THE increasing uptake of certain treatment as prevention (TASP) methods has given some HIV and AIDS researchers and academics hope in the continuing struggle to control its spread, yet a cause for concern is an emerging stigma surrounding the drug.

Results of research showing the improving uptake and effectiveness rates of pre-exposure prophylaxis (PrEP) announced yesterday at the AIDS 2014 conference has given advocates pushing for awareness and usage of the prevention measure cause for cautious optimism.

Along with encouraging study progress and outcomes, another major finding was announced, in what could be considered major coup for PrEP advocates, experts and users.

Evidence provided by Iniciativa Profilaxis Pre-Exposición (iPrEx) Protocol chair Robert Grant shows that, unlike daily anti-retroviral therapy (ART) for people living with HIV, people that choose to take PrEP do not have to adhere to the same medication regiment.

According to Grant, PrEP provides a high degree of protection against transmission when medication is taken at least four times a week.

This research shows that PrEP allows for the occasional missed dose, which is in clear contrast to a stringent daily dosage of ART. However it is still strongly suggested PrEP medications are taken on a daily basis.

“[The findings] are particularly important in relation to emerging guidelines recommending expanded use of PrEP,” Grant said.

“The project provides critical insight into what happens as PrEP transitions from clinical trials to clinical practice. It is particularly compelling to see such strong interest in PrEP among young gay and bisexual men, who are increasing impacted by HIV.”

Outcomes from a particular iPrEx study shows growing evidence that PrEP is safe for HIV prevention and among men who have sex with men (MSM), trans women who have sex with men (TGW).

The study also showed greater interest in and use of PrEP among key communities at higher risk of HIV transmission and in a key finding, there was no evidence of increased sexual risk-taking among MSM and TGW using PrEP.

The study results come on the back of a recent World Health Organisation recommendation that MSM and other affected communities consider using PrEP as a HIV prevention method.

Unfortunately news of progress being made with PrEP and other TASP methods had been met with a new emerging wave of stigma directed towards people that choose to take PrEP medications such as Truvada.

“Truvada whore” is a term making its way into the MSM community lexicon as an attempt to stigmatise people taking PrEP, with some believing that taking such medication serves as an excuse for people to disregard safe-sex messages and engage in unsafe sexual practises without condoms.

It’s an issue for advocates of prevention strategy, with some comparing the stigma to the one that faced women during the early stages of the pill.

“There’s a bit of fear-mongering surrounding prep and we need to stop that and engage with the science,” MSM Global Forum program associate Keletso Makofane said.

“These people should be able to make their own decisions about how to protect themselves.”

Grant said that while stigma is on the rise, people on PrEP were still more willing to go on the record and speak publicly.

“Stigma is a social process and as such it changes over time. A year ago I couldn’t find any PrEP users to speak out publicly using their full name,” Grant said.

“PrEP users now will tell you how proud they are to be protecting themselves and their partners. Things change, stigma can change.”

(Main photo credit: David Alexander; Star Observer)


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