IRIN Humanitarian News and Analysis (09.03.2013)
Aids Weekly Plus
The Uganda Ministry of Health’s AIDS Control Programme stated that Uganda had no plans to roll out pre-exposure prophylaxis (PrEP) for uninfected people who were in a sexual relationship with an HIV-infected partner (serodiscordant couples) despite evidence supporting the protocol’s effectiveness. The US Food and Drug Administration has approved a daily dose of two antiretroviral (ARV) drugs (Truvada) to prevent HIV infection of an uninfected partner, and clinical trials have indicated that PrEP reduced HIV transmission by 73 percent. PrEPWatch, a Global Advocacy for HIV Prevention (AVAC) Web site, asserted that Truvada was effective in reducing HIV risk from “sexual exposure” among heterosexuals, men who have sex with men, and transgender women.
According to Alex Ario, program manager in the Ministry of Health’s AIDS Control Programme, the ministry’s technical committee rejected the PrEP protocol because public misunderstanding of PrEP could encourage “reckless sex,” and it was “morally incorrect” to administer Truvada as a prophylactic measure when the ministry had not connected all HIV-infected persons to ARVs. Ario emphasized that ABC—“Abstinence, Be faithful, and Correct and Consistent Condom use”—would continue to be the foundation of Uganda’s HIV prevention strategy.
Activists encouraged the government to rethink its anti-PrEP policy, since HIV prevalence increased from 6.4 percent to 7.3 percent throughout the last five years, and approximately 400 people acquire HIV daily in the country. According to the Uganda AIDS Commission report, “Rolling Back the Epidemic,” Uganda diagnosed 145,000 new HIV cases annually.
AVAC Executive Director Mitchell Warren stated that upcoming PrEP demonstration projects would answer critical questions about best practices for rolling out daily oral PrEP to high-risk populations. Warren agreed that PrEP would not replace biomedical, behavioral, and structural HIV prevention strategies, but could be a valuable tool.