The continuing HIV epidemic among men who have sex with men and transgender women in the ASEAN region: implications for HIV policy and service programming

Frits van Griensven; Jan Willem de Lind van Wijngaarden; Patrick Castillo Eustaquio; Stephen Wignall; Iskandar Azwa; Vanessa Veronese; Laurent Ferradini; Nittaya Phanuphak; Stephen Mills

doi:10.1071/SH20134

REVIEW (Open Access)

Previous Next Contents Vol 18(1)

The continuing HIV epidemic among men who have sex with men and transgender women in the ASEAN region: implications for HIV policy and service programming

Frits van Griensven

^A ^B ^C ^J , Jan Willem de Lind van Wijngaarden ^D , Patrick Castillo Eustaquio ^E , Stephen Wignall ^F , Iskandar Azwa ^G , Vanessa Veronese ^H , Laurent Ferradini ^I , Nittaya Phanuphak

^A ^B and Stephen Mills ^I

+ Author Affiliations

- Author Affiliations

^A Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok 10330, Thailand.

^B Center of Excellence in Transgender Health, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.

^C Department of Epidemiology and Biostatistics, University of California at San Francisco, Mission Hall, Box 1224, 550 16th Street, San Francisco, CA 94158, USA.

^D Independent consultant.

^E Love Yourself Foundation, 858 Blumentritt Street, Manila 1008, Philippines.

^F FHI 360 Cambodia, Phnom Penh Center, Building F, Samdach Sothearos Boulevard (3), Phnom Penh HW3M+9H, Cambodia.

^G Infectious Diseases Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.

^H Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.

^I FHI 360 Asia-Pacific Regional Office, 9 Witthayu Road, Bangkok 10330, Thailand.

^J Corresponding author. Email: fritsvg@gmail.com

Sexual Health 18(1) 21-30 https://doi.org/10.1071/SH20134
Submitted: 29 July 2020 Accepted: 28 December 2020 Published: 26 February 2021

Journal Compilation © CSIRO 2021 Open Access CC BY

Abstract

Men who have sex with men (MSM) in Western urban areas have seen substantive decreases in new diagnoses of HIV infection. This paper explores whether such declines are present among MSM and transgender women (TGW) in Southeast Asia and discusses implications for HIV policies and programming. A scoping review was conducted of scientific publications and selected documents regarding the spread of HIV infection among MSM and TGW in major urban centres of the Association of Southeast Asian Nations (ASEAN) region. Continued high HIV prevalence and incidence among MSM are found in integrated behavioural and biological surveillance (IBBS) and research studies. HIV prevalence among MSM under IBBS decreased only in Bangkok from 28.6% in 2014 to 10.3% in 2018, whereas it was increasing in Kuala Lumpur, Ho Chi Minh City, Vientiane, and Phnom Penh. HIV/AIDS case reports regarding new HIV infection diagnoses among MSM have started to decrease in Singapore since 2011 and have been plateauing in Metropolitan Manila since 2017. Where data were available, it was found that HIV prevalence among TGW was high and if IBBS was conducted, it was increasing. HIV prevalence among TGW under IBBS in Jakarta had risen to 34.0% (2015) and 14.0% (2019) in Phnom Penh. These findings suggest that most ASEAN member states have so far failed to effectively implement and scale-up scientifically proven biomedical HIV prevention measures and counter stigma and discrimination that impedes access to appropriate HIV prevention and treatment services for MSM and TGW.

Keywords: epidemiology, HIV/AIDS, prevalence, incidence, prevention, men who have sex with men, Southeast Asia, transgender.

References

[1] O’Halloran C, Sun S, Nash S, Brown A, Croxford S, Connor N, et al. HIV in the United Kingdom: towards zero HIV transmissions by 2030. Public Health England; 2019. Available online at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/858559/HIV_in_the_UK_2019_towards_zero_HIV_transmissions_by_2030.pdf [verified 12 January 2021].

