A study on service models for pre-exposure prophylaxis (PrEP) provision in Thailand
DOI:
https://doi.org/10.14456/taj.2026.1Keywords:
service model, HIV, pre-exposure-prophylaxis (PrEP)Abstract
This descriptive study aimed to examine models of pre-exposure prophylaxis (PrEP) service delivery and to explore challenges and recommendations for PrEP implementation in Thailand. The study included 129 personnel from 110 pilot PrEP service units under Thailand’s National Health Security Office (NHSO) who voluntarily participated. Data were collected through surveys and interviews conducted with multidisciplinary teams in 12 health service facilities. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through thematic analysis. The findings revealed that PrEP services were delivered through three primary models: (1) healthcare facilities independently providing PrEP services, (2) healthcare facilities receiving referrals from civil society organizations (CSOs), community leaders, or other groups, and (3) healthcare facilities co-delivering PrEP services in partnership with CSOs, where clients accessed PrEP through these organizations. The majority of PrEP services were delivered in HIV Antiretroviral (ARV) clinics (81.40%), followed by counseling clinics (45.74%), and specialized PrEP clinics (34.88%). The most frequently served client groups were men who have sex with men (MSM) (17.32%), followed by serodiscordant couples (16.24%) and transgender women (14.34%). The most common outreach method was index testing (80.62%), where partners of people living with HIV were encouraged to undergo HIV testing. Additional approaches included intra-facility referrals (74.42%) and proactive collaboration with CSOs (46.51%). However, challenges remained in developing effective strategies to reach key populations, including limited workforce capacity, restricted service access channels, and persistent stigma and discrimination. Some providers reported concerns and limited confidence in delivering PrEP. To enhance service accessibility and effectiveness, the study suggests expanding the number of PrEP service facilities, strengthening collaborations between healthcare facilities and CSOs, strengthening provider capacity and awareness of the importance of PrEP, and promoting accurate public understanding of PrEP as part of a comprehensive HIV prevention strategy in Thailand.
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