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Pre-exposure prophylaxis PrEP use is accelerating among men who have sex with men and transgender women in two south-east Asian countries where it is receiving funding and government support, the 22nd International AIDS Conference AIDS conference heard two weeks ago.

As with PrEP in other settings, one of the challenges is retention; in Thailand only half of the gay men and a quarter of the transgender women who started PrEP in one scheme were still taking PrEP a year later. The other is knowledge of and access to PrEP: with under people taking PrEP altogether in these populous countries, programmes will have to be considerably larger to start having an effect on epidemics that are still expanding.

Thailand was very early into the epidemic and a peak of incidence was reached in injecting drug users as early as , to be followed closely by female sex workers and their clients in the early s. Even as late as there were more diagnoses among heterosexual women who were not sex workers than among gay men. Depending on the context, may include men who have sex with men, transgender people, sex workers, people who inject drugs, adolescent girls, prisoners and migrants.

A serodiscordant couple is one in which one partner has HIV and the other has not. Many people dislike this word as it implies disagreement or conflict. Alternative terms include mixed status, magnetic or serodifferent. About people have accessed PrEP so far in Thailand, though not all are necessarily current users. This was followed in by a small implementation research programme offering free PrEP in metropolitan Bangkok and the tourist hub of Pattaya.