[2] San Francisco Department of Public Health. HIV epidemiology annual report 2018. 2019. Available online at: https://www.sfdph.org/dph/comupg/oprograms/HIVepiSec/HIVepiSecReports.asp [verified 18 January 2021].

[3] Grulich AE, Guy R, Amin J, Jin F, Selvey C, Holden J, et al Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study. Lancet HIV 2018; 5 e629–37.
| Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study.Crossref | GoogleScholarGoogle Scholar | 30343026PubMed |

[4] van Sighem AI, Wit FWNM, Boyd A, Smit C, Matser A, Reiss P. HIV monitoring report 2019: human immunodeficiency virus (HIV) infection in the Netherlands. Amsterdam: Foundation HIV Monitoring; 2019. Available online at: https://www.hiv-monitoring.nl/application/files/4115/7616/1682/HIV_Monitoring_Report_2019_update_dec_2019.pdf [verified 18 January 2021].

[5] Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363 2587–99.
| Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 21091279PubMed |

[6] Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016; 375 830–9.
| Antiretroviral therapy for the prevention of HIV-1 transmission.Crossref | GoogleScholarGoogle Scholar | 27424812PubMed |

[7] Scheer S, Hsu L, Schwarcz S, Pipkin S, Havlir D, Buchbinder S, et al Trends in the San Francisco human immunodeficiency virus epidemic in the ‘getting to zero’ era. Clin Infect Dis 2018; 66 1027–34.
| Trends in the San Francisco human immunodeficiency virus epidemic in the ‘getting to zero’ era.Crossref | GoogleScholarGoogle Scholar | 29099913PubMed |

[8] Rozhnova G, Heijne J, Bezemer D, van Sighem A, Presanis A, De Angelis D, et al Elimination prospects of the Dutch HIV epidemic among men who have sex with men in the era of preexposure prophylaxis. AIDS 2018; 32 2615–23.
| Elimination prospects of the Dutch HIV epidemic among men who have sex with men in the era of preexposure prophylaxis.Crossref | GoogleScholarGoogle Scholar | 30379687PubMed |

[9] Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the United States. JAMA 2019; 321 844–5.
| Ending the HIV epidemic: a plan for the United States.Crossref | GoogleScholarGoogle Scholar | 30730529PubMed |

[10] Joint United Nations Programme on HIV/AIDS. 2011–2015 strategy: getting to zero. 2010. Available online at: https://www.unaids.org/sites/default/files/sub_landing/files/JC2034_UNAIDS_Strategy_en.pdf [verified February 2020].

[11] Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid-Based Healthc 2015; 13 141–6.
| Guidance for conducting systematic scoping reviews.Crossref | GoogleScholarGoogle Scholar | 26134548PubMed |

[12] Atkins GL. Imagining gay paradise: Bali, Bangkok, and cyber-Singapore. Hong Kong University Press; 2012.

[13] Lee JGL, Wimark T, Ortiz KS, Sewell KB. Health-related regional and neighborhood correlates of sexual minority concentration: a systematic review. PLoS One 2018; 13 e0198751
| Health-related regional and neighborhood correlates of sexual minority concentration: a systematic review.Crossref | GoogleScholarGoogle Scholar | 29949611PubMed |

[14] van Griensven F, Varangrat A, Wimonsate W, Tanpradech S, Kladsawad K, Chemnasiri T, et al Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007. J Acquir Immune Defic Syndr 2010; 53 234–9.
| Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007.Crossref | GoogleScholarGoogle Scholar | 19901844PubMed |

[15] van Griensven F, Varangrat A, Wimonsate W, Tappero J, Sinthuwattanawibool C, McNicholl J. HIV prevalence among populations of men who have sex with men – Thailand, 2003 and 2005. MMWR Morb Mortal Wkly Rep 2006; 55 844–8.

