It has been a while since I last posted an article. But It’s all good and I am so excited that I am finally at it again.
A month ago, a colleague from my office asked me to attend a certain media training on his behalf. I was excited to be part of the training because I knew it had something to do with health and as a professional journalist, I sensed it was an opportunity to learn further how to report on the subject professionally.
It was hence an honor to be part of the group and talk about HIV and AIDS because HIV and AIDS remains a major health concern in Malawi with new infections reaching 33,000 in 2019 (according to the Malawi National Strategic Plan for HIV and AIDS 2020-2025). Thankfully, there is a biomedical intervention called oral PrEP that can greatly help us reduce new infections
To begin, I first came across the word PrEP in 2015 back when I was pursuing my journalism diploma during a lesson on HlV and AIDS reporting class. In case you have no idea of what Prep is, then this article is for you.
PrEP is a short form for Pre-Exposure Prophylaxis –a form of ARV drugs but one consumed by HIV negative persons to prevent the acquisition of HIV.
As I have learnt, taken on a daily basis, PrEP is highly effective for preventing HIV acquisition from sex or injection drug use but is much less effective when it is not taken consistently.
But prEP is not a vaccine. Its designed to be taken when one is at risk of acquiring HlV prior to exposure. If one’s risk of getting HlV infection becomes low because of changes in their lives,one may choose to stop taking prEP.
Perhaps, the question might be just how good is the drug? Well, pretty good, if you trust the scientists. According to Centre for Disease Control and Prevention, studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. The margin for error, for lack of a better word, apparently, is that slim.
Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily. However, PrEP does not protect against STIs or prevent pregnancies, so don’t get carried away. It is quite important therefore to use PrEP as a combination prevention package with other existing interventions such as condoms and VMMC.
There is a bit of history about the use of PrEP in Malawi that I learnt as well at the training. PrEP was provided to HIV-negative people as part of demonstration studies in two districts of Lilongwe and Blantyre.
In Lilongwe, the study was implemented by Lighthouse Trust, which targeted adolescent girls and young women (AGYW). In Blantyre, the study was led by Pakachere Institute for Health Development and Communication and the study participants were female sex workers. As of now, PrEP has not been rolled out nationally in Malawi.
I was so curious about this topic and I decided to talk to someone who could testify about this and luckily I found one.
A sex worker, whose real name I shall conceal but shall only identify as Sharon, from Area 25 residential township in Lilongwe, has been a regular user of the drug and speaks highly of its effectiveness.
She told me: “I was introduced to this drug last year and I was part of a study to find out if the drug really works. So first of all they tested my HIV status to find if I was negative then I was given the drug and instructions that I should follow.”
Sharon, however, further explained to me that during the first week of taking the drug, she experienced some side effects like nausea, vomiting, headache and when she visited the hospital she was told it is normal and there was nothing wrong with it.
“I was taking the pill each and every day while doing my work every night, without protection sometimes, with different men and when time came for me to get tested again if the drug really worked I was found negative and that proved the drug worked. Since I am at risk of getting HIV with the work I do, I have been taking the pill everyday ever since to protect myself from the virus. I encourage everyone who knows they are at risk of getting HIV to visit a near clinic and ask about prep and they will be helped,” she recalled.
Although praising PrEP’s effectiveness in preventing HIV, Sharon is quick to remind everyone that as a sex worker it does not protect her from STDs or pregnancy hence she is forced to use some contraceptive methods including condoms.
PrEP was endorsed in the National Policy in 2018, however, the PrEP guidelines have yet to be approved.
AIDS Vaccine Advocacy Coalition Fellow Chisomo Chaweza said the Constitution, under the bill of rights, mandates Malawi to make accessible health services to its people. The delay in approving PrEP guidelines directly delays the roll out of PrEP, an intervention that other African countries such as Kenya, eSwatini and South Africa are already implementing at larger scale to achieve the goal of eliminating HIV by 2030.
He said: “I call for the speedy approval of the PrEP guidelines so that we can protect many lives. This is especially important now, as we are faced with covid-19, another pandemic that has claimed many lives. Let us not lose the gains we have already made on HIV. Access to HIV prevention services is a human rights issue.”