South Africa is reviewing the success of a drug used as an oral pre-exposure prophylaxis for HIV prevention, which was introduced in 2016
South Africa is reviewing the success of a drug used as an oral pre-exposure prophylaxis for HIV prevention, which was introduced in 2016.
It was the first country on the continent to register Tenofovir/Emtricitabine, an anti-retroviral drug referred to as PrEP, following a recommendation by the World Health Organisation.
After procuring the licence, the Department of Health launched a national policy and set of guidelines on providing HIV test and treatment services, allowing people to access the anti-retroviral as soon as they test positive.
The aim was to target high risk populations, including sex workers, gay men, injection drug users and young women, following a cost-effectiveness analysis conducted by the government.
The PrEP programme was implemented at 17 sites serving sex workers and gay men, then expanded to supply 9 clinics and more than 120,000 young people.
Rollout data shows the uptake of PrEP is increasing, but slowly.
A year after the procurement of the licence, the rollout does not seem to be effectively reaching the country’s most high risk and critical population.
Young women in South Africa, aged 15-24 years, have the highest HIV incidence, with roughly 1,745 new HIV infections reported weekly.
They also represent 10% of the population, meaning that rates of new infections are unlikely to be reduced if this cohort is not sufficiently targeted.
Complex health system requirements and cost considerations are the main prohibitions to realising the drug’s potential.
A number of small scale research projects in and around Johannesburg and Cape Town will be used to find out the best practices and models for delivering PrEP to adolescents, as well as to raise awareness of the anti-retroviral pill in communities that either don’t know about it or remain concerned about its side effects.
Medics have called for a campaign as part of a broader conversation in how South Africa addresses the underlying issues of HIV.
Stigma, violence against women, judgement of young people having sex and ignorance of the effective use of PrEP all make it more difficult to realise the drug’s potential.
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