Each one of us is prone to get caught up in situationships that we can barely escape within our LGBTI community and Sex Workers’ movement. A person decides to get involved in a committed sexual relationship with a partner that is already living with HIV with or without being aware of their HIV status, multiple casual sexual encounters barely using protection (condoms), having unprotected sex with partners of the opposite sex whose HIV status is unknown and sharing injections or piercing objects (especially if one has been in a treatment programme for injecting drug use) are all not things of the past but also in the present. Hence, a rise to a need for the availability of PrEP as a preventive measure or strategy against the HIV scourge within our community.
PrEP is Pre- Exposure Prophylaxis which is an anti HIV medication that keeps HIV negative people from getting infected. Truvada is currently the only drug approved to be used as PrEP with a combination of two Anti- HIV drugs in one; Tenofovir and Emtricitabrine according to AVERT (www.avert.org). A single oral pill that is swallowed daily is recommended for key populations who are HIV negative but are at a substantial risk of contracting HIV namely; Sex Workers, Men who have Sex with Men and People Who Inject Drugs (PWIDs). If it is taken consistently and correctly, PrEP works in a way that the medication interferes with HIV’s ability to replicate itself in one’s body after they have been exposed to the virus. Because there will be a high enough level of PrEP in the body to prevent you from getting HIV, the chances of getting sick are close to zero and thus prevents one from HIV infection(s).
The limitations of PrEP include the fact that this medication has been around for a short while so it is unpopular. Few people will claim to have knowledge of it’s existence and information to make informed decisions on whether to or not to use PrEP but a large number of the LGBTI/ Sex Workers’ population in Uganda are ignorant about the accessibility of PrEP in the health facilities. Even among those that have knowledge about PrEP, most of them are concerned with where they can access it rather than knowledge on how it works in the body to prevent HIV infections and the side effects like nausea, vomiting, fatigue, dizziness and mild headaches which may however disappear over time. Persistence of such symptoms require the full attention of a health care professional (http://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf).
PrEP alone doesn’t protect someone from other STDs/ STIs like Gonorrhea, Chlamydia, Syphillis, Hepatitis C unless condoms are used as well. Compared to HIV treatment, PrEP is not lifetime medication. It is taken within short periods of time, could be weeks, months or a few years during which a person is most at risk of HIV. It is advisable that whoever wills to start PrEP takes an HIV test to make certain that they are HIV negative. Otherwise, starting or stopping PrEP while one is HIV positive will likely lead to development of drug resistance in one’s body. PrEP services in Uganda can be accessed from MARPI clinic in Mulago, Ice Breakers Uganda, KCCA clinics, TASO and MildMay.
Photo Credit: Men of the Night.