Joy over HIV infection prevention drugs

Tinomuda Chakanyuka Sunday News Reporter
SEX workers have welcomed the latest World Health Organisation (WHO) guidelines which recommend the use of oral pre-exposure prophylaxes (PrEP) to prevent HIV infection in populations at risk. PrEP is the use of antiretroviral to prevent HIV infection, with Truvada being the drug that has been proved to be more effective in stopping HIV infection.By taking PrEP daily, the presence of the medicine in one’s bloodstream can often stop HIV from taking hold and spreading.
Several studies of PrEP have shown that the risk of getting HIV infection was about 92 percent lower for those who took the medicines consistently than for those who didn’t take the medicines.

The guidelines recommending the use of PrEP by key population were launched at the just ended International Conference on AIDS and STIs (Icasa) with the World health body urging all countries to immediately consider adopting them to prevent new HIV infections.

Some sex workers in the country were already using PrEP, albeit illegally, to prevent themselves from HIV infection as they sometimes offer their clients unprotected sex at costs higher than their normal charges.

Sex workers who spoke to Sunday News on the sidelines of the conference said the guidelines would go a long way in encouraging a number of African governments to include sex workers in their HIV programming.

Africa Sex Workers Alliance (ASWA) communications and membership officer Mr Denis Nzioka said with the new guidelines in place, governments should now work towards increasing accessibility of PrEP to key populations who are at risk of contracting HIV.

Mr Nzioka said while PrEP was welcome as prevention mechanism, it should be used together with other preventive measures to achieve optimum results.
“Of course we are excited because the use of PrEP will increase sex worker’s options when it comes to preventive measures they can use. In as much as WHO recommends the use of PrEP that we should not take it as the magic bullet. It should be used together with other measures such as condoms, lubricants, having fewer multiple partners and getting tested regularly,” he said.

Mr Nzoika, however, lamented the knowledge deficiency existing among sex workers on PrEP, a situation he said may militate against the effective use of the preventive measure.
He encouraged Government and other partners in the HIV fight to educate sex workers on PrEP first before rolling it out as an option to prevent HIV infection.

“We have done a study in 40 countries across the African continent as the Global Network for Sex Workers, talking to our members and we have observed that there is limited knowledge on PrEP. There are uncertainties on the long time effects of the drug, which made us realise that there is a need to educate sex workers first before offering them PrEP as an option,” he said.

Some sex workers who attended Icasa confirmed Mr Nzoika’s assertions, saying they were not aware of how PrEP really works, but welcomed it if it helps them protect themselves from HIV infection.

The sex workers also confirmed offering unprotected sex to some of their clients for charges higher than normal rates, a practice that increases their risk of HIV infection.
“We sometimes have unprotected sex because some of our clients demand it and offer higher rates. It’s not everyone of course that you offer unprotected sex but your regular clients. We are happy that there is now this PrEP that is being spoken about which allows us to have unprotected sex with our clients but having reduced the risk of getting HIV,” said a sex worker who only identified herself as Sylvia.

Lancing the latest WHO guidelines, WHO director for HIV programmes Dr Gottfried Hirnschall urged all countries to immediately start considering adopting the guidelines to accelerate efforts of eradicating Aids by 2030.

“Countries should look at these guidelines and immediately start using them as quickly as possible. Each country has to take them seriously as we move towards ending the Aids epidemic by 2030,” Dr Hirnschall said.

The latest WHO guidelines also recommend that all those who would have tested HIV positive be immediately initiated on anti-retroviral treatment regardless of their CD4 count.
The country is initiating ART to people living with HIV whose CD4 count is at 500 and below.

HIV prevalence rate among sex workers is higher than the national prevalence increasing the need to include such key populations in HIV prevention, treatment and care.
The Ministry of Health and Child Care is already working on integrating the key populations in HIV programming to ensure that they are protected from new HIV infections. According to the latest WHO report, the world is set to end the Aids epidemic by 2030.