HIV/Aids advocate – Make HIV drugs available

HIV/Aids advocate Ronaldo Castillo is urging Government to change its policy and make Pre-Exposure Prophylaxis (PrEP) – a drug used to prevent people from contracting HIV – more easily and readily available to the general public.

He made his call during an interview with Newsday on Thursday, a day before World Aids Day. Castillo, 24, has been living with the virus since he was a baby and uses his social media platforms to educate people about the virus, as, he sayshis life's mission is to end discrimination and stigmatisation of people living with the virus.

In an e-mailed answer to a query from Newsday on whether or not the ministry will consider making PrEP available to the public, the ministry said Government’s position on this issue has not changed – and the drug would not be made widely available.

In the past, Health Minister Terrence Deyalsingh has said Government would not introduce PrEP as a subsidised form of HIV medication, and to date, it remains unavailable in the public sector.

National AIDS Co-ordinating Committee (NACC) technical director Dr Ayanna Sebro said the committee will defer to the health ministry’s position on PrEP.

Sebro told Newsday that PrEP is currently locally available as a form of medical intervention post-exposure to HIV – in select circumstances – for instance, if a person is a victim of sexual assault, or a medical professional who has been exposed to the virus from a needle.

According to the NACC’s website, PrEP is a treatment plan that can be administered after someone has been exposed to HIV, while their viral load is still undetectable.

“The NACC supports access to comprehensive prevention and is quite keen on the re-establishment of the wider prevention response.”

In May 2016, this country signed an UNAids agreement to eliminate the spread of the virus by 2030.

Castillo said Government's stance that PReP  would not be made available to the wider public runs counter to its commitment – by way of signing on to the UNAids agreement – to eliminate the spread of the virus by 2030.

'Nnot making sense'

“I find it doesn’t make sense. As they (the health ministry) know, PrEP or PEP works 99 per cent good once taken as prescribed.”

Castillo said he hopes PrEP will be made available in the public sector to groups which are especially vulnerable to contracting HIV, such as sex workers.

In keeping with this year’s World Aids Day theme – Let Communities Lead – the Health Ministry collaborated with the NACC and regional health authorities to expand free HIV-testing in various communities.

The ministry is also encouraging HIV-positive people who have not maintained their treatment regimen to return to it. To facilitate this, field officers are contacting previous clients to encourage them to return to care and restart their medication.

Sebro said ending Aids by 2030 is linked firstly in ensuring access to everyone infected with HIV to life-saving treatment and support.

“It means sustainability of the HIV response considering robust prevention, comprehensive HIV and NCD (non-communicable diseases) treatment, disaster response that consider sexual and reproductive health matters, resource mobilisation and a quality response,” Sebro said.

The ministry said  in order to end HIV/Aids there are two criteria to meet.

“First, ending the epidemic of Aids as defined as having a decline of HIV/Aids–related deaths by 90 per cent between 2010 and 2030.

“Secondly, a decline in the number of new HIV infections by 90 per cent between 2010 and 2030.”

The ministry said it has taken a combination approach that includes “public education, behavioural change and biomedical interventions.”

However, Castillo reiterated that general availability of PReP is a major weapon in the ministry's battle to fulfilling its second criterion of seeing a decline in new HIV infections.

What is PReP?

According to the US' Centers for Disease Control and Prevention (CDC) website, PrEP is medicine that reduces the chance of getting HIV from sex or injection drug use. When taken as prescribed, the website said, PrEP is highly effective for preventing HIV.

PrEP can be taken in 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.

The CDC said that the drug Apretude is the only shot approved for use as a PrEP. Apretude is for people at risk through sex who weigh at least 77 pounds (35 kg).

The CDC website said PrEP is safe, but some people experience side effects like diarrhoea, nausea, headache, fatigue, and stomach pain. These side effects usually go away over time, the website said.