Almost a decade ago since the HIV/AIDS virus was discovered, no cure seems to be at the horizons, despite billions of dollars spent and pumped into research to stop the transmission of the disease which has claimed millions of lives across board.
It was nothing short of joy when scientists announced that a new drug, Truvada, can actually prevent the transmission of the virus.
It stipulates that once the person is taking the drug and has intercourse with an infected person, it would not jeopardize his immune system as he or she will be immune to the virus.
Gloria Funsho (Not real name) told Health Insight that there is hope for those of them that are living with the virus because their chances of marrying is now ascertained since the fear of infecting their partners has been eliminated.
The Director General of National Agency for the Control of AIDS (NACA), Professor John Idoko, speaking on the discovery said the drug which is just like the malaria drug, will prevent one from getting infected even if he or she has intercourse with a positive person.
Prof John Idoko, explaining the new prevention treatment drug, pre- exposure Prophylaxis, said "if we give the drugs to somebody who doesn't have HIV, and the person has sexual relationship with an HIV positive partner, it can prevent transmission from the positive person to the person. That is why it's called a pre- exposure prophylaxis because before exposure, the person has taken the drugs and because he has the drugs in him, the virus cannot infect him or her."
Also, Idoko says: "If you take this sero-discordant couples; one is positive and the other is negative, instead of giving the drug to the negative person before the sexual relationship, just put the positive one on drug as soon as you know. It doesn't matter what his CD-4 count is, even if it's 500, just give him the drugs. It has shown clearly one of the best study results that we have seen, as 96 per cent chance of the person transmitting HIV is blocked. So we call that treatment as prevention.
"So you can now imagine that if you go to a community, and they are using this method, your chances of blocking transmission are very high. We believe that these are the two things we need to put together as part of our combination prevention method."
The pre-exposure prophylaxis is the newest HIV prevention tool that has been developed. It involves the use of Truvada, an antiretroviral to prevent HIV infection. A few studies have shown the ability of this drug to prevent HIV infection in sero-discordant couples, MSMs, transgenders and in men and women.
Most recently, on the 10th of this month, the drug was approved by FDA in USA for use as HIV prevention tool also. It had been previously approved for use as an HIV treatment drug.
PrEP may be part of a new comprehensive HIV prevention services that had been proved "safe and effective" in which HIV negative people who are at high risk take antiretroviral medication daily to prevent infection.
The Director (Prevention, Care and Treatment) at the Family Health International, Dr Hadiza Khamofu, said about 62 per cent of new infections occur among persons perceived as practising "low risk sex" including married sexual partners.
She stated that the ante-natal care prevalence rate of 4.1 per cent exists among the 160 million Nigerian populations, adding that pregnancy presents a period of higher risk of acquiring or transmitting HIV infection.
At the moment, there are stakeholders conducting a study in the country to evaluate the use of Truvada as PrEp in combination with other HIV prevention tools (male and female condoms, PMTCT, HTC, PEP, behaviour change communication) in reducing the incidence of HIV in Nigeria.
According to the director of resource mobilization, NACA, Dr Emmanuel Alhassan, the roadmap for moving forward the agenda on PrEP access in Nigeria aims at identifying areas of collaboration on policy, regulatory and delivery and implementation.
"We've found out in other countries that the prep actually reduces new infections- and very significantly. And so, this particular meeting is trying to look at ways and means of using that in Nigeria to ensure that we bring down the rate of new infection of HIV."
"It's been in use now for quite some time, although its relatively new, in South Africa, it's in use and that's why we have this stakeholders meeting to decide, to see whether we should do feasibility study first. We need to get all the stakeholders involved to look at evidence from other countries, to look at our programmes especially the rate of discordance in couples, because some men could be HIV positive and their wives negative and vice versa. We are looking at this as a potential to helping those who are not positive to, at least, remain negative.
However, a lecturer at the Obafemi Awolowo University who is also involved in the research, Mrs Morenike Ukpong, noted that combination prevention is not a new phenomenon.
According to her, HIV has structural issues that promote it. For example, she says, poverty, gender inequality and stigma are structural problems that must be addressed.
"The combination you put together for male sex workers might not be the same combination for females. This is why combination prevention becomes specific in strategy."
She said that right now, there is an interest in looking at prEp as a component of combination treatment for women who are pregnant and are into discordant relationship, knowing that within that structure, the use of condom becomes a challenge.
"It's a challenge especially when you're asking couples now who are sero discordant to use condom all the rest of their lives. Within that challenging situation, if you now use prEp, how effective will it be on the population?
However, as good as this new 'wonder prevention' drug may seem, many experts have expressed some reservations.
Tope, a midwife and HIV counsellor based her concerns on the issue of adherence to the drug.
"I read on the internet that Truvada needs to be taken every day, for prevention of HIV virus in HIV sero-negative person/partner. My 22 years experience as registered nurse/midwife and five years experience as an adherence counsellor tells me that won't happen. It is difficult to get somebody that is not sick to take drug consistently every day. Adherence is a big issue that must be critically discussed. "
Also, she observed that the use of PrEp drug could give the users a false sense of security and encourage risky behaviour. For example, she says men who had had challenges using condom who now hear about PrEP could abandon condom and there is the risk of contracting other sexually transmitted diseases like gonorrhea and syphilis.
Another expert expressed the fear that if clients on PrEP get infected with HIV either by skipping some doses of the drug or by stopping the use of condom, then the country will be faced with the problem of drug resistance which is more deadly. "Imagine spreading drug resistance virus in Nigeria," the expert warned.
However, Ukpong says that despite the fears, it is a proof that there is hope in the fight of HIV infection. "So we should not be tired and we should continue the fight. We shall overcome.