[16] García MC, Meyer SB, Ward P. Elevated HIV prevalence and risk behaviours among men who have sex with men (MSM) in Vietnam: a systematic review. BMJ Open 2012; 2 e001511
| Elevated HIV prevalence and risk behaviours among men who have sex with men (MSM) in Vietnam: a systematic review.Crossref | GoogleScholarGoogle Scholar | 23015604PubMed |

[17] Kanter J, Koh C, Razali K, Tai R, Izenberg J, Rajan L, et al Risk behaviour and HIV prevalence among men who have sex with men in a multiethnic society: a venue-based study in Kuala Lumpur, Malaysia. Int J STD AIDS 2011; 22 30–7.
| Risk behaviour and HIV prevalence among men who have sex with men in a multiethnic society: a venue-based study in Kuala Lumpur, Malaysia.Crossref | GoogleScholarGoogle Scholar | 21364064PubMed |

[18] Ramly M. Challenges in ending AIDS in Malaysia 2030. Kuala Lumpur: Ministry of Health; 2018.

[19] Morineau G, Nugrahini N, Riono P, Nurhayati , Girault P, Mustikawati DE, et al Sexual risk taking, STI and HIV prevalence among men who have sex with men in six Indonesian cities. AIDS Behav 2011; 15 1033–44.
| Sexual risk taking, STI and HIV prevalence among men who have sex with men in six Indonesian cities.Crossref | GoogleScholarGoogle Scholar | 19641986PubMed |

[20] Ministry of Health. Report of biological and behavioral surveillance, 2007 to 2019. [In Indonesian] Jakarta: Ministry of Health; 2016.

[21] Sheridan S, Phimphachanh C, Chanlivong N, Manivong S, Khamsyvolsvong S, Lattanavong P, et al HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People’s Democratic Republic, 2007. AIDS 2009; 23 409–14.
| HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People’s Democratic Republic, 2007.Crossref | GoogleScholarGoogle Scholar | 19114858PubMed |

[22] National AIDS Program. Myanmar integrated biological and behavioural surveillance survey and population size estimates among men who have sex with men, 2015. Naypyitaw: Ministry of Health and Sports; 2019.

[23] National Center for HIV/AIDS, Dermatology and STD. Integrated biological and behavioural survey among men who have sex with men and transgender women in Cambodia 2019. Phnom Penh: Ministry of Health; 2020.

[24] Department of Health, Epidemiology Bureau. 2015 Integrated HIV behavioural and serologic surveillance fact sheet, Philippines. 2015. Available online at: https://www.aidsdatahub.org/sites/default/files/resource/ihbss-philippines-2015-fact-sheets.pdf [verified December 2020].

[25] Division of AIDS, TB and STI. Results of HIV surveillance in the Bangkok Metropolitan Administration area. Bangkok: Department of Health, Bangkok Metropolitan Administration; 2019.

[26] Ministry of Health, Center for HIV/AIDS and STI. Integrated biological and behavioral surveillance (IBBS) among men who have sex with men (MSM) 2017. Vientiane: Ministry of Health; 2018.

[27] Department of Health, Epidemiology Bureau, National HIV/AIDS & STI Surveillance and Strategic Information Unit. 2018 integrated HIV behavioral and serologic surveillance fact sheets, Philippines. 2018. Available online at: https://doh.gov.ph/sites/default/files/publications/2018%20Integrated%20HIV%20Behavioral%20and%20Serologic%20Surveillance%20%28IHBSS%29%20Factsheets.pdf [verified December 2020].

[28] Ministry of Health Singapore. Update on the HIV/AIDS situation in Singapore 2019 (June 2020). 2020. Available online at: https://www.moh.gov.sg/resources-statistics/infectious-disease-statistics/hiv-stats/update-on-the-hiv-aids-situation-in-singapore-2019-(june-2020) [verified December 2020].

[29] Department of Health, Epidemiology Bureau. HIV/AIDS and ART registry of the Philippines. 2020. Available online at: https://doh.gov.ph/sites/default/files/statistics/EB_HARP_October-December_AIDSreg2019.pdf [verified December 2020].

