This week the results of the PROUD study were presented at the Conference on Retroviruses and Opportunistic Infections in Seattle (CROI). This is an important study UK based analyzes how men who have sex with men who are HIV negative can take Truvada, a medicine used to treat HIV, to avoid contracting the virus through sexual intercourse, it is also known as Pre Exposure Prophylaxis (PrEP)(Author's note: In Portuguese would be something like Prophylaxis Pre Exhibition which is different from PEP which means Post Exposure Prophylaxis on which you can learn more here in this link). The PROUD study showed that the drug with the trade name Truvada could offer 86% protection for HIV infection.
Truvada was taken by HIV-positive people for over 10 years in the treatment of HIV, and is relatively safe. However, one should not forget that he has potentially harmful effects, especially kidney and bones. People who take it must be strictly monitored.
Truvada has been recognized as suitable to work in HIV prevention for a while, and it was approved for the prevention of HIV in the US for over 2 years, but is not yet approved in Europe. The PROUD study is important for us in the UK, as well as prove the effectiveness of Truvada as PrEP, also offers an excellent model for the provision of prevention for men who have sex with men within the NHS. People in the study not only received the pill, but also had psychological support and opportunities to discuss and reflect on their sex lives. An interesting result of the study was that participants did not increase their risk behaviors of days, because they were in preventive medication with Truvada. This probably happened because of all the psychological support they received.
Much can be said and others have said, about PrEP; which generated a wave of activism and demands (and controversy) readily available in the National Health Service (British).
Access to PrEP for gays at high risk of contracting HIV has become the number one priority of HIV-related activism / AIDS.
I supported my fellow activists in the LGBT community by demonstrating Ministry of HealthFor quick access to PrEP. I have done this in the spirit of solidarity, as I
I want to support the demand of many gay men feel is best for you.
I believe it has been proven that PrEP, if provided properly, could save many lives. I know that PrEP research was directed to the community, and this is also important.
However PrEP could be provided only to men who have sex with men in the UK? What about the others? What about other vulnerable populations such as black women and migrants? And women transsexuals? All the data we have here in the UK are about men who have sex with men, and that worries me.
I have so many questions in my head. First, and above all I am extremely nervous about HIV prevention become totally focused on ARV. What about all the other issues? What about choice? Can we really treat ourselves out of this epidemic?
For now I just like to share some questions I have regarding women's access to PrEP that keep popping up in my head. What are yours?
- Do women in the UK want to PrEP? Under what circumstances? And as they would like to use it?
- How PrEP be included in sexual and reproductive services holistic health for women next to female condoms, contraception, etc.?
- PrEP can be supplied as an opportunity to improve women's agency and increase our abilities (and opportunities) in sexual negotiation, so we can have a safe and pleasurable sex and experience it all with intimacy (hopefully!)
- How would PrEP provided to women in our health facilities? Would it be provided in family planning clinics? For GPs? Who will pay for it?
- How do health professionals will be trained in providing PrEP for women? How will they be trained to deal with the stigma of HIV and gender-based violence?
- If women are vulnerable to HIV as a result of violence and abuse, PrEP would be the answer? Might be in the short term, while women are supported to end the abuse.
- How can the provision of PrEP be fully integrated services that support women to leave abusive relationships?
- How do we ensure that the supply of PrEP for women provide ways for other essential services for women: including mental health services, drug and alcohol services, access to shelters and safe housing (for those leaving abusive relationships etc. .)?
Translated By Cláudio Souza from the original Are women prepared? Reviewed by MTM in 19 night of March 2015