiative, supported by the Global Fund Project, aims to reduce new HIV infections in Bhutan by 90 per cent by 2030.
According to the World Health Organisation, the oral medication called Pre-Exposure Prophylaxis, PrEP, when taken consistently, can reduce the risk of HIV infection during sex by more than 90 per cent.
An individual can take the medication daily or two hours before sexual intercourse. However, they will be required to visit hospitals every three months to test for HIV, sexually transmitted infection (STI) screening, and kidney function assessments.
As of now, about 40 people have started using the medication since its launch last year.
People are advised to take PrEP if their partner is HIV-positive, if they have inconsistent condom use, have been diagnosed with an STI in the past six months, or share injection equipment.
“Maximum percentage of new HIV infection is happening among the key population. For a few recent years, we have been seeing increasing cases of HIV among our key populations. That is why I think the introduction of PrEP right now turned out timely,” said Tenzin Gyeltshen, executive director of Pride Bhutan.
However, while PrEP is highly effective in preventing HIV, it does not protect against STIs like gonorrhoea or syphilis.
“I think when we talk about prep, people misunderstand that. I think people have to understand that prep is just for HIV prevention, not for other STDs. It doesn’t protect for STDs such as gonorrhoea. That is the most important thing that preps users and people planning to use it should know about it,” added Tenzin Gyeltshen, executive director of Pride Bhutan.
To mitigate the risk of STIs, health officials also provide condoms and counselling during PrEP distribution.
Those interested in using PrEP can visit any healthcare centre or hospital, where they will be tested for HIV and, if negative, provided with the medication package.
Although some users may experience initial side effects like nausea, vomiting, fatigue, or dizziness, officials have stated that these symptoms subside quickly and pose no long-term health risks.
Bhutan has nearly 1,000 active HIV cases as of June last year.
The next phase of the PrEP pilot rollout is scheduled for March in Gelephu and Phuentshogling, further advancing the goal of making the medication accessible across all 20 districts by 2026.
Namgay Dema
Edited by Phub Gyem