HIV pre exposure prophylaxis is the use of antiretroviral drugs to reduce the risk of contracting HIV infection by an HIV negative person.
The level of protection from HIV infection does not differ by regimen of antiretroviral, age , sex and mode of exposure to the virus (sexual inteercourse, sharing of contaminated sharp object). Instead, the level of protection is strongly related to adherence tom HIV prophylactic medications.
Guidance for offering Pre-exposure Prophylaxis:
HIV pre exposure prophylaxis is recommended for the following category of people:
1. Commercial sex workers
2. Injecting drug users
3. Serodiscordant couples
4. Individuals who engage in prolonged, regular anal sex
It is recommended that pre-exposure prophylaxis should be offered as an additional preventive measure to HIV negative persons due to their substantial risk of acquiring HIV infection. Clients are also encouraged to continue to implement all of the other risk reduction interventions including safer sex practices. When used daily and consistently, pre-exposure prophylaxis can reduce the risk of HIV infection among these HIV risk individuals by as much as 90%.
Approved Drugs for Pre-exposure Prophylaxis:
Antiretroviral drugs approved for HIV pre exposure prophylaxis is a daily dose regimen of Truvada (Tenofovir + Emtricitabine) or a daily dose of Tenofovir; which is the alternate regimen. It is recommended that once on pre-exposure prophylaxis, clients should return to their health facility for follow-up every 3 months.
Discontinuation of pre-exposure prophylaxis:
It is not recommended to discontinue pre-exposure prophylaxis while a client is still exposed to influences that expose s/he to high risk of HIV infection. However, client may discontinue pre-exposure prophylaxis when:
- Client becomes HIV positive in the course of receiving pre-exposure prophylaxis
- Client’s personal choice against medical advice
- Client is no longer at risk of acquiring HIV infection
- Consistent poor medication adherence despite adequate counseling
- Client experiences intolerable adverse drug reactions.
Clients may also resume pre-exposure prophylaxis following discontinuation but they must undergo the same pre-initiation evaluations.