[30] Ongwandee S, Lertpiriyasuwat C, Khawcharoenporn T, Chetchotisak P, Thiansukhon E, Leerattanapetch N, et al Implementation of a Test, Treat, and Prevent HIV program among men who have sex with men and transgender women in Thailand, 2015–2016. PLoS One 2018; 13 e0201171
| Implementation of a Test, Treat, and Prevent HIV program among men who have sex with men and transgender women in Thailand, 2015–2016.Crossref | GoogleScholarGoogle Scholar | 30044867PubMed |

[31] Seekaew P, Pengnonyang S, Jantarapakde J, Sungsing T, Rodbumrung P, Trachunthong D, et al Characteristics and HIV epidemiologic profiles of men who have sex with men and transgender women in key population-led test and treat cohorts in Thailand. PLoS One 2018; 13 e0203294
| Characteristics and HIV epidemiologic profiles of men who have sex with men and transgender women in key population-led test and treat cohorts in Thailand.Crossref | GoogleScholarGoogle Scholar | 30161226PubMed |

[32] Wasantioopapokakorn M, Manopaiboon C, Phoorisri T, Sukkul A, Lertpiriyasuwat C, Ongwandee S, et al Implementation and assessment of a model to increase HIV testing among men who have sex with men and transgender women in Thailand, 2011–2016. AIDS Care 2018; 30 1239–45.
| Implementation and assessment of a model to increase HIV testing among men who have sex with men and transgender women in Thailand, 2011–2016.Crossref | GoogleScholarGoogle Scholar | 29950108PubMed |

[33] Sapsirisavat V, Phanuphak N, Keadpudsa S, Egan JE, Pussadee K, Klaytong P, et al Psychosocial and behavioral characteristics of high-risk men who have sex with men (MSM) of unknown HIV positive serostatus in Bangkok, Thailand. AIDS Behav 2016; 20 386–97.
| Psychosocial and behavioral characteristics of high-risk men who have sex with men (MSM) of unknown HIV positive serostatus in Bangkok, Thailand.Crossref | GoogleScholarGoogle Scholar | 27553027PubMed |

[34] Maek-a-nantawat W, Phanuphak N, Teeratakulpisarn N, Pakam C, Kanteeranon T, Chaiya O, et al Attitudes toward, and interest in, the test-and-treat strategy for HIV prevention among Thai men who have sex with men. AIDS Care 2014; 26 1298–302.
| Attitudes toward, and interest in, the test-and-treat strategy for HIV prevention among Thai men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 24766659PubMed |

[35] Piyaraj P, van Griensven F, Holtz TH, Mock PA, Varangrat A, Wimonsate W, et al The finding of casual sex partners on the internet, methamphetamine use for sexual pleasure, and incidence of HIV infection among men who have sex with men in Bangkok, Thailand: an observational cohort study. Lancet HIV 2018; 5 e379–89.
| The finding of casual sex partners on the internet, methamphetamine use for sexual pleasure, and incidence of HIV infection among men who have sex with men in Bangkok, Thailand: an observational cohort study.Crossref | GoogleScholarGoogle Scholar | 29861202PubMed |

[36] Ananworanich J, Chitwarakorn A, Wimonsate W, Varangrat A, Chaikummao S, Sriporn A, et al HIV and syphilis infection among men who have sex with men – Bangkok, Thailand, 2005–2011. MMWR Morb Mortal Wkly Rep 2013; 62 518–20.

