Medicine can cut risk by 90 percent, but it's not approved for prevention

Thailand has been a hot destination for Chinese tourists for years. Yet many now are heading to the Southeast Asian country for a new reason - to buy cheap drugs to prevent HIV.

Pre-exposure prophylaxis, commonly known as PrEP, is a type of medicine that, if taken daily, can reduce the risk of HIV infection via sexual intercourse by more than 90 percent, according to health studies.

Several countries recommend the drugs as a weapon to prevent the spread of HIV among people in high-risk groups, such as gay men.

However, the China Food and Drug Administration approved PrEP in 2015 for the treatment of HIV/AIDS - not prevention - which means doctors are not allowed to prescribe it to patients unless they test positive for the virus.

Xiao Dong, who runs Tongzhi, an NGO based in Beijing that is committed to combating AIDS, said he began traveling to Thailand early last year, for vacations and to stock up on anti-HIV medicine.

As an openly gay man, he said health and safety are his top priorities: "I use both condoms and PrEP to guard against HIV," he said.

Advocates say prevention is worthwhile, given that the prevalence of HIV among Chinese gay men averages more than 5 percent in most cities and can exceed 10 percent in major metropolises, according to the National Center for AIDS and Sexually Transmitted Disease Control.

Given increasing awareness, more gay men in China have followed suit. Xiao said he knows nearly 100 men from Beijing who have also traveled to Thailand to purchase PrEP.

"It's a positive sign that our community has become more responsible for our own health, and each other's. They are willing to pay out of pocket," he said.

Thailand is easy to visit, as Chinese citizens do not require a visa, and the country is recognized for its friendliness toward the LGBT community.

It also offers easy, affordable access to PrEP, Xiao said, who added that generic products can cost 300 yuan ($44) for a one-month supply, while brand-name products are about 800 yuan for the same amount.

By contrast, the brand-name drugs sell for nearly 2,000 yuan in China, said Wu Hao, director of the infectious diseases department at Beijing's You'an Hospital.

You'an treats most of the AIDS patients in Beijing. Last year, he said, more than 90 percent of the newly detected HIV sufferers in the capital were gay men.

According to Wu, who specializes in sexually transmitted diseases, the efficacy of PrEP has been widely recognized internationally. It has been included in the HIV/AIDS prevention and treatment guidelines of the World Health Organization and health authorities in the United States.

However, Wu said, China has not yet introduced PrEP in its national guidelines. In addition, he ruled out the possibility that the government would give the drugs free to willing subjects, largely because of the high costs involved.

Wu's department will launch a yearlong PrEP research study this summer with the center, recruiting 600 to 1,000 gay men and giving them free PrEP drugs.

"I welcome PrEP as prevention for those who are at high risk of infection, given that condom use is low, particularly among gay men in China," he said.

shanjuan@chinadaily.com.cn