The Ministry of Health in Trinidad and Tobago is conducting a comprehensive evaluation of two key preventative medications for HIV and sexually transmitted infections (STIs) as part of a potential shift in public health strategy. Health Minister Dr. Lackram Bodoe confirmed the review is examining pre-exposure prophylaxis for HIV (PrEP) and doxycycline prophylaxis (DoxyPEP) through the ministry’s HIV/AIDS Coordinating Unit, following global health guidance.
This development comes in response to growing advocacy from public health experts and organizations, including a recent call for expanded access to these tools amid rising HIV and STI cases. Of particular concern is a sharp increase in syphilis infections among pregnant women.
Minister Bodoe emphasized that the technical assessment encompasses clinical benefits, behavioral implications, cost considerations, and international best practices. “Our priority is always to reduce new HIV infections and protect the health and well-being of the population,” Bodoe stated. “Any decision related to PrEP or DoxyPEP will be guided by science, expert advice, and what is best for the people of TT.”
The Family Planning Association of TT (FPATT) identified these medications as critical components in the national effort to eliminate HIV/AIDS by 2030, aligning with global UNAIDS targets. While recognized globally as effective prevention tools, neither medication is widely available through public health services except under specific circumstances such as occupational exposure for healthcare workers or following sexual assault.
Significant barriers to implementation include the absence of a national policy enabling general access, sustainable funding challenges for government programs and NGOs, persistent stigma around HIV, logistical and procurement issues, and insufficient awareness among both the public and healthcare providers.
Dion Gill, founder of the KingK Initiative and mental and sexual health educator, highlighted the need for a comprehensive approach beyond clinical considerations. He emphasized addressing cultural misconceptions that these medications encourage promiscuity, instead framing them as tools for sexual autonomy and mental well-being. Gill advocated for community-led healthcare services, particularly for reaching vulnerable populations like men who have sex with men, and stressed the importance of confidentiality in encouraging uptake.
The ministry has not provided a specific timeframe for completing its review but has committed to updating the public once the technical assessment is finalized.