Kenya: Fight Against HIV – Pre – Exposure Prophylaxis

Diana Wangari

The Star [Kenya]

Some time back, the international media was flooded with reports of a baby in Mississippi who was cured of HIV. The miraculous procedure was performed by Dr. Gray, a pediatrician with the University of Massachusetts alongside Dr. Persaud of John Hopkins University.

The daring move to treat the child before confirmatory test results of infection was done thirty hours after the child’s birth. In addition, Dr. Gray went a step further to use three drugs instead of the usual one or two. This could have posed a health risk, but against all odds the child survived and eighteen months later, was found to have no viral load despite the mother having discontinued the antiretroviral therapy. The one question on everyone’s mind was: Could this be the breakthrough in finding the cure to HIV/AIDS epidemic?

We would all like to think so, but the fact still remains that there are over 34 Million people living with HIV globally and 1.7 Million fatalities annually. In Kenya, there are 1.6 Million people living with HIV and with such figures, the main focus currently is not to find a cure but to prevent transmission of HIV.

Several trials have been launched over the past few years to investigate whether certain drugs could be used to curb HIV infection before exposure. One such study funded by the Bill and Melinda Gates Foundation was started in Kenya in 2011. The Pre-Exposure Prophylaxis (PrEP) study showed reduced risk of HIV acquisition by 73%. Another trial known as VOICE (Vaginal and Oral Intervention to Control the Epidemic) whose results were released on 4th March 2013 proved that the battle was far from over.

The results indicated that none of the three pre-exposure prophylaxis and microbicide intervention provided additional protection against HIV in the study. The large scale trial among African women utilized daily oral tenofovir, daily oral Truvada (TDF/FTC) and daily 1% vaginal tenofovir gel. However, the disappointing results were not due to the inefficiency of the drugs themselves, but were more likely as a result of the large number of women who did not use the products as directed.

The results which were presented in Atlanta at the 20th Conference on Retroviruses and Opportunistic Infections (CROI) confirmed the correlation between higher levels of adherence and protection from HIV.

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