[37] Phanuphak N, Paris R, Colby D, Pinyakorn S. Low incidence of HIV infection in an anonymous HIV counselling and testing clinic cohort in Bangkok, Thailand despite high HIV prevalence and self-report of high-risk behaviour. J Virus Erad 2015; 1 89–95.
| Low incidence of HIV infection in an anonymous HIV counselling and testing clinic cohort in Bangkok, Thailand despite high HIV prevalence and self-report of high-risk behaviour.Crossref | GoogleScholarGoogle Scholar | 27482397PubMed |

[38] Veronese V, Traeger M, Oo ZM, Tun TT, Oo NN, Maung H, et al HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community-based HIV testing services. J Int AIDS Soc 2020; 23 e25454
| HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community-based HIV testing services.Crossref | GoogleScholarGoogle Scholar | 32112538PubMed |

[39] Gangcuangco LM, Tan ML, Berba RP. Prevalence and risk factors for HIV infection among men having sex with men in Metro Manila, Philippines. Southeast Asian J Trop Med Public Health 2013; 44 810–7.
| 24437316PubMed |

[40] Le TM, Lee PC, Stewart DE, Long TN, Quoc CN. What are the risk factors for HIV in men who have sex with men in Ho Chi Minh City, Vietnam? A cross-sectional study. BMC Public Health 2016; 16 406
| What are the risk factors for HIV in men who have sex with men in Ho Chi Minh City, Vietnam? A cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 27184025PubMed |

[41] Holtz TH, Wimonsate W, Mock PA, Pattanasin S, Chonwattana W, Thienkrua W, et al Why we need pre-exposure prophylaxis: incident HIV and syphilis among men, and transgender women, who have sex with men, Bangkok, Thailand, 2005–2015. Int J STD AIDS 2019; 30 430–9.
| Why we need pre-exposure prophylaxis: incident HIV and syphilis among men, and transgender women, who have sex with men, Bangkok, Thailand, 2005–2015.Crossref | GoogleScholarGoogle Scholar | 30626283PubMed |

[42] Weissman A, Ngak S, Srean C, Sansothy N, Mills S, Ferradini L. HIV prevalence and risks associated with HIV infection among transgender individuals in Cambodia. PLoS One 2016; 11 e0152906
| HIV prevalence and risks associated with HIV infection among transgender individuals in Cambodia.Crossref | GoogleScholarGoogle Scholar | 27732613PubMed |

[43] Chhim S, Ngin C, Chhoun P, Tuot S, Ly C, Mun P, et al HIV prevalence and factors associated with HIV infection among transgender women in Cambodia: results from a national Integrated Biological and Behavioral Survey. BMJ Open 2017; 7 e015390
| HIV prevalence and factors associated with HIV infection among transgender women in Cambodia: results from a national Integrated Biological and Behavioral Survey.Crossref | GoogleScholarGoogle Scholar | 28801398PubMed |

[44] Yi S, Ngin C, Tuot S, Chhoun P, Chhim S, Pal K, et al HIV prevalence, risky behaviors, and discrimination experiences among transgender women in Cambodia: descriptive findings from a national integrated biological and behavioral survey. BMC Int Health Hum Rights 2017; 17 14
| HIV prevalence, risky behaviors, and discrimination experiences among transgender women in Cambodia: descriptive findings from a national integrated biological and behavioral survey.Crossref | GoogleScholarGoogle Scholar | 28535758PubMed |

[45] Wickersham JA, Gibson BA, Bazazi AR, Pillai V, Pedersen CJ, Meyer JP, et al Prevalence of human immunodeficiency virus and sexually transmitted infections among cisgender and transgender women sex workers in Greater Kuala Lumpur, Malaysia: results from a respondent-driven sampling study. Sex Transm Dis 2017; 44 663–70.
| Prevalence of human immunodeficiency virus and sexually transmitted infections among cisgender and transgender women sex workers in Greater Kuala Lumpur, Malaysia: results from a respondent-driven sampling study.Crossref | GoogleScholarGoogle Scholar | 28708696PubMed |

[46] Colby D, Nguyen NA, Le B, Toan T, Thien DD, Huyen HT, et al HIV and syphilis prevalence among transgender women in Ho Chi Minh City, Vietnam. AIDS Behav 2016; 20 379–85.
| HIV and syphilis prevalence among transgender women in Ho Chi Minh City, Vietnam.Crossref | GoogleScholarGoogle Scholar | 27435074PubMed |

