As we conclude the month of June which focuses on men’s health, it is important to turn the focus to one of the most pressing issues affecting men’s health: HIV prevention using pre exposure prophylaxis otherwise known as PrEP.
PrEP is a preventive healthcare strategy that comes in various forms and is aimed at preventing HIV infection. It involves HIV-negative individuals taking antiretroviral medication to reduce their risk of contracting the virus. PrEP works by creating a protective barrier in the body, drastically reducing the risk of HIV infection from sexual activity or arterial drug use.
PrEP is highly effective when used consistently and is recommended for people at high risk of exposure, such as those with an HIV-positive partner, individuals who engage in unprotected sex, or people who inject drugs. There are several forms of PrEP available, catering to different preferences and needs. The most common form of PrEP is a daily oral pill. The oral pill is taken seven days before an individual is exposed to the risk of contracting HIV. The pill is also used for even Driven PrEP, where males can take the pill between 2 – 24 hours and there after taking one pill after 24 hours and another pill after another 24 hours.
There is also PrEP Ring, which is used by female which is inserted in one’s private part, and it stays there for 28 days and that individual will be protected. The last form of PrEP that is available is injectable PrEP known as CAB – LA which can be injected once in two months. Recent developments in the HIV and AIDS space saw the approval of a long-acting injectable PrEP, which is a game changer as individuals will be expected to take one injection in six months, meaning only two injections in a year.
One of the significant benefits of PrEP is its potential to empower individuals to take control of their sexual health.
It has become a vital tool in comprehensive HIV prevention strategies, alongside condom use, regular testing and counselling. PrEP is also contributing to the broader public health goal of reducing new HIV infections worldwide
According to Sindi Matse, Eswatini National AIDS Programme Manager and PrEP focal person, Sindi Matse PrEP works by building up antiretroviral levels in the bloodstream, which block the virus from establishing infection if exposure occurs. “Eswatini is fortunate to have all the forms of PrEP that are available,” said the program manager.
PrEP Efficacy
The most common form of PrEP is an oral pill and this method has demonstrated substantial efficacy in reducing HIV transmission. According to Matse clinical trials and studies have consistently shown that when taken consistently and as prescribed, PrEP can reduce the risk of HIV infection by over 90 per cent in high-risk populations. The high efficacy rate is contingent upon daily adherence to the medication, as missing doses can significantly decrease its protective effect.
The PrEP ring is infused with the antiretroviral drug dapivirine, and is designed to be worn inside the vagina for a month at a time. Its main advantage lies in its discreet, long-acting nature, empowering women to take control of their sexual health without needing daily medication. Clinical trials have demonstrated varying efficacy rates, with an overall reduction in HIV risk ranging from about 30 per cent to over 70 per cent. Factors influencing effectiveness include adherence to usage guidelines and biological differences among individuals. While the efficacy is lower than some oral PrEP options, the ring offers an essential alternative for those unable or unwilling to take daily pills.
Injectable PrEP using Cabotegravir Long-Acting (CAB-LA) has emerged as the most effective method for the prevention of HIV. Its development marks a significant advancement in HIV prevention strategies, offering a highly effective alternative to daily oral PrEP. Studies have shown that CAB-LA is superior in preventing HIV compared to traditional oral PrEP, because it maintains effective drug levels in the bloodstream over a prolonged period. This long-acting formulation requires an injection every two months, which enhances adherence and convenience compared to daily oral regimens.
Men Uptake of PrEP
While the benefits of PrEP are clear, men continue to hesitate to adopt this preventive measure. The SNAP programme manger says the uptake of PrEP in Eswatini remains low among men who are currently around 32 per cent in uptake compared to women who are at 72 per cent. Cultural stigma, lack of awareness and limited access to healthcare services are among the primary barriers. Men often face societal expectations to appear invulnerable, making it difficult for them to acknowledge their susceptibility to HIV and take proactive steps.
To encourage more men to embrace PrEP, it’s essential to foster an open dialogue around sexual health, normalizing discussions that have historically been shrouded in taboo. Community outreach programmes and awareness campaigns can play a pivotal role in educating men about the benefits of PrEP. By highlighting stories of individuals who have successfully integrated PrEP into their lives, these initiatives can break down misconceptions and build trust within communities.
Tackling HIV prevention through PrEP is not solely a medical issue but also a societal one. It requires a shift in the narrative around masculinity and health, encouraging men to prioritize their wellbeing.
Men’s Health Month provides an opportune moment to champion these efforts, reminding us that taking control of one’s health is not a sign of weakness, but of strength and responsibility. Increasing the uptake of PrEP among men is a critical component in the global fight against HIV. Through education, accessible healthcare and supportive community environments, we can bridge the gap and achieve significant strides in HIV prevention. As we celebrate Men’s Health Month, let us commit to empowering men to make informed health decisions that will protect not only themselves but also their communities.
While the advent of PrEP has brought about positive changes in HIV prevention, individuals must understand while it cannot protect you from sexually transmitted infections, and unplanned pregnancy. It is against this background the stakeholders in the fight against HIV and AIDS always encourage people to always use the available prevention modalities together, for instance when you use PrEP, you must also use a condom and also circumcise if you are a man.
Eswatini Observer Press Reader
