Pre-Exposure Prophylaxis

For the first time in India, the National AIDS Control Organisation (NACO) and Union Health Ministry have given clearance to launch an experimental project to provide HIV preventive medicine – ‘Pre-Exposure Prophylaxis’ (PrEP) to sex workers in Sonagachi district of West Bengal. PrEP is designed to prevent sex workers from contracting HIV infections and it is given as regular medicine to HIV-negative sex workers who engage sexually with an HIV-positive person. The Melinda Gates Foundation is financing the project.  The regular intake of the medicine along with the use of condoms would provide double protection against HIV infection. The use of medicine can bring down the HIV risk factor by 60-70% among the high-risk groups such as sex workers. The project would be implemented for two-year period. During the period, the selected sex workers who are provided with the medicine will undergo blood tests regularly for one in three months to ascertain their HIV status. After two reports, a report would be published and the project could turn into a policy to prevent AIDS in India. The main advantage with PrEP is that it is cheap. But the acceptability of society especially sex workers should be considered before making its use as a policy.

Facts about PrEP

PrEP is not a vaccine. Currently, there is no vaccine to prevent HIV infection. PrEP is not for use by everyone. It is recommended for people who are HIV-negative and at substantial risk for HIV infection. In case of infection, the regular intake of PrEP will work to keep the virus from taking hold of the body. The pill contains two medicines that are also used to treat HIV. Though PrEP is a powerful prevention toll, for sexually active people it is not a 100% preventive strategy. It should be used along with other HIV prevention strategies such as condoms. For people who need to prevent HIV after a single high-risk event of potential HIV exposure—such as sex without a condom, needle-sharing injection drug use, or sexual assault—there is another option called post exposure prophylaxis, or PEP. PEP must begin within 72 hours of exposure. The use of PEP is allowed in US but not in India.

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