Date Night China: PrEP & PEP HIV Prevention in Beijing
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This article comes from Date Night China (WeChat ID: datenightchina), your guide to dating in China, from love to lust, first dates to worst dates, hilarious stories, and top tips to avoid (or steer into) disaster. Single in the city? Season 2 of their podcast is out now (listen via QR code below). To connect with others in the DNC community, add co-host Rachel to join their WeChat group: rachelweiss22.
A history of stigmatism and discrimination lies around HIV and the people it infects. Sometimes the prejudice that follows can seem worse than the disease itself. Individuals can be labeled and deemed socially unacceptable, believed to be part of certain social groups that make immoral judgments. It’s not uncommon for people to be judged as "deserving" of HIV because of their life choices, despite their efforts to prevent HIV transmissions and raise awareness.
Outdated beliefs and fears need to be stripped back and the truth exposed for all to hear and see.
HIV (human immunodeficiency virus) is a virus that attacks your immune system interfering with the body’s ability to fight infections. Once you get it, you have it for life. Currently, there is no cure, but with the right medical care, it can be controlled. Untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome).
The virus can be transmitted through contact with infected blood, semen, or vaginal fluids. Within a few weeks of HIV infection, flu-like symptoms can occur such as fever, sore throat, and fatigue. The disease is typically asymptomatic until it progresses to AIDS.
Over 16,000 HIV positive cases were reported in China in 2018 among 15-24-year-olds. HIV infection has surged in recent years among this age group despite steps taken to discourage the spread. Counseling services and anonymous test kits placed in vending machines across university campuses in Beijing have not decreased the ever-mounting new cases among young people, with 3,000 new student cases every year.
Fear of stigma and criticism from peers? From family? Fear of people knowing you are sexually active? Fear of being judged? These issues hold back change. Whether young or old, we have a responsibility to ourselves and our children to be educated on healthy sexual practices: being responsible about protection and seeking help and advice without fear of reprisal is crucial when fighting against stigma and discrimination.
There are three types of medication available for HIV, each with its own unique purposes:
HAART (Highly Active Anti-Retroviral Therapy) is the medications used to treat HIV. As stated above, there is no cure at present for HIV, but it is manageable through lifelong treatment of HAART.
PrEP (Pre-Exposure Prophylaxis) is preventative medicine for people who do not have HIV but are at risk of HIV. Insurance plans may cover the cost of PrEP, check with your provider for details. If you are at risk of repeated exposure to HIV, talk to your healthcare provider about PrEP.
PEP (Post-Exposure Prophylaxis) is medication taken after possible exposure to prevent HIV. PEP is for emergency situations only and must be started within 72 hours after possible exposure to HIV. If you believe you have been exposed whether through sex (condom broke), through needle sharing, syringes or other equipment for injecting drugs, or have been assaulted, then the sooner the better, every hour counts. Once prescribed, a course of PEP should be taken daily for 28 days. Depending on the reason you are prescribed PEP, you may qualify to be covered by insurance or your workplace (exposure at work).
In 2015, Charlie Sheen, a famous American actor – probably most well-known for his role on US television show Two and a Half Men – spoke out publicly on being HIV positive, having being diagnosed four years prior. This action of “talking” caused a major chain-reaction resulting in over a million people googling HIV, increasing awareness and testing, and later became known as the Charlie Sheen Effect.
Another element of Charlie Sheen’s HIV news that caught great attention was his sexual relations with women while living with HIV. He’d had unprotected sex with partners knowing of his condition. To quote Heather Boerner, a writer specialized in health care and the author of Positively Negative:
“Based on what Charlie Sheen said, how is it possible for someone that’s HIV-positive to have unprotected sex without passing it on?
The answer is highly-active antiretroviral treatment (HAART). That is, HIV meds. Today’s HIV meds are better, have fewer side effects, and are often available in a single combination pill. When taken consistently and when followed closely by their doctors, people with HIV can achieve an undetectable viral load and maintain it for years.
So when Sheen says that it’s virtually impossible for him to pass on the virus, he’s right."
An undetectable viral load means that the copies of HIV in his blood are so few, they are undetectable by current tests. This does not mean a person is cured, but while correctly using HAART medications, an undetectable viral load also means there is no virus in his system to pass to sexual partners. A major study, Prevention of HIV-1 Infection with Early Antiretroviral Therapy, found that just having a suppressed viral load can reduce the risk of transmitting the virus by 96 percent.
Although Sheen had an undetectable viral load due to his continued use of HAART, his lovers also took measures to protect themselves with PrEP, while continuing sexual relations with him.
PrEP Efficacy Rating: 99 percent
PrEP, when taken daily, is highly effective at preventing HIV. It is 99 percent effective against HIV transmission through sexual contact and 74 percent effective against HIV transmission through injection drugs.
PEP Efficacy Rating: 80 percent
With PEP, every hour counts. If you fear exposure, seek medical assistance as soon as possible and within the first 72 hours of exposure.
Note: Neither PrEP nor PEP provides protection against STDs such as gonorrhea, syphilis, HPV, etc. Condoms provide additional protection against HIV and most STDs and unintended pregnancies. No method is 100 percent effective against HIV infection, but together, these methods offer a more complete protection.
These medications are available in a number of hospitals across Beijing:
OASIS International Hospital (北京明德医院) is a private hospital that will also provide PrEP and PEP services beginning in the New Year. They are an established HIV and STD testing center that have added these medications to their services to provide a more comprehensive healthcare package.
PrEP. Sufatin (200mg entritabine + 300mg tenofovir) *30 tablets
PrEP. 舒发泰（恩曲他滨200mg+替诺福韦300mg）*30片PEP. Wirade 0.3g*30 PCS
PEP. 韦瑞德 0.3g*30片Lamivudine 0.1g*14 tablets
拉米夫定 0.1g*14片Rilpivirine 25mg*30 PCS
利匹韦林25mg*30片
Sexually active heterosexual men and women without HIV: recommended for men and women without HIV who have a sexual partner with HIV with a detectable viral load.
Sexually active gay and bisexual men without HIV: men who have sex with men (MSM) if, within the last six months, they have engaged in high-risk sexual behaviors or had a documented bacterial sexually transmitted infection.
Sexually active transgender persons without HIV
People who do not have HIV but inject drugs and have the possibility of sharing needles with others.
OASIS is a certified HIV antibody testing center, certified since 2013 by the Beijing Municipal Health Commission. Their in-house laboratory is accredited by the NCCL EQA since 2018 and is in full operation 24/7. Follow OASIS on WeChat by searching official accounts for MyOASIS.
*STI screening may be covered by your insurance. Contact OASIS to query your insurance benefits.
*For corporate and individual memberships, discounts apply.
Author Joshua Hiller has lived in China since 2007 and currently works at the OASIS International Hospital in Beijing. Read more from Joshua on Date Night China: Sexual Health: STDs, STIs, & Getting Tested in Beijing.
READ: Date Night China: Men’s Guide to Dressing for Winter
Images: OASIS International Hospital, CDC
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