Reducing the risk of contagion of the Human Immunodeficiency Virus (HIV) by more than 90%, in a preventive manner, is the main objective of the use of a new pilot treatment that is being carried out in the Dominican Republic since 2017, called PrEP (pre-exposure prophylaxis).
The trade name of this drug approved in 2012 by the U.S. Food and Drug Administration (FDA), is Truvada (brand developed by Gilead Sciences of tenofovir and emtricitabine).
The use of this preventive drug is for people who do not have HIV. The effectiveness of PrEP is further enhanced when other prevention measures such as condoms are used.
“PrEP is not for people who already have HIV but for those who do not have it and have tested negative,” emphasized epidemiologist Robert Paulino of the Center for Comprehensive Counseling and Research (COIN).
According to the United Nations Office for HIV/AIDS (UNAIDS), by 2017 in the Dominican Republic 67 thousand people were living with HIV, of this number, 50 thousand are diagnosed, while some 17 thousand do not know they have the virus.
“Not everyone can access this program, it has a limit of people per province. What we are looking for with this study is to see if the country has the resources to supply the vulnerable population with this type of preventive medicine,” said Dr. Santo Rosario, executive director of COIN.
He said that this drug is currently in an experimental stage in the country.Volume 90%
The use of PrEP is being implemented in the United States since 2012, focusing on the population most at risk for contracting the virus. This new drug has also been offered in European and Asian countries, and in Latin America, Brazil and Mexico were two of the first countries to implement it as a prevention strategy. While in the Caribbean, the Dominican Republic was the first to offer the drug in 2017.
The first pilot implementation of PrEP was carried out at the initiative of the Ministry of Public Health, through the General Directorate of STI/HIV Control (Digecitss), the Centers for Disease Control and Prevention (CDC), PEPFAR, the Center for Orientation and Integral Research (COIN), the Ibero-American University (Unibe) and the Pan American Health Organization (PAHO/WHO).
So far 170 people are part of the HIV prevention program at COIN, which is located at Anibal de Espinosa Street #352, in Villas Agrícolas, Distrito Nacional. In the coming months it will expand to Puerto Plata and La Romana.
Who should use PrEP?
Priority candidates for this program are those at risk of infection, those who are having sex outside of a relationship with different people without the use of condoms, sex workers, those who use injected substances, among others.
- You do not use condoms frequently.
- You have a sexual partner with HIV (sometimes called serodiscordant, serodifferent, magnetic, or mixed status partners).
- You have a sexual partner who is at high risk of contracting HIV (for example, if they have anal or vaginal sex with others without a condom, or are injection drug users).
- You have anal or vaginal sex with many partners, especially if you do not use condoms regularly
- You recently had another STI (such as chlamydia, gonorrhea, or syphilis).
- You engage in sex work that includes vaginal or anal sex
- You have injected drugs, shared needles, or been in treatment for drug use in the last 6 months.
If you are in a high-risk HIV group and are pregnant, trying to get pregnant, or breastfeeding, PrEP can help you and your baby avoid getting HIV.
As explained by COIN epidemiologist Robert Paulino, treatment consists of administering antiretroviral drugs (the same drugs used in the treatment of HIV infection) to people who might have some risky contact and who have taken an HIV test that shows they are negative for infection. PrEP is a prevention strategy to avoid disease progression and should be used with appropriate clinical follow-up.
PrEP can cause some side effects such as nausea, loss of appetite or headaches. These usually improve over time, once your body gets used to the drug. But most people don’t experience any.
“PrEP is not a panacea, it is not the solution to eliminating HIV, the solution is for people who have the virus to be diagnosed and take their medications so that it becomes undetectable and they cannot infect others,” Dr. Rosario emphasized.
He said that the use of this preventive medicine is only effective in preventing the spread of HIV, so it is necessary to use condoms to avoid other sexually transmitted diseases.
