1 June 2014

Zimbabwe: Furore Over Use of HIV Drug

Post exposure prophylaxis (PEP) for HIV infection was initially a preserve for medical staff exposed to the virus and victims of rape.

But over the years, even ordinary people who find themselves at risk of being infected have adopted this method.

Although not a popular route that health officials would advocate for ahead of other preventative methods like the correct and consistent use of a condom, PEP is fast becoming a standard alternative for many people.

PEP is used by anyone who may have been exposed to HIV during a sexual encounter and involves taking anti-HIV therapy soon after exposure. These drugs keep HIV from making copies of itself and spreading through your body but it must be taken within 72 hours.

Questions of morality have been raised over the PEP use by ordinary people who deliberately ditch the condom and then the next morning rush to their doctors to get the prophylaxis which is also readily available at most pharmacies.

Deputy minister of Health and Child Care Paul Chimedza said it was not the ideal preventative method that they would want to encourage as it may send wrong signals.

"We do not want to advocate for this method. It is not a substitute for other proven HIV prevention methods, such as correct and consistent condom use," he said.

Chimedza however, said it was available to members of the public but upon consultation with their doctors.

Some people however said PEP had come in handy in those instances where one has unprotected sex or for some reason a condom breaks.

"I once took it and am glad I did because I did not know the status of this girl but it just so happened we had unprotected sex," said a 26- year-old male from Highlands.

Most pharmacies have the facility and while some insist on the doctor's prescription, others will go ahead and offer the drugs even in the absence of such.

The basic package costs around US$11 while the more expensive can go up to US$60. The more expensive it is, the more effective, according to a pharmasist.

"Most of our clients who seek this type of method are well to do people and many come without the doctor's prescription. They say that it is embarrassing to tell the family doctor so they come and we discuss options," said one pharmacist in the Avenues.

PEP consists of 2-3 antiretroviral drugs and should be taken for 28 days. For those who consult their doctors, the latter will determine what treatment is right for them based on how they were exposed to HIV.

A medical doctor operating in Mabelreign, Nkosilathi Mabhena said people should not be too quick to judge and condemn this method.

"It takes one who has been in that situation to know how scary it is not knowing if you have been infected or not. This is an option that might actually eliminate this risk so I do not see anything wrong with it," he said.

Mabhena said it was just the same as someone who carries condoms in their pockets when they move around.

"It does not mean that they are of loose morals. They are just taking precautions. It is about saving lives and not trying to play judge and jury," he said.

"I have many patients that I have initiated on the method and in most cases they have unprotected sex with someone whose status they do not know."

The method is safe but may cause side effects like nausea, headaches, vomiting and skin eruptions in some people. These side effects can however be treated and are not life-threatening.

Another down side of this method is that it is not 100% effective and does not guarantee that someone exposed to HIV will not become infected with HIV. There is also a chance that one might develop ARV resistance which might pause problems later when they need to take the drugs for life.

Although many people have heeded to calls to go for testing, a lot more are still uncomfortable about taking their partnersfor testing.

"For women, it is extra difficult to ask your new dude [man] to go with you for testing," said a woman identified as Sheila from Belvedere.

According to statistics from National Aids Council (NAC), Zimbabwe's HIV prevalence rate for last year rose to 15%, a 0,74% increase from 14,26% recorded in 2012.

Officials attributed the rise to early marriages, spousal separation and low-risk perception of HIV infection.

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