THABO MOLELEKWA writes: When Samkelisiwe Chiliza from
Durban heard about Pre-Exposure Prophylaxis or PrEP, she did not hesitate to join the PrEP study through the Centre for Aids
Programme and Research in South Africa (Caprisa).
PrEP is the use of anti-HIV
medication to keep HIV negative people from becoming infected. PrEP has been
shown to be safe and effective in clinical trials that have taken place in many
countries, including South Africa, and is approved by the South African
Medicines Control Council (MCC). Taken as a single pill once daily, it is highly
effective against HIV when taken every day. The medication interferes with
HIV’s ability to copy itself in one’s body after one has been exposed. This
prevents HIV from establishing an infection and making one sick.
Samkelisiwe is one of the
young women who are currently on PrEP in South Africa and she is encouraging
other young women to participate in one of the PrEP projects taking place
around the country so that they can help
stop the spread of HIV and keep themselves safe.
“I have been taking one
pill every night for the past 14 months and I am not willing to stop as I am
saving my life,” said Samkelisiwe, adding that she is not scared of testing for
HIV because she knows what results to expect since she is on PrEP.
According to Samkelisiwe, many
young women are already infected and are not eligible for PrEP as it is only
for HIV-negative people.
“Lots of people don’t know
about these kind of studies but I do spread the word as much as I can,” she
said.
She said that
her grandmother was happy to hear that she is taking a pill to protect herself from contracting HIV.
According to Professor
Linda-Gail Bekker of the Desmond Tutu HIV Centre, PrEP is a prevention option, not a treatment. It works properly when taken correctly and consistently, but that, currently, only 13,000 people who are receiving PrEP from the government. These are sex
workers and men who have sex with men. And there are only 1,387 people who are taking
PrEP through demonstration projects run by various organisations.
Prof Bekker said that, while
PrEP is not yet widely available, “there is advocacy going on to make sure that
the government rolls out PrEP to everyone who needs it.”
The high cost of PrEP is what stops the government from rolling it out to
everyone who needs it. Currently, there are only two ways to access
PrEP – “People can buy it at a chemist or they can join the demonstration
projects that are taking place in the country,” added Bekker.
Bekker said that educating people in the communities about PrEP is important because that
will give them knowledge of what the intervention is so that they can make
decisions about protecting themselves from HIV and preventing the spread of the
disease.
According to World
Health Organisation guidelines, PrEP is rolled out to people at substantial risk
of contracting HIV. Deborah Baron of Wits Reproductive Health and HIV Institute
(WRHI), believes that in South
Africa, PrEP should also be rolled out to young women because 7,000 young women
become newly infected with HIV every week in Eastern and Southern Africa. “And a third of those women are right here in
South Africa.” Said Baron.
Baron said that in order to
make PrEP interesting for young women there is a need for youth-friendly PrEP
delivery models and tools. “We need to be responsive to realities of young
women’s lives.”
In late 2015, the South
African Department of Health developed policy and
guidelines for oral PrEP as well as test-and-treat implementation to protect groups at high risk in line with World Health Organisation
guidance. The ARV drug, TDF/FTC, was approved for use as PrEP by the
Medicines Control Council.