PrEP offers relief to HIV pandemic
Ruth Butaumocho Gender Editor
From the time the first case of HIV was diagnosed more than 30 years ago, the epidemic decimated communities as scientists the world over battled to find treatment for the HIV pandemic.
With no previous medication that was known to prevent the spread of HIV except abstaining from sex, being faithful or using preventative measures such as condoms, nations across the globe were almost losing the battle until the introduction of the anti-retroviral therapy to manage the conditions of those living positively with HIV.
Zimbabwe, being part of the global village, was not left out in all the initiatives as the country battled to put people living positively on ART while rolling out national campaigns against new infections.
In all the intervention strategies, it has remained undoubtedly clear that HIV has the face of a woman.
Despite the avalanche of preventative strategies, including the condom, which happens to be among the most popular HIV preventative methods, women continue to be the major victims of HIV infection due to physical, social and cultural issues.
Even the global outlook on HIV is telling of the predicament that women find themselves in, with statistics from organisations like the World Health Organisations and UNAIDS showing that globally, more women than men are dying of HIV/AIDS, and the age patterns of infection are significantly different.
It is against this background that the decision by Zimbabwe to launch PrEP — pre-exposure prophylaxis — should be embraced by all, particularly women, because they are now able to prevent HIV infection from their intimate partners without the risk of physical violence.
A fortnight ago, the Government launched the pre-exposure prophylaxis strategy (PrEP), which is meant to reduce the risk of contracting HIV.
Speaking at the “Million-Man Circumcised” celebrations and launch of the PrEP strategy, Minister of Health and Child Care Dr David Parirenyatwa said the oral PrEP was strictly for those at a higher risk of contracting HIV.
“We are launching the strategy for our fairly new HIV prevention initiative and that is, Pre-Exposure Prophylaxis (PrEP) for the period 2018 to 2020,” he said.
The launch of PrEP is an add-on tool to a coterie of initiatives in the country’s bag of tools and approaches in the prevention of new HIV infections.
PrEP comes in the form of a pill that is taken seven days before one is exposed to possible infection and is now available at most hospitals across the country.
Unlike other preventative measures, the pill allows a client, particularly those at risks like long distance truck drivers, commercial sex workers and tertiary students, an opportunity to take precautionary measures when there is still time.
It is heartening to note that PrEP comes on the heels of yet another similar initiative, the monthly vaginal ring, whose trials are ongoing.
Suffice to say, the introduction of the vaginal ring might hit a snag amid revelations that several women on the pilot project have since stopped using it following a series of gender-based violence from intimate partners, leaving PrEP as the user-friendly alternative method.
The introduction of PrEP should not be seen as an additional preventative measure on the market, but could prove to be a game changer for the majority of women who have been relying on the benevolence of their partners to prevent HIV instead of taking the lead.
PrEP presents the opportunity to change the face of HIV prevention by offering a new option for protection against the virus disrupting current HIV prevention systems.
Nevertheless, as with all new technologies, both practical and social requirements for implementation must be taken into account if there is to be sustained and widespread adoption, which will also apply to forthcoming prevention technologies.
The implementation of oral PrEP comprises a few critical logistical components. These include initial HIV testing to confirm an HIV-negative status, continued testing to ensure no change in HIV status and use of other preventative methods to achieve the same result.
Often, people apply preventive measures on an ad hoc basis, further limiting their effectiveness and eroding public confidence in these methods.
Far from being just a preventative method, if used properly PrEP could prove to be the panacea that women have been looking for in preventing HIV infection without unduly exposing themselves to physical violence from their intimate partners since the method is discreet, unlike the condom.
HIV disproportionately affects women and adolescent girls because of their unequal cultural, social and economic status in society.
Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV/AIDS infections in male and female, reflecting differences in biology, sexual behaviour, social attitudes and pressures, economic power and vulnerability.
In many ways, the inequity that women and girls suffer as a result of HIV/AIDS serves as a barometer of their general status in society and the discrimination they encounter in all fields, including health, where their ability to choose the most appropriate method is determined by their intimate partners, further exposing themselves to HIV.
Having shown that HIV/Aids is inherently a gender-based issue that needs to be seen in that light, the introduction of PrEP should be supported by all stakeholders keen on curbing new HIV infections, while promoting the well-being of women.
While the introduction of PrEP is a welcome development and a step towards reduction of new HIV infection, users should be wary of abusing the method, rendering it useless in the process.
Several women’s organisations have since expressed optimism on the launch of the preventative method, which they hope will be accessible to a majority of vulnerable women so that they can make use of such scientifically proven interventions to prevent HIV.