As of July 2015, 24 million people throughout the world are living with HIV. There are a number of methods to prevent becoming infected with HIV, such as proper and consistent use of a condom, using disposable needles etc. These methods caused a decrease in the percentage of new individuals infected with HIV in several countries, however in certain places the disease is spreading, which raised the need for additional preventative strategies. The efforts to find a vaccine for HIV were unsuccessful, nor was a treatment found that is not a mixture of several pills. Therefore, the World Health Organization (WHO) suggested a new approach, preventative treatment before exposure for people at risk of being infected with HIV, but who have not yet been infected with the virus.
What is PrEP?
The new recommendations by the World Health Organization relate to the daily use of medical treatment for HIV for a population who has not yet been infected with HIV in order to prevent becoming infected with HIV. This preventative measure before exposure is called Pre-exposure Prophylaxis, or in short, PrEP.
Does it work?
The primary studies upon which the recommendations for treatment are based were carried out on two groups of the populations. The first group is transgender men and women having sex with men. The second group is heterosexual couples, where one partner is HIV positive and the other partner is HIV negative. The results of these studies indicated that the treatment is effective.
The recommendations of the World Health Organization for when to consider administration of PrEP are:
- In countries where HIV infections occur between couples, administering PrEP to the spouse who is HIV negative should be considered.
- In countries where HIV infections occur between men who have sex with men or transgender women having sex with men, administering PrEP should be considered.
Magic Pill? All that glitters is not gold!
- The drug treatment is not a simple treatment and may have side effects, such as a decrease in bone mass, side effects in the digestive system (nausea, diarrhea, stomach pains) and an effect the kidneys’ function. Therefore, the question that arises is whether a healthy population should be administered drug treatment?
- The treatment is not recommended for people who have kidney problems since the treatment may induce the appearance of severe and irreparable kidney problems.
- The treatment is not recommended for people who have Hepatitis B since the treatment suppresses only a part of the Hepatitis B virus and may be resistant to treating Hepatitis B.
- There is a risk for anyone who takes the treatment before exposure to develop future resistance to HIV treatment in the event that an exposure does occur , making the treatment of an HIV carrier even be more difficult.
- There is an additional risk of decreased response to treatment due to compromised compliance since it is difficult for a healthy population to take a pill on a regular basis.
- The prophylactic treatment may cause a decrease in the usage of condoms and an increase in other diseases, some of which may have fewer methods of efficient treatment.
What is happening in Israel?
As of February 2016, the Ministry of Health approved a program to prevent HIV infection. Thus, Israel will become one of the first countries to approve a drug based HIV prevantion program.
In addition, there is a Post-exposure prophylaxis treatment called PEP
To read more about PrEP go here