PrEP to the rescue

15th May 2018
PREVENTING INFECTION: Truvada is used for HIV prevention Source:The Midweek Sun

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By Sun Reporter - Reporter


Life challenges drove Bathabile Nyathi to sex work at a tender age, but she is thankful she has been able to avoid HIV infection because of the Pre-Exposure Prophylaxis (PrEp) pill she is taking.

This is an HIV prevention pill that the ministry of health hopes to have rolled out throughout Botswana by mid-year as the country strives to step up its prevention campaigns with a view of annihilating AIDS and resultant deaths by 2030. Having lived through the worst of the HIV/AIDS pandemic, Nyathi was just a child when she lost her parents and many of her relatives to the scourge and by the time she was 13 years old, she had dropped out of school and was pregnant.

With no qualifications to speak of, she felt she had no choice but to be a sex worker to support herself and her baby. Countless times she says she has been raped, beaten and suffered other atrocious deeds while in the line of duty and a lot of time, she has no control when and if condoms are used with her clients, making HIV-prevention difficult.

But while she can’t stop the attacks or the unprotected sex, the 23 year old is committed to staying HIV-negative thanks to the Pre-Exposure Prophylaxis (PrEp) pill that she has been taking every day for four years now. Scientific studies have shown that PrEp, a blue pill called Truvada, which is a combination of antiretroviral drugs taken once a day to reduce the risk of contracting HIV, is effective in protecting people from HIV during both anal and vaginal sex. “I really wanted to try using PrEP obviously for protection from HIV. I don’t want my daughter to lose me and have to fend for herself like I have had to do. But more than anything I took it for peace of mind to get rid of the ‘what if’ feeling” after every sexual encounter, Nyathi said in an interview on the sidelines of a Southern African Regional journalist training programme on HIV Prevention Research.

She shared how she even feels better choosing to hustle for more money with condomless sex now that she has the extra protection of PrEp. “And ‘choosing’ is definitely the word,” she added. “I feel much more in control of my choices and there is no feeling of guilt or shame after having condom-less sex”. Nyathi is aware of the risk of other STIs when choosing condomless sex. “The advantage of PrEP is that it is prescribed monthly along with an HIV test, pregnancy test and STI screening. This increased frequency of testing supports early detection and treatment of STIs,” she explained. Nyathi hopes that the increased use of PrEP could also help to change attitudes towards HIV and stigma towards people living with HIV.

While PrEP hasn’t been rolled out yet in Botswana, Head of Programme, HIV/AIDS at the Ministry of Health and Wellness, Dr Bornapate Nkomo said this will be done hopefully before mid year. “We want to roll it out as soon as possible. The committee that is spearheading the programme is just working on fine tuning implementation details,” he said.

The programme will specifically target key populations including men who have sex with men, sex workers, adolescent girls and mismatched couples. However the drug is already available in private practices. Botswana PrEp Ambassador, Beauty Tlhalerwa believes PrEP has a valuable place in sexual health risk management as well as reducing new HIV infections which stand at an estimated 10000 annually in the country. “We really need PrEp now if we want to end AIDS by 2030. Key populations should be the priority and the rest of the population should be assessed according to their risk profile so that it does not become an overly expensive exercise that we can’t sustain. “This is not to say people should now ignore condoms,” she said, adding that, “prevention is two-fold”.




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