Consider using Pre-exposure Prophylaxis (PrEP) to reduce the risk of HIV contraction

Recently, while conducting Antenatal Care (ANC) in one of the lower health facilities, a pregnant woman walked in with her spouse for these services. “What a young couple this is!” said one of the midwives.  During our interaction, we noted that the young girl was 14 years old while the boy was 20 years old. As part of the routine and baseline investigations required during the 01^st ANC visit/contact, HIV testing was done for the mother and the spouse. When the results were out, the young girl tested negative for HIV while the boy tested positive. 

The pregnant teenager was so worried about herself and the unborn baby contracting HIV from her HIV-infected spouse. At the same time, she feared separating from her spouse, yet they had been preparing together for a new bundle of joy on the way.

Well, with the team, we allayed their anxiety and explained how it’s very possible to still stay together in their heaven of love for life and still bear children as the father was to inherently take ARVs while the mother was to take pre-exposure prophylaxis (PREP) to protect her and the baby from contracting HIV infection. Their first question was, “Basawo, tell us more about PrEP”.

According to the World Health Organization (WHO), Pre-exposure prophylaxis (PrEP) is an HIV medication that when used consistently, reduces the risk of HIV infection during sex by over 90%. It can only be taken by HIV-negative people.

The WHO PrEP guidelines currently recommend the use of PrEP taken daily for both men and women who are at substantial risk of acquiring HIV. Daily PrEP use provides the highest amount of medication in the blood and body tissues and, thus, the highest level of protection. 

Unlike HIV-positive clients who take Antiretroviral Therapy (ART) for life, PrEP is not taken for life. 

Who should consider using PrEP?

• PREP is recommended for anyone who is HIV-negative and is at a higher risk of acquiring HIV.
• Discordant couple; your partner has HIV and does not have an undetectable viral load.
• You are not using condoms all the time with all sexual partners.
• You are having or have had sex with more than one sexual partner in a six-month period.
• You have a sexual partner who has other sexual partners and may be likely to have or be at high risk of HIV infection.
• You are having unprotected sex with a person who injects drugs and shares injection equipment with others.
• You inject drugs and share injecting equipment.
• You have sex when drinking alcohol and/or taking recreational drugs.
• You have been told that you have a sexually transmitted infection, such as gonorrhoea, syphilis, chancroid or herpes.
• You have a sex partner who was recently told that he or she has a sexually transmitted infection, including HIV.
• You are having unprotected sex with someone who has HIV and who is not on antiretroviral therapy, or who is on antiretroviral therapy but has not achieved suppression of viral load to undetectable levels.
• You and your sexual partner do not discuss your concerns about HIV, or your partner does not know his/her HIV status

While PrEP helps to prevent HIV infection prior to sex exposure, PEP (Post Exposure Prophylaxis) helps prevent contracting HIV by people who have been exposed to HIV. PrEP is free at different government health facilities and available for whoever is eligible. It is therefore important to protect yourself, your partner, your friend, or your relative from contracting HIV by spreading this information about PrEP.

Together we can end HIV/AIDs by 2030.

The authors are; Aisha Naava; a Nursing officer working with Kawolo General Hospital and Lilian Nuwabaine Luyima; a BSc Nurse & MSN-Midwife & Women’s Health Specialist