Africa:Is Prep The Key To Hiv Infection Reduction?

Africa:Is Prep The Key To Hiv Infection Reduction?

By Kelvin Mbewe

AT exactly 14 hours in the afternoon Dorcas Muma (not real name) 23 has to take a tablet of her medication.

The medicine is meant to prevent her from being infected with HIV.

She takes truvada, an anti-retroviral (ARV) medication that has the capacity to prevent HIV by 75 percent if taken accordingly.

In late 2015, the World Health organisation recommended PREP as an additional prevention option for HIV negative people at substantial risk of acquiring HIV.

This is in an effort to achieve the ambitious 90.90.90 treatment target to help end the AIDS epidemic.


The target states that by 2020, 90% of all people living with HIV will know their HIV status.

By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.

By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Ms Muma is a Zimbabwean that sells sex and has been on truvada for four years and has remained HIV negative despite having unprotected sexual intercourse with different men.

The process of this type of HIV prevention is known as Pre-exposure prophylaxis (PREP) which means protection against activity that can lead to acquiring HIV before the actual activity.

“Personally as a young woman that sells sex I saw the risks that I was in because I sometimes get violent clients such that I find it challenging to negotiate for condom use, I was also on drugs at some point and also shared needles with other people to make tattoos,” she said.

Ms Muma has been selling sex since the age of 13.

She is not the only one at risk of getting infected; almost everyone that has sexual intercourse is at risk.

She gets PREP from a local non-governmental organization in Zimbabwe.

A month ago she tested negative when she went for checkups at the hospital.

“In terms of pleasure sex, there is need to have it without a condom. But when PREP was being administered to us, they made it very clear that it does not protect you from getting Sexual Transmitted Infections, or pregnancy. Am young lady and I have boyfriends who I can’t deny sex without a condom,” she said.

She says PREP gives her a free mind when she sleeps with different men.

“What they advise is that one should take this medication 7 days before being exposed to HIV, but as for me I take it daily because I can have a client’s anytime,” she said.

She however had fears when she just started taking PREP because she was not sure of the product.

Just like any other medication Truvada has some minor side effects.

“Definitely yes, there are side effects when you are taking PREP, in my first days I had nausea, I could vomit, I had flu, I could also feel sleepy,” she said.

Stigma has however been a challenge for other people at high risk of getting HIV.

“Some young people that are at high risk of getting infected are afraid of taking PREP because of the stigma that is attached to it,” she said.

Similar to Zimbabwe, Zambia has some NGOs that administer PREP to a few clients.

Treatment Advocacy and literacy campaign (TALC) is an NGO that is spearheading the campaign for government to formulate a policy that will make it possible for citizens to access PREP.

In an interview TALC executive director Felix Mwanza said people that are negative are anxious to having access to the drug.

“There are also discordant couples, meaning that one in that particular couple is negative while the other is positive, the one that is negative can be put on prep, especially when the positive one has not attained viral suppression,” he said.

When one attains viral suppression they become less infectious, their ability to transmit the virus becomes minimal.

It is also advisable that people that are in a relationship or even in marriage where one suspects that there partner is not trustworthy, for such a person to safe guard themselves they can be on prep.

And also for men that have sex with men because of their biological makeup, the can also be on prep because of the high risk of contraction.

Meanwhile when contacted for a comment Ministry of Health Permament secretary Kennedy Malama could not give a comment on when Zambia will roll out PREP.

Dr Malama said he has to consult relevant authorities before making a comment on the matter.

HIV/AIDS has led to a lot death, according to research 35 million people are living with HIV worldwide.

Therefore preventive measures such as PREP ought to be embraced in an effort to minimize the effects of HIV.




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