Use of PrEp in Uganda Needs Interim Guidelines

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In short
According to Dr. Patrick Ndase a regional HIV Prevention Research expert with the Microbicide Trials Network, if the sero status of the HIV negative partner has to be maintained then a drug like PrEp could just be the right answer, but the Ministry of health should issue interim guidelines.

Different experts on HIV/Aids treatment in Uganda have differed on the use of Pre-Exposure Prophylaxis or PrEP- an HIV prevention strategy, where a person takes antiretroviral drugs before sex to reduce the risk of acquiring HIV.
 
Dr. Patrick Ndase, a regional HIV Prevention Research expert with the Microbicide Trials Network, says that there is significant evidence to show that the use of PrEP among discordant couples, limits the chances of getting infected with the virus.
 
 He argues that the level of adherence and commitment in the use of PrEp is high among couples who know the HIV status of their partners, compared to those who do not know.
 
According to Dr. Ndase if the sero status of the HIV negative partner has to be maintained then a drug like PrEp could just be the right answer, but the Ministry of Health should issue interim guidelines.
 
However the Ministry of Health has not officially approved guidelines on the use of PrEP. Prof.Vinand Nantulya Chairman of the Uganda Aids Commission says it is too early to approve the drug since the US. Food and Drug Association (FDA) which approved the drug in 2012, has since tasked the manufacturer Gilead Sciences, Inc to provide verifiable evidence on the efficacy of the drug.
 
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This comes after the Aids Health Care Foundation a consortium of activists pushing for the scaling up of HIV treatment in the US, disagreed with the initial roll out plan of PrEp. They activists argue that Gilead Sciences Inc would make millions of dollars out of the drug, without ascertaining its efficacy.
 
Speaking to Uganda Radio Network (URN) on phone Dr.Ndase explained that in clinical trials already done, PrEP was administered alongside other preventive measures like consistent condom use and a reduction in the number of sexual partners.
 
Since 2010, a series of large-scale clinical trials have shown that PrEP can reduce HIV infection in high risk groups such as men who have sex with men (MSM), injection drug users (IDUs), and commercial sex workers and among discordant couples.
 
But, Prof. Nantulya maintains that Uganda should hold on passing PrEP as a HIV/Aids treatment.
 
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Clinical studies done in Kenya and Uganda’s Mbale, Tororo, Bushenyi, Jinja and Kampala districts explored the use of two different drug regimens Truvada and tenofovir in serodiscordant couples, where one partner was HIV-negative and the other was HIV-positive. According to Dr. Ndase overall, risk was reduced by 75% and 67%, respectively.