Advances in biomedical HIV prevention research have revolutionised the safe sex paradigm
HIV advocates at the first ever HIV Research for Prevention Conference (R4P) in Cape Town last week said that new technologies are giving people confidence and their lives back, and that it was time to start redefining safe sex.
PrEP and microbicides are among the many new choices that may soon be available in South Africa.
PrEP, which stands for Pre-Exposure Prophylaxis, is a way for people who are HIV negative and who are at high risk to prevent infection by taking a pill every day. The pill contains the antiretroviral drugs tenofovir and emtricitabine.
Microbicides are substances being studied that could be used in the vagina or rectum to reduce the risk of HIV infection via sexual exposure.
Speaking at the conference, James McIntyre of the Anova Health Institute in Johannesburg and the UCT School of Public Health and Family Medicine in Cape Town, said there was growing evidence for oral and topical PrEP and its high efficacy.
PrEP is not meant as a replacement for condoms but as a supplement – extra protection against HIV — but many there are many who do not use condoms and may choose to rather go on a daily pill regimen.
Andrea Schneider of the TB/HIV Care Association, one of South Africa’s leading NGOs in the effort to prevent HIV, noted that there were no free condoms available at the conference whereas at a previous AIDS conference there were many.
She added that many advocates and researchers acknowledge that people often do not use condoms.
“People find it very difficult to admit that condoms are not used,” she said.
Another speaker Jim Picket of the Aids Foundation of Chicago said: ”The paradigm has shifted. Change is the law of life. Those who look only to the past or present miss the future. We are going through a prevention revolution,” Picket said.
“Larry Kramer was wrong when he said ‘the only important thing is to wear a condom,” he said.
He added that science has outpaced policy and people were carrying too much baggage from the past.
“This prevents us going forward. We spent a long time scaring the hell out of people. We need to stop.”
According to Lebogang Ramafoko of the Soul City Institute for Health in Johannesburg:
“It’s not just a pill it’s a program. We need to reclaim pleasure. PrEP give us an opportunity to do this.”