[47] van Griensven F, Ayutthaya PPN, Wilson E. HIV surveillance and prevention in transgender women. Lancet Infect Dis 2013; 13 185–6.
| HIV surveillance and prevention in transgender women.Crossref | GoogleScholarGoogle Scholar | 23260127PubMed |

[48] Januraga PP, Reekie J, Mulyani T, Lestari BW, Iskandar S, Wisaksana R, et al The cascade of HIV care among key populations in Indonesia: a prospective cohort study. Lancet HIV 2018; 5 e560–8.
| The cascade of HIV care among key populations in Indonesia: a prospective cohort study.Crossref | GoogleScholarGoogle Scholar | 30143455PubMed |

[49] Zablotska I, Grulich AE, Phanuphak N, Anand T, Janyam S, Poonkasetwattana M, et al PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers. J Int AIDS Soc 2016; 19 21119
| PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers.Crossref | GoogleScholarGoogle Scholar | 27760688PubMed |

[50] van Griensven F, Guadamuz TE, de Lind van Wijngaarden JW, Phanuphak N, Solomon SS, Lo Y-R. Challenges and emerging opportunities for the HIV prevention, treatment and care cascade in men who have sex with men in Asia Pacific. Sex Transm Infect 2017; 93 356–62.
| Challenges and emerging opportunities for the HIV prevention, treatment and care cascade in men who have sex with men in Asia Pacific.Crossref | GoogleScholarGoogle Scholar | 28729520PubMed |

[51] Bien-Gund CH, Zhao P, Cao B, Tang W, Ong JJ, Baral SD, et al Providing competent, comprehensive and inclusive sexual health services for men who have sex with men in low- and middle-income countries: a scoping review. Sex Health 2019; 16 320–31.
| Providing competent, comprehensive and inclusive sexual health services for men who have sex with men in low- and middle-income countries: a scoping review.Crossref | GoogleScholarGoogle Scholar | 31213225PubMed |

[52] van Griensven F, Holtz TH, Thienkrua W, Chonwattana W, Wimonsate W, Chaikummao S, et al Temporal trends in HIV-1 incidence and risk behaviours in men who have sex with men in Bangkok, Thailand, 2006–13: an observational study. Lancet HIV 2015; 2 e64–70.
| Temporal trends in HIV-1 incidence and risk behaviours in men who have sex with men in Bangkok, Thailand, 2006–13: an observational study.Crossref | GoogleScholarGoogle Scholar | 26424462PubMed |

[53] Colby D, Srithanaviboonchai K, Vanichseni S, Ongwandee S, Phanuphak N, Martin M, et al HIV pre‐exposure prophylaxis and health and community systems in the Global South: Thailand case study. J Int AIDS Soc 2015; 18 19953
| HIV pre‐exposure prophylaxis and health and community systems in the Global South: Thailand case study.Crossref | GoogleScholarGoogle Scholar | 26198342PubMed |

[54] Phanuphak N, Sungsing T, Jantarapakde J, Pengnonyang S, Trachunthong D, Mingkwanrungruang P, et al Princess PrEP program: the first key population-led model to deliver pre-exposure prophylaxis to key populations by key populations in Thailand. Sex Health 2018; 15 542–55.
| Princess PrEP program: the first key population-led model to deliver pre-exposure prophylaxis to key populations by key populations in Thailand.Crossref | GoogleScholarGoogle Scholar | 30249317PubMed |

[55] National Health Security Office (NHSO). NHSO board adds PrEP for high risk populations to fiscal year 2020 budget. [In Thai] Nonthaburi: National Health Security Office; 2019. Available online at: https://www.nhso.go.th/frontend/NewsInformationDetail.aspx?newsid=MjUzMg== [verified July 2020].

