Organization: Institute of HIV Research and Innovation (IHRI)
Nittaya Phanuphak finished her medical degree from Chulalongkorn University in Bangkok in 1996 and received her PhD in medicine from the University of Amsterdam in 2013. She is the Executive Director of the Institute of HIV Research and Innovation in Bangkok, Thailand, founded in 2020. She joined the Thai Red Cross AIDS Research Centre (TRCARC) in 2002 to lead a countrywide prevention of vertical transmission operational study of almost 8,000 pregnant women living with HIV. Data generated were used to change Thailand’s guidelines to recommend three-drug regimens to prevent vertical transmission in 2010.
Nittaya has developed a deep interest in the use of key population-centred approaches to enhance access to HIV testing, prevention and treatment. In 2008, she established an anal neoplasia screening service to bring men who have sex with men into HIV services at TRCARC; the model was then replicated in Bali, Jakarta and Kuala Lumpur to form the IeDEA-funded Anal Neoplasia Study in Asia and the Pacific (ANSAP). In 2015, she supported the establishment of the Tangerine Community Health Center at TRCARC using an integrated hormone therapy and sexual health service approach to effectively bring almost 4,000 trans women and trans men into services over five years. The model is currently being expanded to community-based organizations (CBOs), as well as public and private clinics, working with trans people in the region.
The high uptake of immediate antiretroviral therapy (ART) among Thai men who have sex with men and trans women, together with high HIV prevalence and incidence (demonstrated in Thailand’s first test-and-treat study led by her team in 2012), pushed national HIV guidelines to recommend ART regardless of CD4 count and PrEP for people vulnerable to HIV since 2014. In 2015, she started exploring the use of the Key Population-Led Health Services (KPLHS) approach to enhance HIV cascades, with PEPFAR and USAID support. In the KPLHS model, partnerships between CBOs and government/public health facilities allow capacity building for lay providers, who are members of key populations, to perform HIV testing, link clients living with HIV to ART, dispense PrEP and PEP, and retain both HIV-positive and HIV-negative clients in the programmes. She is working intensively with community and government partners to establish a national technical assistance platform to support KPLHS certification and legalization to ensure its sustainability through domestic financing mechanisms.
Through KPLHS, key population lay providers in Thailand have successfully dispensed PrEP to more than half of the PrEP users in the country. Nittaya strongly believes that PrEP must be demedicalized and requires differentiated service delivery models to rapidly reach high coverage and see its impact on the reduction of new HIV acquisitions.