Anti-HIV Drugs | Oscar Miranda | Sunday | Sunday

Third floor of a building in the urbanization of Santa Luz Mira, commais one of the mildest scenarios in which Peru begins to win the fight against the epidemic since August 2 last year. HIV AIDS.

In this space is the integrated care module sexually transmitted infection Director of the Maternal and Child Health Center of Mira II in St. Luz. One of 10 places selected by the Ministry of Health (Minsa) began offering free pre-exposure prophylaxis. The prestigious and long-awaited foundation course.

PreP, a treatment consisting of tablets of two antiretroviral drugs (emtricitabine and tenofovir), can reduce the chance of contracting HIV by up to 92% if taken daily.

It was originally produced by North American laboratory Gilead Sciences and marketed under the name Truvada as an antiretroviral drug for HIV-positive people until it was found in 2012 to be very effective in preventing infection as well.

For years, governments around the world have begun distributing the drug for free, especially to those deemed at high risk of infection: men who have sex with men, transgender women and sex workers. In Latin America, Brazil, Argentina and Chile are countries following this example.

But in Peru, this has not happened, although the number of annual infections, far from decreasing, seems to be increasing: more than 8,000 new cases in 2021 and more than 9 new cases in 2022. Thousands, according to the National Epidemiology and Centers for Disease Control and Prevention (CDC).

However, this year things have changed.

population at risk

On August 2nd, on the third floor of the Maternal and Child Health Center Mira II in Santa Luz, Dr. Felipe de la Torre and his team began distributing PreP to all those interested in using it, as part of a prevention package which included other measures, Such as HIV testing, diagnosis and treatment of sexually transmitted infections, hepatitis B vaccination, and sexual health counseling sessions.

The same thing happened at the Mexican Health Center in San Martin de Porés. Additional institutions in Lima were added over time, and by the end of the period 10 were offering PreP, including the Diez de Octubre Health Center in San Juan de Lurigancho and the Centro de Salud San Jose Maternal and Child Center, Villa Salvador.

Rosa Tran, a doctor at the Ministry of Health’s HIV, STI and Hepatitis Prevention and Control Unit, said the project is expected to reach 30 health facilities nationwide by the end of this year and 100 by next year. – Beneficiaries of comprehensive prevention programs are men who have sex with other men, transgender women, sex workers, and serodiscordant couples who are partners of HIV-infected individuals – say experts.

Terán explained that people who come to the health center must undergo screening tests for HIV and other STIs and attend a counseling session, after which the doctor will use his assessment to decide whether to start PreP treatment. If so, each patient would be given a bottle of 30 tablets for a month, after which they would have to return for a new control, he said. From the third month onwards, you will be given a bottle of 90 pills.

Strengthening HIV prevention through PreP is important for Minsa, experts say, because, like other countries, Peru does not use the main method of preventing infection, the use of condoms.

If the HIV/AIDS epidemic is far from over, why aren’t people using condoms? Maybe it’s the fear gone?

Commitment and Effectiveness

For epidemiologist Carlos Cáceres, that’s exactly what’s happening.

“Before fear and fear drove people to keep using condoms,” he said. But now, with antiretroviral treatment, there’s not as much fear anymore. But people need to understand that if you have HIV, you have to be on treatment for life, unlike PreP, which is treatment you only use when you are at risk.

Cáceres is the principal investigator of the ImPreP project, the first project to demonstrate the efficacy of PreP in Peru from 2018 to 2021, initiated by the Osvaldo Cruz Foundation in Brazil and in association with the University of Cayetano Heredia. test.

“We wanted to see how it would work in an uncontrolled trial,” he said. Simultaneously in Brazil, Mexico and Peru. In Peru, we recruited nearly 2,000 people.

Cáceres said the project showed that people who committed to taking their medication strictly did not become infected, unlike those who received only half of their treatment.

“People who took the pill without failure, without any problems, were not infected,” he said. What we see is that the most persuasive and determined people are those who have never had a problem. Those who didn’t believe it, those who said “let’s see,” were the first to stop taking it.

Based on this experience, Cáceres said, for the Minsa prevention program to work, they must do their best to communicate the benefits of PreP to people, clearly inform them of possible minor side effects, and reassure them of any doubts. Might come up among those who are interested.

–Peru was one of the last countries in Latin America to offer PreP coverage to its population – he said. — but in several other countries, they didn’t work as well. We want Peru to do better and reach as many people as possible.

Where can I find preparatory courses in Lima?

These healthcare facilities in Lima already offer PreP:

• Diez de Octubre Health Center in San Juan de Lurigancho.
• Independence City Tahuantinsuyo Bajo Maternal and Child Center.
• CS Laura Caller, Los Olivos.
• CMI Los Sureños, located in Puente Piedra.
• CS Mexico, located in San Martin de Porez.
• CMI Santa Luzmila II, in Comas.
• CS Caquetá, located in Rimac.
• CMI San Jose, located in Villa El Salvador.
• CMI José Gálvez in Villa Maria del Triunfo.
• CS Alberto Barton in Callao.