Would Ethiopian sex workers benefit from PrEP?

Are our media ready to accurately and adequately report this to our public ?

By Mekonnen Teshome

Pre-Exposure Prophylaxis (PrEP) is the tablet taken by a negative partner of HIV positive person.

As research on HIV progressed, medical experts came up with a way for HIV negative people to prevent infection with the virus without having to abstain from sex. This was by swallowing a PrEP tablet each day for the negative partner in a discordant relationship.

This prevention tablet is useful for anyone who does not have the confidence of negotiating condom use, including sex workers who often have clients who would pay more for sex without a condom.

The difference between anti-retroviral drugs (ARVs) taken by HIV positive people and PrEP taken by HIV negative people is that ARVs as treatment prevent the HIV virus from multiplying in the body while PrEP prevents infection in the first place.

The Demonstration and Implementation Projects of PrEP Open Label has been ongoing and planned in many countries including Ethiopia.

In Kenya, for instance, close to 2,000 facilities are offering PrEP services to an estimated over 20,000 current users. Overall about 63,000 Kenyans have used PrEP since PrEP was launched in Kenya 3 years ago, according to latest figures from PrEP Watch, recently launched by AVAC.

Started in 2007, the iPrEx study was the first to offer PrEP. Oral PrEP was provided to 2,500 men who have sex with men at 11 sites in six countries on four continents (Brazil, Ecuador, Peru, South Africa, Thailand and the USA). It found that the HIV infection rate in HIV-negative gay men who were given PrEP was reduced by 44%, compared with men taking a placebo. Crucially, among those who took PrEP seven days-a-week as prescribed, the risk of infection was reduced by 99%. Similarly, the IPERGAY study, which offered oral PrEP at six hospitals in France and Canada, reported an 86% reduction in the HIV infection rate compared to those taking a placebo.

The Partners PrEP trial recruited around 4,750 heterosexual couples in which one partner was living with HIV across Kenya and Uganda. The risk of HIV infection was reduced by 62% among those who took oral tenofovir and 73% among those who received Truvada. The TDF2 Study Phase II/III trial evaluated daily oral Truvada in 1,200 heterosexual men and women in Botswana and found it reduced the risk of HIV infection by 62%.

The 5th HIV prevention pillar of the six pillars of Ethiopia’s National HIV Prevention Road Map ( 2018 – 2020) also underscores the vitality of administrating Pre-exposure prophylaxis (PreP) for population groups at substantive risk and with high levels of HIV incidence, particularly female sex workers and discordant couples.

It seems that PrEP would become the next new normal in protecting people from HIV virus but the question is: How much would it be useful for the target people including sex workers who often have clients who would pay more for sex without a condom?