This blog post, written by Thabo Molelekwa, first appeared on What'sUpHIV as part of a series covering the 8th South African AIDS Conference.
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.
The National Department of Health, together with the implementing partners, like Baron’s organization, continue to work together to move PrEP forward and get it to the people who most need it. Individuals like Chiliza who take PrEP and talk about it their peers are helping to expand an important HIV prevention option for South Africans.