Time has come for the pro­vi­sion of PrEP within the Guyanese pub­lic health­care sys­tem

Stabroek News Sunday - - REGIONAL NEWS -

Dear Edi­tor, Pre-Ex­po­sure Pro­phy­laxis (PrEP) is medicine that can re­duce the chance of get­ting HIV by more than 90% and can re­duce the chances even more when com­bined with con­doms. The med­i­ca­tion works by stop­ping HIV from tak­ing hold and spread­ing through­out the body if there is ex­po­sure to the virus and it has been proven to be safe and ef­fec­tive in high-risk groups all over the world. For the last four years, the World Health Or­ga­ni­za­tion has been rec­om­mend­ing PrEP as an ad­di­tional HIV pre­ven­tion choice, but up­take in the Caribbean has been slow, but steadily in­creas­ing. Cur­rently, the Ba­hamas and Bar­ba­dos are the only two coun­tries that pro­vide PrEP to per­sons who meet the cri­te­ria for use, but Suri­name, St Lu­cia, Grenada, Cuba, and Ja­maica ei­ther pro­vide PrEP to cer­tain pop­u­la­tions or have plans to start pro­vi­sion in 2019.

Guyana’s So­ci­ety Against Sex­ual Ori­en­ta­tion Dis­crim­i­na­tion (SASOD Guyana) con­ducted an as­sess­ment on the knowl­edge, at­ti­tudes and de­liv­ery pref­er­ences on PrEP among men who have sex with men and trans­gen­der per­sons ear­lier this year, and from the fo­cus groups held in five re­gions, it was found that 60% of the par­tic­i­pants had never heard of PrEP be­fore. This was es­pe­cially the case for per­sons who lived out­side of Re­gion 4. Once per­sons be­came aware of it how­ever, al­most ev­ery­one was in­ter­ested in tak­ing it for their per­sonal pro­tec­tion. This led to the con­clu­sion that there is the need for a lot more ed­u­ca­tion and sen­si­ti­sa­tion on PrEP, es­pe­cially in­volv­ing NGOs within this ef­fort, and that the time has come for the pro­vi­sion of PrEP within the Guyanese pub­lic health­care sys­tem. Start­ing PrEP in Guyana will en­tail the use of a med­i­ca­tion that is al­ready present in the coun­try and that is al­ready pro­cured at fairly low cost. Stud­ies in other coun­tries have demon­strated that the sav­ings a coun­try re­ceives from the HIV in­fec­tions avoided by us­ing PrEP makes it a cost-ef­fec­tive pre­ven­tion mea­sure.

The theme for this year’s World AIDS Day is “Know your sta­tus” which em­pha­sises HIV test­ing as a strat­egy that also em­pow­ers peo­ple to make choices about HIV pre­ven­tion, so they can bet­ter pro­tect them­selves and their sex­ual part­ners. Be­fore per­sons can be placed on

PrEP, they must know their sta­tus be­cause the med­i­ca­tion is only for HIV-neg­a­tive per­sons. Be­ing on PrEP helps to strengthen the en­tire HIV care con­tin­uum in the coun­try be­cause per­sons must present for ini­tial and reg­u­lar test­ing, in­creas­ing en­gage­ment with the health ser­vice sys­tem and also pro­vid­ing op­por­tu­ni­ties for link­ing any HIV-pos­i­tive per­sons into care and treat­ment. Know your sta­tus so that you can know whether you should be us­ing PrEP as an ad­di­tional pre­ven­tion mea­sure to con­tinue to stay HIV-neg­a­tive. Yours faith­fully, Dr Nas­tas­sia Ram­bar­ran Dr Roger Welch and Joel Simp­son for SASOD Guyana

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