Health Ministry reviewing PrEP, DoxyPEP for wider public access

Dr Lackram Bodoe, Health Minister says the ministry is considering the use of STI preventative medicine as a public health policy. - File photo

HEALTH Minister Dr Lackram Bodoe says the ministry is undertaking a comprehensive review of pre-exposure prophylaxis for HIV (PrEP) and doxycycline prophylaxis (DoxyPEP) through its HIV/AIDS Coordinating Unit, in alignment with global public-health guidance.

His response follows a November 26 Newsday report in which several public health experts and advocates called for expanded access to HIV and STI prevention tools, specifically PrEP and DoxyPEP, to address rising HIV and STI cases, including a sharp increase in syphilis among pregnant women.

Bodoe said the review includes an assessment of the clinical benefits, behavioural considerations, cost implications and best practices from countries where these treatments are already in use.

“Our priority is always to reduce new HIV infections and protect the health and well-being of the population. Any decision related to PrEP or DoxyPEP will be guided by science, expert advice, and what is best for the people of TT,” Bodoe said.

He added once the technical review is completed, the ministry will provide an update to the public, though no timeframe was given.

In a response to Newsday's earlier enquiry on November 25 about the availability of both drugs, the Family Planning Association of TT (FPATT) said the fight against HIV and other sexually transmitted infections (STIs) remains a national priority as the country works toward the global goal of eliminating HIV/AIDS by 2030.

The association said while significant progress has been made, particularly in treatment, care, and advancing toward the UNAIDS targets, the proactive introduction and scale-up of newer prevention tools such as both remain critical areas for development.

“As part of the national response, the FPATT continues to play a vital role by providing essential services, health education, community outreach, and advocacy for more comprehensive, rights-based sexual and reproductive health strategies,” the organisation said.

FPATT added access to both medications, though recognised globally as effective prevention tools, is not yet widely available as a public-health service.

“The Ministry of Health and the National AIDS Coordinating Committee acknowledge their value, but general public access has not been implemented. It is available through the Ministry of Health under specific circumstances, such as occupational exposure among healthcare workers or following sexual assault.”

The association said these medications are essential tools in reducing HIV transmission when taken as prescribed. It said it is among the most effective biomedical methods for preventing HIV acquisition.

FPATT stressed DoxyPEP has also demonstrated promising results in reducing bacterial STIs, including chlamydia, gonorrhoea and syphilis, among high-risk populations.

“When integrated with condoms, regular testing, counselling and comprehensive education, these tools support a multi-layered, evidence-based approach to sexual health that complements behavioural-change efforts.”

The primary barrier to widespread use, it added, remains the absence of a national policy enabling general access. Sustainable funding for both government programmes and NGOs also continues to be a major challenge.

As for FPATT and its role, the association said it provides comprehensive sexual health services, including STI and HIV testing, counselling, and referrals for treatment and care.

It said direct data on increased demand for both drugs is limited at this time: the association continues to prioritise education, patient empowerment and equitable access to a full range of sexual health services.

It highlighted persistent HIV-related stigma and discrimination remain significant barriers to care, deterring people from seeking testing, treatment and prevention services, especially in public-health institutions.

Logistical challenges, procurement issues and inconsistent supplies can also impede the availability of prevention tools, while insufficient awareness among both the public and healthcare providers contributes to underutilisation.

FPATT said there is an urgent need for stronger policies that integrate HIV/STI prevention and care within the broader sexual and reproductive health landscape.

"Strengthening laws that protect the rights of people living with HIV, as well as individuals vulnerable to infection, is essential to reducing discrimination and improving access to care."

Expanding national access to both drugs, FPATT said, requires a coordinated, multi-pronged approach that includes political commitment, policy shifts to include these medications within the essential-services framework, and strategic partnerships to secure affordable procurement options.

It said continued collaboration among the Health Ministry, NACC, civil-society partners and community organisations is vital for reaching key populations such as men who have sex with men, transgender people, sex workers, youth, people with disabilities, migrants and refugees.

Achieving the UNAIDS goal to end AIDS by 2030, it added, requires an “all hands on deck” approach.

Founder of the KingK Initiative and mental and sexual health educator Dion Gill told Newsday the conversation around PrEP and DoxyPEP must be comprehensive, not just clinical.

“While these medications are vital, accessibility is only the first step – especially for men, including men who have sex with men, who face disproportionate STI risks,” he said.

Gill said cultural claims that both drugs encourage “promiscuity” must be addressed directly.

“These tools are fundamentally about sexual autonomy, mental well-being, and reducing anxiety related to disclosure. Organisations like the KingK Initiative advocate for seeing these drugs as essential tools for self-care and relationship stability, thereby destigmatising their use and encouraging all men to seek them without shame.”

He believes the public health system lacks cultural competency needed to effectively serve men, especially those in the queer community.

“We need to prioritise and fund community-led healthcare services. These trusted groups already possess the established networks necessary to conduct effective, confidential and trauma-informed outreach and distribution of PrEP and DoxyPEP, ensuring better uptake.”

Gill added, “The societal fear of men being seen as weak for prioritising their sexual health is also a major deterrent.”

“We must use confidentiality as a key prevention strategy.”

He stressed guaranteeing absolute confidentiality at clinics and community centres partnered with the Health Ministry is critical to ensuring high uptake among vulnerable populations.