[56] Zhang L, Phanuphak N, Henderson K, Nonenoy S, Srikaew S, Shattock AJ, et al Scaling up of HIV treatment for men who have sex with men in Bangkok: a modelling and costing study. Lancet HIV 2015; 2 e200–7.
| Scaling up of HIV treatment for men who have sex with men in Bangkok: a modelling and costing study.Crossref | GoogleScholarGoogle Scholar | 26423002PubMed |

[57] United States Agency for International Development. Vietnam launches national program for pre-exposure prophylaxis for HIV. 2018. Available online at: https://www.usaid.gov/vietnam/press-releases/nov-30-2018-vietnam-launches-national-program-pre-exposure-prophylaxis [verified March 2020].

[58] Ministry of Health Cambodia. Concept-note on HIV pre-exposure prophylaxis (PrEP) implementation in Cambodia. 2019. Available online at: https://niph.org.kh/niph/uploads/library/pdf/GL199_PrEP_concept_note-EN.pdf [verified March 2020].

[59] Wheelock A, Eisingerich AB, Ananworanich J, Gomez GB, Hallett TB, Dybul MR, et al Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance. PLoS One 2013; 8 e54288
| Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance.Crossref | GoogleScholarGoogle Scholar | 23342121PubMed |

[60] Lim SH, Mburu G, Bourne A, Pang J, Wickersham JA, Wei CKT, et al Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: findings from an online survey. PLoS One 2017; 12 e0182838
| Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: findings from an online survey.Crossref | GoogleScholarGoogle Scholar | 28902857PubMed |

[61] Logie CH, Newman PA, Weaver J, Roungkraphon S, Tepjan S. HIV-related stigma and HIV prevention uptake among young men who have sex with men and transgender women in Thailand. AIDS Patient Care STDS 2016; 30 92–100.
| HIV-related stigma and HIV prevention uptake among young men who have sex with men and transgender women in Thailand.Crossref | GoogleScholarGoogle Scholar | 26788978PubMed |

[62] Mendos LR. State-sponsored homophobia: global legislation overview update. 2019. Available online at: https://ilga.org/downloads/ILGA_World_State_Sponsored_Homophobia_report_global_legislation_overview_update_December_2019.pdf [verified 12 January 2021].

[63] Chiam Z, Duffy S, Gonzalez Gil M. Trans legal mapping report: recognition before the law. 2017. Available online at: https://ilga.org/downloads/ILGA_Trans_Legal_Mapping_Report_2017_ENG.pdf [verified 12 January 2021].

[64] Gamarel KE, Nelson KM, Stephenson R, Santiago Rivera OJ, Chiaramonte D, Miller RL. Anticipated HIV stigma and delays in regular HIV testing behaviors among sexually-active young gay, bisexual, and other men who have sex with men and transgender women. AIDS Behav 2018; 22 522–30.
| Anticipated HIV stigma and delays in regular HIV testing behaviors among sexually-active young gay, bisexual, and other men who have sex with men and transgender women.Crossref | GoogleScholarGoogle Scholar | 29214408PubMed |

[65] World Health Organization (WHO). Policy brief: WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP). 2015. Available online at: https://apps.who.int/iris/bitstream/handle/10665/197906/WHO_HIV_2015.48_eng.pdf?sequence=1 [verified December 2020].

[66] World Health Organization (WHO). WHO implementation tool for pre-exposure prophylaxis of HIV infection. 2017. Available online at: https://www.who.int/hiv/pub/prep/prep-implementation-tool/en/ [verified December 2020].

[67] World Health Organization (WHO). Technical brief: what’s the 2+1+1? Event-driven oral pre-exposure prophylaxis to prevent HIV for men who have sex with men: update to WHO’s recommendation on oral PrEP. 2019. Available online at: https://apps.who.int/iris/bitstream/handle/10665/325955/WHO-CDS-HIV-19.8-eng.pdf [verified December 2020].