“There are women out there who find it hard to finish antibiotic doses let alone take their birth control pills at the same time everyday no matter how many times their doctor insists that they do. So in the same way as contraceptives, women need options where HIV prevention is concerned.”
Developers are therefore working on microbicide gels, rings, injectables, barriers and implants that would serve the dual purpose of preventing pregnancy and guarding against HIV infection.
“Women want a product that can protect against both pregnancy and disease without unpleasant side effects that do not interfere with sex, require little or no medical supervision and are effective when used post-coitally,” Sharon Camp said when she was President of the Guttmacher Institute.
But HIV is not the only disease those who engage in risky sexual behaviour are exposed to and there is concern around PrEP use in the United States, where its prescription is sanctioned, Kay Marshall of the Global Advocacy for HIV prevention admits.
“There is concern that it could discourage the use of condoms, lead to promiscuity and lead to a spike in STIs and even HIV if it’s not taken as religiously as it should,” she says.
An argument Ndase discounts: “Are we to ignore this life saving treatment for fear that people won’t use condoms? That seems to me too heavy a price to pay. It’s simply another option. It’s the same thing with contraceptives, microbicides, if a woman feels the gel leaves her too wet, we switch to pills. One shouldn’t affect the other.”
But testimonials following the adoption of PrEP in the US paint a different picture, that PrEP has created a sense of sexual freedom especially among the HIV high risk population of MSMs.
“I’m not scared of sex for the first time in my life, ever. That’s been an adrenaline rush,” Damon Jacobs, 43, is quoted as saying in a New York Magazine feature titled Sex Without Fear, published last month.
In a testimonial following the death of another leading AIDS researcher in April, Dr Charles Farthing, Howard Grossman himself a specialist in HIV medicine wrote:
“I’ve decided to go on PrEP. I’m a 60-year-old single gay man. After all I’ve seen, I cannot get the shadow of the epidemic out of my head when I’m having sex. I don’t have the luxury of having a steady partner. I can’t predict when I’ll have sex again. If there is something out there that can reduce my risk of getting HIV by 95pc, I will use it. I’m tired of being scared of HIV.”
He did however add that, “Personally, I will continue to use condoms. I want to decrease my risk of getting HIV and also of getting STIs. Far too few places are testing for STIs in the anal and oral areas and far too many of my patients are getting infections there and not in the urethra. PrEP will not protect against these infections, but condoms will.”
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