A revolutionary drug that significantly reduces a person’s chances of becoming infected with human immunodeficiency virus (HIV) has become available for use in Antigua and Barbuda.
Pre-exposure prophylaxis (or PrEP) is said to be 99% effective against preventing a person from contracting HIV from sex when taken as prescribed. HIV is the virus that causes acquired immunodeficiency syndrome (AIDS).
“It’s something you can take when you need it and if you don’t need it anymore then you can come off of it,” Dr. Maria Pereira, AIDS Clinical Care Coordinator said.
PrEP can be taken in a number of ways to include daily, on-demand (within 72 hours (3 days) after sex with an HIV positive person or weeks before intercourse with your partner.
It can also be taken on-demand. This means taking two (2) pills, two (2) to 24 hours before sex, one (1) pill 24 hours after the first dose, and one (1) pill 24 hours after the second dose.
Ms. Pereira explained that a combination of drugs can be taken within 72 hours of exposure to a person with HIV.
“That medication is taken before that person has intercourse …it’s a combination of two different medications that a person takes,” she said.
In other instances, the woman must take the medication three weeks before having sexual intercourse while the man can take it a week before.
PrEP can also be taken daily, particularly by couples in discordant relationships where one person is HIV positive and the other is negative.
“Especially in a situation where a person would like to become pregnant in that relationship, they can take the PrEP and then they have unprotected intercourse so that they can have their family,” she noted.
Who can take PrEP?
- An individual must be tested to ensure they do not have HIV before they start– once a person has HIV, they would need a different set of medication
- Those wanting to take PrEP must commit to doing an HIV test every three (3) months
- Individuals should strongly consider using condoms during sex – PrEP does not prevent the transmission of other sexually transmitted diseases (STDs) like syphilis, chlamydia and gonorrhea
Are there different types of PrEP?
According to the Centers for Disease Control (CDC), PrEP can be pills or shots.
There are two pills approved for use as PrEP: Truvada® and Descovy®.
- Truvada® is for people at risk through sex or injection drug use.
- Descovy® is for people at risk through sex. Descovy is not for people assigned female at birth who are at risk for HIV through receptive vaginal sex.
PrEP is provided free of cost by the government of Antigua & Barbuda. Persons interested in using PrEP should contact the AIDS Secretariat.
PrEP has been recommended by the World Health Organisation (WHO) since 2015.
In September 2015, WHO recommended that people at substantial risk of HIV infection should be offered tenofovir disoproxil fumarate (TDF)-based oral PrEP as an additional prevention choice, as part of comprehensive prevention.
In 2021, WHO recommended that the dapivirine ring may be offered as an additional prevention choice for women at substantial risk of HIV and, in 2022, that long-acting injectable cabotegravir (CAB-LA) may be offered as an additional prevention choice for people at substantial risk of HIV.
Other products (e.g., multipurpose prevention products that combine antiretroviral drugs with contraception) are currently studied as additional PrEP options.