Free sex is back... via ARVs

Trendy youths believe that they have discovered the secret of protecting themselves against unwanted pregnancy and HIV.With two scientific studies showing that antiretrovirals (ARVs) can prevent the risk of HIV transmission, the youth, particularly the working class population, now think they have a trick or two up their sleeves.Combine this with the use of morning-after pills and there you have it — a dual protection from pregnancy and HIV.Pre-Exposure Prophylaxis (Preps) is a form of treatment involving use of ARVs to prevent HIV infection. Preps is administered following accidental exposure to rape, contact with foreign blood in, for instance, road accidents, bomb blasts and earthquakes, or occupational hazards like a health worker being pricked by an infected needle.Despite ARVs being amongst the list of drugs sold by prescription, some chemists are dispensing them without it.In some cases, people get unscrupulous doctors to write them prescriptions for the Preps at a fee.Dr Lilian Otiso, the HIV services director at Liverpool Voluntary Counseling and Testing Centre (LVCT) says they have increasingly noted that some youth are coming to them with fictional rape stories in order to access Preps.Currently, discussions are going on globally on whether to use the ARV medication tenofovir (TDF), either alone or in combination (Prep) for the prevention of HIV.Scientific evidence has found Prep to be an important tool for HIV prevention. If a HIV — positive person adhere to an effective antiretroviral therapy regimen, the risk of transmitting the virus to an uninfected sexual partner can be reduced by 96 per cent. For the HIV — negative, research has found a reduced HIV infection risk by 73 per cent. It is this knowledge that the youth are using to their advantage as a free ticket to having promiscous sex without worrying about contracting HIV.Dr Otiso pointed out that a majority of people misusing Preps are aged 30 and below.“They are engaging in risky sexual encounters and taking ARVS to keep them safe,” Se reveals, adding that “Most of these young people are going by the word spreading on the streets that the Preps meant for rape survivors can be used to reduce the risk of HIV infection.”Studies among discordant couples have shown that if the HIV — positive partner takes ARVs, chances of transmitting the virus are reduced by 96 per cent. But, if the positive partner is not on ARVS, the negative one can take the drugs and reduce the risk of contracting the virus by 73 per cent. Otiso warns that once the youth begin taking Preps, they experience negative side effects and discontinue treatment. Preps are a 28-day treatment therapy where two or three ARV drugs are prescribed. Dr Otiso says the full dose is split in two in order to follow up and encourage patients to complete treatment when they go for the next refill. Side Effects The side effects of Preps include nausea, vomiting, headaches, disturbed dreams and skin eruptions.“The body requires time to adjust to the drugs and patients on treatment should be counselled to be patient,” says Dr Otiso.Before a patient is put on Preps, they are first tested for HIV in order to determine their status. To increase HIV test uptake, LVCT and Regional Aids Training Network (RATN) have been educating counsellors to improve their ability to encourage people to test and patients to adhere to treatment.The RATN trainings are also equipping counsellors with skills to respond to the emerging challenges in HIV management in order to combat the spread.Dr Otiso says the message going out to the youth is that ARVs are not a means of HIV prevention.The National Aids and Sexually Transmitted Disease Programme (Nascop) director Dr Nicholas Muraguri is warning individuals selling Preps without prescription that this is criminal.Muraguri says Preps are meant for rape survivors and to safeguard health workers who accidentally expose themselves to the HIV virus in the line of duty.“It is illegal to sell Preps over the counter without prescription, It is criminal and people who are engaging in such activities need to have their licenses revoked,” says Dr Muraguri.Muraguri says the pharmacists doing that are being unethical and asked Kenyans to be vigilante and to report the culprits to the registrar of the Pharmacy and Poisons Board. Resistant Strain Dr Muraguri says an individual is likely to take the wrong drug and dosage.“Infact when you think you are protecting yourself, you are not. There are better methods to protect your health ,”advises Dr Muraguri.The Aids expert points out that while there are no guidelines for Preps use, the rule is clear that they can only be administered by prescription.Muraguri observes that there are very few ARVs in the pipeline and hence the need to guard the existing drugs from resistance.He cautions that the country risks developing a Multiple Drug Resistant HIV strain. Globally countries are required to have less than ten per cent of HIV patients requiring second line treatment otherwise it would be too expensive.

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