In India, where more than 2.3 million people are living with HIV, trans women are among the groups at the highest risk of the virus. But a daily pill called pre-exposure prophylaxis (PrEP) is proving to be a powerful tool in the fight against HIV. PrEP is highly protective against HIV and is usually taken as a once-daily pill. However, global take-up of PrEP is still well below targets and remains concentrated in a relatively small number of countries.
In India, access to PrEP is patchy, and it is not offered through government-funded healthcare programs. While several brands are available for sale, the price of PrEP is often too steep for many who are potentially at risk. Many people on the medication access it through non-profits, but such charities are usually based in urban hubs, bypassing vulnerable people in smaller towns and rural areas.
Activists pushing to increase PrEP access said take-up is limited by stigma and stereotypes linking it to promiscuity. The stigma surrounding PrEP is also perpetuated by doctors and medical professionals, who are often unaware of the medication. For sex workers, PrEP can be the only way to stay safe as most are in no position to refuse sex without condoms.
Trans people are often reluctant to take the medication due to the widespread discrimination they face. The discrimination against hijras, an umbrella term that includes crossdressers, trans women, and intersex people, forces many into begging or sex work to survive. But community outreach schemes are making progress. Trans woman Adhya, who gets her daily pill through an LGBTQ+ healthcare clinic, says PrEP is a blessing.
In conclusion, while PrEP is a highly effective tool in the fight against HIV, access to it is limited in India. To combat the stigma surrounding the medication, the government needs to subsidize its cost across the country, make it available free of charge in government centers, and create a central database of dispensaries, clinics, and hospitals where it can be accessed. Campaigns aimed at raising awareness about PrEP are also necessary to encourage more people to take the medication and protect themselves against HIV.