A little known drug that can prevent HIV infection if taken consistently could change Ugandans sex lives forever.
Until now, the only option for preventing infection for Ugandans who had engaged in unprotected sex had been PEP- or Post Exposure Prophylaxis, which entails embarking on preventive treatment within 72 hours after one gets exposed to the HIV virus. That treatment, although available in medical facilities in Kampala doesn’t come cheap, costing between Shs80,000 and Shs150,000 for a dose.
There isn’t just an option now, it is also a better option. It is called PrEP; Pre Exposure Prophylaxis, and the most common brand name under which it is sold is a drug called Truvada.
PrEP is applied in reverse to how PEP works, with people at very high risk of HIV taking the drug daily to lower their chances of getting infected. According to the Centers for Disease Control and Prevention its use can reduce the risk of getting HIV from sex by more than 90%.
First tried in the USA and later rolled out to countries such as France, Canada, Israel and South Africa, it has now got into sharp focus in Uganda after our neighbours Kenya announced plans to roll out the use of the drug last week.
Tried and tested
Uganda and Kenya have a history with PrEP, as both countries were used for clinical trials when the drug was first tested locally eight years ago, among discordant couples (i.e. couples where one partner is HIV positive and the other is not). These involved administering PrEP to the HIV negative partner for a while. These clinical trials yielded positive results, proving PrEP could be effective in preventing HIV infection.
According to Mr. Charles Brown, Advocacy and Liaison Officer at Infectious Diseases Institute, Makerere, PrEP was initiated with an aim of protecting people who face high risk of exposure such as sex workers and medics.
“The drug is supposed to be taken for two weeks before any potential exposure if it is to be effective as the drug needs time to build up immunity,” he told us. Once exposed before the wonder drug has been used for this time span, one is at a higher risk of infection, he added.
96% success rate
According to Mr. Brown, 1013 couples across Uganda and Kenya were used in the clinical trials and they were followed up for a period of three years.
“The results were overwhelming. Partners using PrEP were 96% resistant to infection which was close to near elimination,” he said.
These remarkably successful tests persuaded government to take steps to clear the use of the drug in the country, and in December 2016, technical guidelines for PrEP’s use were passed by the Ministry of Health. Yet, the ministry is non-committal about when exactly the drug will be available to Ugandans. In a phone interview with Matooke Republic, Dr. Joshua Musinguzi, the Programs Manager, AIDS Control Program told us the ministry had no plans of supplying these drugs under government funding.
“Even those who are HIV positive are not getting sufficient medication from the state,” he remarked, in apparent reference to the fact that government will continue to prioritise other means of HIV and AIDS prevention, such as access to condoms and antiretroviral drugs (ARVs).
Asked whether the drug will be accessible in pharmacies, he said the ministry was reluctant for such a sensitive drug being dispensed “anyhow” in pharmacies.
“These are not drugs for a headache. This is HIV we are dealing with here,” he said.
The World Health Organization and AIDS advocacy groups however are for making the drug widely available.
In Kenya, the estimated cost of a yearly dose is $602- approximately Shs2.1m, or about Shs45,000 for a week’s dose.
Below is an infographc with PrEP basics courtesy of the Centers For Disease Control.
