Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - November 30, 2008
Buyekezwa Makwabe
That is if a worldwide study on the pre-exposure prophylaxis (PrEP) drug Truvada as a preventative measure proves to be a success.
The research combines a preventative pill, counselling and the use of condoms by "high risk" individuals in the sex trade or unsteady, dysfunctional and risky relationships.
While countries like Botswana are studying the impact this has on heterosexual couples, South Africa is studying its efficacy on high risk, sexually active HIV-negative men who have sex with other men.
The Desmond Tutu HIV Centre at the University of Cape Town commenced the study in October by rolling the drug out to 12 volunteers who will undergo a 24-month study period and a further six months of observation.
Dr Linda-Gail Bekker, one of the principal researchers at the centre, said: "The concept of pre-exposure prophylaxis is that an antiretroviral is taken daily by individuals to try to ward off infection should you be exposed to it."
She said the idea was to "try to abdicate acquisition by having the drug on board in the morning, much like the oral contraceptive".
"You pop the pill in the same way and if HIV gets into the system it gets aborted immediately because an antiviral is on board."
PrEP is a therapy taken to prevent, rather than to treat, an infection or illness and Truvada (a combination of two HIV treatment drugs - tenofovir and emtricitabine) is already being used to treat people with HIV infection.
Research done by the institution showed 10% of men who engaged in sex with other men were infected and 35% in townships. UNAids research showed there were 4.3 million new HIV infections worldwide in 2006.
Bekker said South Africa was a country that continued to see an increase in new HIV infections.
She said men who had sex with other men were a vulnerable group and while studies were done on heterosexual couples, this group had received little attention, especially in Africa.
Of the 3000 men having sex with other men worldwide that will take part in the study, 200 will come from Cape Town - Khayelitsha, Guguletu, Mitchells Plain, Retreat, Sea Point and Green Point.
"Our recruitment is in the greater Cape Town area. We go where there are men who sleep with other men and who are willing to participate in the study," she said.
The volunteers receive 30 days worth of pills - half got a placebo - as well as condoms and counselling on how to prevent HIV infection on a monthly basis, Bekker said.
She said medical care for any sexually transmitted infection would be provided.
"We need to offer options to all vulnerable populations and so we need to bring this group back on the agenda.
"They exist in our community and we want to offer them some options for prevention as well."
The results of the study will be available by 2010.
HIV in SA: key facts
# People with HIV: 5.5 million
# Proportion of population (over the age of two) with HIV: 10.8%
# Pregnant women with HIV: 29.1%
# Babies infected with HIV every year: about 60000 (born with HIV and through breast milk)
# New infections a day: estimated 1500
# Aids deaths in a year: 370000
# Total Aids deaths so far: 2.5 million
# People on antiretroviral treatment in the public sector: 370000
# People on treatment in the private health sector: 100000
# People who need treatment but are not receiving it: 540000
# For more information visit: www.tac.org.za
- Treatment Action Campaign
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