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Preventing HIV with PrEP

Written by Dale Hes

South Africans' chances of contracting HIV have been drastically reduced, thanks to the Pre-Exposure Prophylaxis (PrEP) programme currently being rolled out by the Department of Health (DOH).

South Africa become the first country in sub-Saharan Africa to approve the use of PrEP. 

PrEP is a combination of two HIV medications, which should be taken daily to prevent HIV infection.

What is PrEP?

PrEP can be explained a little better by breaking down each word of the name;

 

Pre = before

Exposure = coming into contact with HIV

Prophylaxis = treatment to prevent an infection from happening.

HIV-negative people from high risk groups can use PrEP to avoid being infected with HIV.

Why was PrEP introduced?

The World Health Organization (WHO) first approved the treatment in 2015. The WHO recommended that people with a substantial risk of HIV infection should use PrEP daily as part of a combined HIV prevention strategy. When taken correctly, the treatment has been 99 percent successful in reducing the risk of getting HIV.

Government recognised the value of adding this proven prevention method to the other extensive programmes in place to combat the disease. 

South Africa has one of the highest HIV and AIDS burdens in the world.

The DOH first rolled out PrEP to 11 clinics in five provinces in 2016. The rollout has been progressing steadily, with about 36 000 people now receiving PrEP treatment.

Who should take PrEP?

PrEP treatment is an option available for people who find themselves at risk of possibly contracting HIV. The DOH has identified several groups of people who are most vulnerable:

Sex workers

The department has estimated that 20 percent of the approximately 350 000 people who are infected with HIV every year are connected with sex work. Female sex workers are
especially at risk, with 33 percent of them being infected with HIV by the age of 24, while as many as 80 percent are infected after the age of 25. The department said that these high rates confirm the urgency of using PrEP amongst members of this group, especially because of issues such as high rates of Gender-Based Violence and rape, and a lack of legal protection. Several PrEP rollouts have been completed or are underway in areas where sex workers operate.

Girls and young women

Girls and women between the ages of 15 and 24 are also at risk of contracting HIV. This is due to several reasons including having sex with older infected men, low condom use, limited power in controlling safe sex practices, and sexual and Gender-Based Violence.

 

Men who have sex with men
The department notes that men who have sex with other men are especially at risk because they may also be involved in other risky behaviours such as injecting drugs and selling sex. In trials, it has already been proven that offering PrEP to these groups has shown the largest impact in preventing HIV infection.

 

Sexual partners of HIV-positive people
Some couples find themselves in a situation where one partner is HIV-positive and the other is negative. In many cases, this can occur without either partner knowing that one of them is HIV-positive. Providing antiretroviral treatment to the infected partner can reduce the risk of transmission by 96 percent, while PrEP for the uninfected partner can reduce their risk by 75 percent.

Does PrEP have side effects?

Some people may experience side effects when they start PrEP. The most common side effects include:

  • Nausea
  •  Headache
  • Tiredness
  • Diarrhoea
  • Depression
  • Abnormal dreams
  • Vomiting
  • Rash
  • Problems sleeping
  • Changes in appetite

In most people, these side effects go away after a few weeks.

Where can you get PrEP?

Free PrEP is currently available at 108 sites around the country. 

For more information logon to, www.myprep.co.za. You can also call the National HIV and AIDS Helpline toll-free at 0800 012 322.

*This information was supplied by the National Department of Health

Did you know?

The Department of Health makes it clear that PrEP should not completely replace other effective and well-established HIV prevention techniques. PrEP studies have all been based on a combined approach to prevention, including regular testing and use of condoms and other contraceptives. These should still be used with PrEP treatment.