Earlier this year, the Korea Disease Control and Prevention Agency (KDCA) released the Second Plan for the Prevention and Control of Acquired Immunodeficiency Syndrome (2024-2028).

The plan’s main objective was to halve the number of new HIV infections, which stands at around 1,000 per year, by 2030.

As one of the key tasks to prevent new infections, the agency plans to expand the use of pre-exposure prophylaxis (PrEP) in vulnerable groups. It also has set a specific goal to increase the number of PrEP prescriptions from 550 in 2024 to 1,500 by 2028.

However, the KDCA's goal of 1,500 was set without scientific grounds. The target does not provide evidence regarding the size of the HIV-infected vulnerable population in the country or the specific PrEP coverage the government aims to achieve.

It is an approach like a proverbial traveler who does not know where he is but says, “It doesn’t matter which way I take as long as I reach Seoul.”

The contrast is evident when compared to the U.S., where PrEP implementation is already active.

In the U.S., before they implemented PrEP, community surveys and other service studies were conducted to determine the exact number of men who have sex with men (MSM) who needed PrEP. The number of people in need of PrEP was set at 1,216,210 and the goal was to achieve a 50 percent PrEP coverage by 2025.

As a result, PrEP coverage has increased each year, 36 percent of people who need PrEP receive appropriate prescriptions. While PrEP policies vary from state to state, places like San Francisco are already seeing a reduction in new HIV infections.

In San Francisco, PrEP popularization has reached 72 percent in the 10 years since its introduction in 2012, which has led to a 67 percent reduction in new HIV infection.

Why has San Francisco been so successful?

San Francisco has a program called “Magnet PrEP Care,” run by the San Francisco AIDS Foundation (SFAF). The program provides comprehensive support services, from HIV testing to prescribing PrEP medication to managing adherence. The program covers the full cost of health insurance for participants enrolled in Covered California and meets income eligibility.

To run an effective PrEP program, it is essential to budget accordingly. Without funding, there is no guarantee of implementation.

Korea is no exception. Without an accurate estimate of the number of people living with HIV and in need of PrEP, the budgeting can’t help being unclear.

To meet the government's 2030 target, it's time for a policy service study to determine the exact number of people in Korea who need PrEP before it gets too late.