September 2016

Sep 21, 2016

Dear aidsfocus readers,

In the face of the high incidence of HIV infections and new cases – around 2 million people are infected annually with HIV – there is a pressing need for an increase in prevention measures. Everyone facing a heightened risk of HIV infection has the right to comprehensive HIV prevention services. Mere education or distribution of condoms does not suffice.

During a side event at the High Level Meeting in New York in June 2016, a sex-worker from Kenya recounted her experiences taking PrEP – pre-exposure prophylaxis. She described how she was raped by a policeman at a police station and then, on her way home, encountered a further three policemen... None of them would use a condom. She emphasised how fortunate she feels to have had access to PrEP and to remain HIV negative to this day.

PrEP is being discussed as an innovative prevention method to reduce the large number of new infections. The medication is effective and cost-efficient, as has been verified by a number of studies, particularly amongst high-risk groups such as men who have sex with men, intravenous drug users and people with HIV-positive partners. At the AIDS conference in Durban, the importance of new means of prevention, above all for heavily affected sections of the population, was much discussed. UNAIDS estimates that only 50,000 of the estimated three million people facing a high risk of HIV have access to pre-exposure prophylaxis.

PrEP is only effective if taken regularly. Many questions remain unanswered: are there enough delivery points? Who should receive this medication? Is there the risk that other methods of protection such as condoms will be neglected, therefore leading to an increased incidence of other sexually-transmitted diseases? How high are the costs? Which guidelines and policies need to be developed? Could PrEP be a valid prevention strategy amongst young African women, who are disproportionately affected by HIV? Finding answers to these questions is the task of public health experts and researchers in order to produce the required evidence necessary to develop high-quality programmes and services for those people for whom it appears to be most expedient.

In our topic of the month, Médecins Sans Frontières Switzerland present their “Corridor” HIV project, a programme in Mozambique and Malawi designed to secure access to antiretroviral (ARV) medication and PrEP for high-risk groups.

Carine Weiss

Coordinator, aidsfocus.ch

Project Leader, Medicus Mundi Switzerland

cweiss@medicusmundi.ch