
HIV IN A NUTSHELL
September 28, 2024Why use HIV prevention? Well, for one, there are so many mistakes that happen during ‘heated’ moments which would predispose you to getting HIV and STIs.
“The condom broke.”
“The condom fell off.”
“I forgot to use a condom.”
“I was drunk, I’m not sure if we used one.”
“I just met the girl last night.”
“I have a new partner, and don’t want to ask his status.”
“I have a new partner, and I didn’t want to force him to use a condom.”
These are some of the many concerns I hear EVERY SINGLE DAY.
Its more common than you would expect.
Still, hats off to every one of my patients for making the effort to protect themselves.
HIV prevention and STI prevention go hand in hand. If you’re putting yourself at risk of HIV, you’re also putting yourself at risk of getting a STI. Moreover, STIs itself also increases the chances of you getting HIV in the future. This is because STI’s can sometimes cause small little sores in the genital areas which then act as an opening for HIV to enter the body.
But there are ways in which we can prevent both STIs and HIV:
Preventing STIs:
In South Africa, our STI prevention strategy works as a post exposure prevention approach, meaning we can issue medication for STI prevention AFTER you’ve had the sexual encounter. This comes in the form of one-two tablets and an injection. There are many types of STIs (See STI post), and we need to ensure that you are covered for most of them. It is given as a once off stat dose. So its quick and easy.
Pre-exposure for STIs is not officially available in the South African public sector. Example: a sex worker, who has multiple partners may want to use regular STI prevention, and perhaps would want to take it prior to having sexual relations. In other countries, and for certain cases, Doxy-Prep is being studied. This includes taking one tablet of antibiotics for long term use in order to prevent STIs before getting exposed to it. More on this in the future.
For now, I will be offering STI post exposure prevention, by virtual consultation.
HIV prevention:
There are two types of HIV prevention strategies:
Pre-Exposure Prophylaxis (PrEP):
Pre = Before
Exposure = The sexual event
Prophylaxis = Prevention.
In essence, it is medication that is to be taken prior to having sexual intercourse with someone who may be HIV positive.
People who would benefit from PrEP would be:
- Discordant couples: e.g. if your spouse is HIV+ and you are HIV neg.
- Sex workers who have multiple partners.
- People who have multiple sexual partners
- MSM: men who have sexual relations with other men.
- If you’re unsure about your partners status.
- If you use injectable drugs.
- If you have sexual intercourse under the influence of drugs or alcohol.
- If you have/ have had a STI.
- If you want PrEP: to be safe.
Even if you’re just unsure, and would like to protect yourself from HIV, you are eligible to start PrEP. The only people who would not qualify to use PrEP would be people who weigh < 35kg, if they’re under 15yrs of age, have kidney problems or if they test positive for HIV.
Post Exposure Prophylaxis (PEP):
Post = After
This is the tablet that should be taken as soon after the sexual event as possible. It is only effective within 72 hours of the sexual event. Thereafter, there is no evidence that it offers any protection. It is more an emergency intervention, and is not to be used routinely.
Both PrEP and PEP medication involve taking one tablet daily; and both of these tablets are made up of ARV components.
Prep takes more effort, but it’s better in protecting you from getting HIV.
PrEP is 99% effective in preventing HIV, PEP is 80% effective.
If you’re interested in having a consultation for HIV prevention, please don’t hesistate to send me a WhatsApp message.
As a HIV medical doctor, who has worked in an HIV clinic for over 5 years, I’ve seen so many cases with complications, like TB of the brain. TB of the eye. Spinal TB. Fungal meningitis. Cancers involving the skin. Lymphoma. Many of these cases take months – years to get fully treated. Some cases are incurable. That is when work gets tough. The emotional aspect is sometimes the hardest part of being a doctor: losing patients.
This is not to say that HIV is a death sentence. It’s nowhere near a death sentence. Not in this day and age.
I heard a saying once that having HIV is less scary than having Diabetes.
Diabetes and HIV both have serious complications. Diabetes may be complicated by having a stroke, a heart attack, leg amputations, and eye or kidney issues. HIV complications include Tuberculosis, Meningitis, certain cancers, and disseminated fungal or parasitic infections. Both of these conditions are serious and have life threatening complications. BUT, to prevent getting the complications of HIV, all that is required of you is to take ONE PILL every day.
To prevent Diabetes complications, it takes a lot more than just popping one pill every day. You need to ensure you have a healthy diet, limit sugar intake, limit fat intake, take a tablet more than once a day and potentially inject yourself with insulin multiple times a day. Not to mention the regular sugar checks throughout the day.
It’s sad to see that HIV is still stigmatized when it’s so easily treatable, and even easier to prevent. Yes, it is a chronic condition, and will require lifelong treatment, so effort should be made to prevent its acquisition. It’s just sad to see that a great deal of people steer clear from anything to do with HIV.
I have a few patients who attend my clinic for STIs, but refuse to be tested for HIV, because they are “not ready.” This is wherein the problem lies. People are too afraid to test for HIV, but are happy to have unprotected sexual intercourse, and end up infecting others. If the world wasn’t afraid of HIV, or there wasn’t any stigma around being HIV positive, more people would test; and more people would be taking HIV prevention.
So, to end off, my message to you, if you are unsure of your partners status, or even if you feel like he/she may have multiple partmers, please consider protecting yourself by using PrEP or PEP. For further information, please see my social media pages, or send me a message on WhatsApp/email if you would like a virtual consultation.
– by Dr S Jakoet