Mon | Jan 27, 2020

Letter of the Day | The next step in HIV prevention

Published:Wednesday | December 4, 2019 | 12:30 AM


With World AIDS Day being commemorated this week, I thought it would be important to talk about the next step in HIV prevention. For Jamaica, that could be the inclusion of pre-exposure prophylaxis (PrEP). PrEP is a way for people who do not have HIV, but who are at very high risk of getting HIV, to prevent HIV infection by taking a pill every day.

The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injected drug use, these medicines can work to keep the virus from establishing a permanent infection.

PrEP is highly effective in reducing the risk of HIV infection through sexual intercourse and injected drug use. The Centers for Disease Control and Prevention in the United States notes that PrEP reduces the risk of getting HIV from sex by about 99 per cent when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74 per cent when taken consistently.

PrEP is for everyone, but more so for persons who engage in risky sexual behaviour, which includes condomless sex. This means that both men and women, and members of the LGBT community, would be able to benefit from the added protector.

PrEP is relatively safe but, like every other drug in existence, it does have some side effects, such as nausea in some people, but these generally subside over time. No serious side effects have been observed, and they aren’t life-threatening.

If you are a member of the trans community and on hormone replacement therapy (HRTs), there are no known drug conflicts or interactions between the medicines used in PrEP and HRTs, but, of course, more study needs to be done on this. Also, it’s important to note that PrEP does not protect against other forms of STIs, so it’s very important that persons still use condoms.

Jamaica already has one of the best HIV programmes in the region, with the infrastructure needed to support the introduction of PrEP. The ministry of health and Wellness just needs to figure out how the drug will be sourced and where, in terms of the facility, would be responsible for its distribution.

While PrEP is not foolproof, it still adds a needed layer of protection and reduces a person’s chances of contracting HIV. Using treatment as prevention can be a useful tool in getting to end the spread of AIDS by 2030.