By Setsen Zayasaikhan and Philips Loh

Pre-Exposure Prophylaxis (PrEP) is a cost effective and innovative approach for people to substantially reduce their risk of HIV infection. Randomised trials have demonstrated that PrEP can decrease HIV incidence among at-risk populations, including men who have sex with men, transgender people, and sero-discordant couples.

In Mongolia, the national guidelines for HIV service delivery include PrEP – but only for sero-discordant couples. A PrEP demonstration project supported by Health Equity Matters under the SKPA program worked to change the guideline to include other at-risk populations who would also benefit from access to and uptake of PrEP, such as men who have sex with men (MSM).

The PrEP demonstration project aimed to assess the feasibility and acceptability of PrEP, any risk compensation, and a model for PrEP service delivery for men who have sex with men. The goal of this demonstration project was to provide the government with the in-country evidence that would support them with including PrEP into their national programming for key populations (e.g., answer operational questions around implementing PrEP such as whether the MSM will accept combination prevention including PrEP, whether the service delivery mechanism can handle the increase in resource needs that these interventions might lead to, etc.).

Now that the demonstration project is complete, the next step is to work with the government in Mongolia to help move from demonstration projects to policy and practice. Under the SKPA-2 program, Youth For Health Centre is working to advocate for the continuation and scale-up of PrEP services as part of the national HIV response and having PrEP be included as part of the benefits package under the country’s universal health coverage.

Published: June 2023