Preexposure Prophylaxis for HIV PREVENTION

The fight against HIV/AIDS has posed a lot of challenges in the scientific world.Several attempts to come up with a vaccine have failed and still attempts and trials are ongoing. The recent case however is expected to prevent further spread of the virus.The use of antiretroviral agents by HIV-uninfected persons before potential sexual exposure to HIV-infected partners, known as preexposure prophylaxis, is a new approach to HIV prevention.

 A study conducted in |Africa showed that the rate of HIV acquisition in young, healthy adults (mostly women) was 3 to 5 per 100 person-years in two trials studying heterosexual transmission of HIV in sub-Saharan Africa as reported in the New England Journal of Medicine (the Preexposure Prophylaxis Trial for HIV Prevention among African Women [FEM-PrEP] and the TDF2 study). This rate of HIV transmission demands the urgent development of new prevention strategies as well as the deployment of all existing strategies, including the use of condoms, male circumcision, and the treatment of HIV-infected partners.
  During the study, there was no evidence that preexposure prophylaxis led to increased unprotected sexual behaviour. However experts have warned that this might be an indirect way of encouraging such behaviors which in return will bring other problems like unnecessary pregnancies. Dr R Sodi from the united kingdom notes that PrEP may inadvertently promote and encourage risky sexual behaviour. "Even if there is evidence that PrEP reduces the acquisition of HIV in some trials, how representative of the general population are these trials? What degree of selection bias was present so as to demonstrate PrEP's efficacy? I think it is too soon to tell. PrEP should be reserved for 'situations' were the need to mitigate HIV exposure is required, for example where one person in a marriage or partnership is known to be HIV positive." Said Dr Sodi.
 Dr Hassan Ahmed of Isiolo district hospital totally disagrees with the use of prophylaxis as a way of preventing the spread of HIV virus. He advises on using the ABC approach of protecting oneself that is Abstinence, being faithful and the use of a condom. "Until we find more robust data on the long-term effect of PrEP regimens;its sustainability and identification of the group that may benefit most,then we should stick to the safer and proven modes of HIV prevention." said Dr Ahmed.
   The decision-making process for recommending PrEP begins with an assessment of the risk of HIV, followed by a determination of the combination of HIV-prevention strategies that provides the maximum protection.Widespread implementation of PrEP is, however, not without challenges that will require additional financial resources and health services capacity. Nevertheless, PrEP is an essential new HIV-prevention strategy that can and should be implemented in combination with the use of condoms, HIV testing, and promotion of treatments for HIV infection. PrEP prevents HIV infection, thereby reducing the need for treatment of AIDS in the future, is cost-effective, and empowers vulnerable populations to directly control their risk of HIV infection.
   If proven workable, the use of prophylaxis will provide hope for most people around the globe. however we should be responsible in our sexual behaviors as their are other problems that we may expose ourselves into if we engage in reckless sexual behaviors. Kenya is yet to get a test of such prevention approach.