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LCQ14: Comprehensive treatment and care services for patients with AIDS
     Following is a question by the Dr Hon Helena Wong and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 14):


     According to a study report published in the United States in 2015, the life-long medical treatment fees for a person living with Human Immunodeficiency Virus (HIV) was US$338,000 (i.e. around HK$2,629,640).  In the past three years, the average expenditure incurred by the Hospital Authority (HA) on the use of prophylaxis on people after exposure to HIV, i.e. post-exposure prophylaxis (PEP), was around $8,800 per case.  In other words, as long as one among every 290 PEP recipients can be successfully prevented from HIV infections as a result of the use of PEP, this intervention measure is cost-effective.  This situation can prove that the timely use of PEP is, apart from providing effective and life-long guard against HIV infections among high-risk groups, also conducive to the Government's efforts in reducing its exorbitant expenditure on anti-HIV drugs.  However, the Scientific Committee on Acquired Immune Deficiency Syndrome and Sexually Transmitted Infections (the Scientific Committee) currently does not recommend the routine use of PEP for non-occupational exposure to HIV (e.g. exposure to HIV through sexual contact) for the prevention of Acquired Immune Deficiency Syndrome (AIDS).  On the other hand, in its Recommended HIV/AIDS Strategies for Hong Kong (2017-2021) released last month, the Hong Kong Advisory Council on AIDS (ACA) has pointed out that the number of new HIV infections has continued to escalate in recent years and that the next few years will be a critical point which may determine if the HIV epidemic in Hong Kong spins out of control.  ACA has also recommended that the Scientific Committee should consider revising its recommendation on the non-occupational use of PEP.  In this connection, will the Government inform this Council:

(1) of the following information in relation to the medical treatment and nursing care provided by the public sector to AIDS patients in each of the past seven financial years: (i) the expenditure incurred by the Department of Health, (ii) the expenditure incurred by HA, (iii) the number of healthcare staff involved, and (iv) the number of patients involved (set out such information in the table below);
Financial year (i) (ii) (iii) (iv)

(2) whether it will allocate additional resources in the coming few years to cope with the worsening HIV epidemic in Hong Kong; if so, of the details; if not, the reasons for that; and

(3) whether it will, in the light of the recommendations of ACA, request the Scientific Committee to revise its recommendation on the non-occupational use of PEP shortly; if so, of the details and timetable; if not, the reasons for that?



(1) The comprehensive treatment and care services provided by the Department of Health (DH) for patients with Acquired Immune Deficiency Syndrome (AIDS) include doctor's assessment, medication, psychological counselling, health education and social support, which are classified as expenditure items for different areas of work.  Therefore, the DH is unable to work out the expenditure of medical treatment and nursing care incurred specifically for AIDS patients.  In the past seven financial years, the number of AIDS patients who received medical treatment and nursing care provided by the DH in each year and the number of healthcare staff involved are set out in the table below:
Financial year Number of healthcare staff Number of patients
2010-2011 25 1,626
2011-2012 25 1,774
2012-2013 25 2,012
2013-2014 25 2,266
2014-2015 25 2,507
2015-2016 25 2,773
2016-2017 25 3,038

     As healthcare professionals of the Hospital Authority (HA) providing medical treatment and nursing care for AIDS patients also provide clinical services for other patients, the HA is therefore unable to work out the expenditure incurred and number of healthcare staff involved specifically for providing medical treatment and nursing care to AIDS patients.  The number of AIDS patients who received medical treatment and nursing care provided by the HA in each of the past seven financial years is set out in the table below:
Financial year Number of patients
2010-2011 955
2011-2012 1,083
2012-2013 1,195
2013-2014 1,342
2014-2015 1,538
2015-2016 1,761
2016-2017 2,008

(2) and (3) The Government has been allocating resources for the prevention and control of Human Immunodeficiency Virus (HIV)/AIDS.  Established in 1990, the Hong Kong Advisory Council on AIDS has been tasked for reviewing local and international trends and developments relating to HIV infection and AIDS; advising the Government on policy relating to the prevention, care and control of HIV infection and AIDS in Hong Kong; and advising on the co-ordination and monitoring of programmes on the prevention of HIV infection and the provision of services to people with HIV/AIDS in Hong Kong. 

     The Finance Committee (FC) of the Legislative Council approved in April 1993 a one-off provision of $350 million for the establishment of the AIDS Trust Fund (the Fund) to provide assistance for HIV-infected haemophiliacs, improve medical and support services, and enhance public education on AIDS.  An additional injection of $350 million was approved by the FC in 2013-14 to provide continuous support for funding applications under the Fund. 

     The DH has also allocated resources to the Student Health Service, Special Preventive Programme (SPP), Men's Health Programme and Social Hygiene Service for HIV prevention, public education and publicity programmes.  The SPP is also committed to appealing to the public to care more about HIV/AIDS, supporting the development of evidence-based AIDS strategies, and training up clinical and public health experts in HIV and infectious diseases.  Besides, the Government has been organising activities in partnership with non-governmental organisations to raise public awareness of AIDS and promote public acceptance of and care for patients with HIV/AIDS. 

     The Scientific Committee on AIDS and Sexually Transmitted Infections (the Scientific Committee) under the Centre for Health Protection of the DH is responsible for advising the Government on the scientific basis of the prevention, care and control of AIDS and sexually transmitted infections.  For non-occupational exposure to HIV, for example, through sexual contact or injection exposure, the current position of the Scientific Committee, as issued in 2006, is that post-exposure prophylaxis (PEP) should not be prescribed as a matter of routine.

     Currently, anyone who had unsafe sex (non-occupational exposure to HIV) may seek medical treatment at the Accident and Emergency Department upon exposure.  The doctor will conduct assessment and examination on the person.  Where necessary and appropriate, the doctor will prescribe PEP and refer the person to the integrated treatment centre of the DH for follow-up treatment.  Records show an increase in the number of PEP prescriptions by the DH in the past few years.  The number of cases increased from 21 in 2014 to 62 in 2016.  In the same period, the number of cases treated by the HA also increased from 15 to 29.

     In view of the rising demand for PEP prescriptions in recent years, the Scientific Committee has planned to review shortly its recommendation made in 2006.  The Government will consider whether and how to revise the current practice in accordance with the updated recommendations of the Scientific Committee, and thereafter consider the amount of resources to be allocated.
Ends/Wednesday, June 14, 2017
Issued at HKT 12:05
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