The recent announcement and expected roll-out of pre-exposure prophylaxis (PrEP) drugs by the National Health Department (NDoH) to help prevent HIV infection is a milestone in the fight against the virus.

Founding member of the Durex Global Advisory for Sexual Health and Wellbeing (GABSHW) and Lead at Nalane for Reproductive Justice, Dr Tlaleng Mofokeng, talks about the innovative PrEP medication and the concern that  even though people, especially the youth, are aware of the anti-retro drug, they aren’t entirely sure of the correct usage and are avoiding using condoms. 

PrEP is an antiretroviral drug in tablet form for use by people who are HIV negative. Taken daily, under a doctor’s supervision, it can reduce a patient’s chances of contracting HIV by more than 90%, according to the US Centres for Disease Control. It is recommended for someone who has an increased risk of exposure to HIV through sexual contact, and who may not be in a position to negotiate condom use or ensure proper use every single time, a position women all too often find themselves in. Certain groups of people are deemed to be at increased risk:  sex workers, and men having sex with men (MSM) for example. PrEP can significantly reduce the chances of contracting HIV for such groups.

PrEP involves daily dose regimen and regular visits to a clinic or a doctor. Doctors’ visits are vital for follow-up which means people with poor access to health facilities may be disadvantaged. PrEP will have a significant impact in reducing the risks of HIV transmission, and thus can contribute to a more pleasurable sexual experience. However, it is not a panacea that removes all the dangers of unprotected sex. What PrEP does not do, is prevent pregnancy or protect against other sexually transmissible infections (STIs) like Gonorrhoea, Syphilis and Chlamydia.

In some cases, certain STIs can be more damaging to the reproductive organs than HIV. Gonorrhoea and Chlamydia, for instance, can lead to scarring of the fallopian tubes, and cause infertility and chronic pelvic pain. This is another reason to continue using condoms during sex, even if you’re on PrEP. Condoms – if used correctly, every time – remain the best way to prevent the transmission of STIs including HIV during sexual contact. You should not stop using condoms if you’re on PrEP. Also, while PrEP can significantly reduce risk of HIV infection if taken daily, using condoms with PrEP reduces risk even further.

It’s also important that men take responsibility for using condoms – the responsibility for negotiating condom use and ensuring correct use has fallen on young women. PrEP does offer options for women, providing another efficacious approach. PrEP reaches maximum protection from HIV for receptive anal sex after about seven days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection after 20 days of daily use. That would mean visiting a doctor at least three weeks before exposure.  It does not cause long-term damage, or affect the ability to take ARVs in future, or to use PrEP again.

We know that condoms are the best barrier method of preventing HIV, as well as pregnancy and other STIs, as long as the condoms are used properly, every single time. South Africa still leads the world in new HIV infections, and PrEP is a great asset in the fight against new HIV infections.

See your doctor if you need information about PrEP and to find out if it’s suitable for you.

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