Uganda joined other countries including Kenya, South Africa, Zambia, Zanzibar, and Zimbabwe for a trial of HIV Pre-Exposure Prophylaxis (PrEP). This followed recent research which shows that anti-retroviral drugs (ARVs) Tenofovir and Truvada reduce the risk of HIV infection in HIV-negative people.
Following this initial research, the Ministry of Health and Uganda Aids Commission initiated separate preliminary discussions on how to take forward the PrEP strategy. Since then the US Food and Drug Administration has approved a prevention indication for Truvada, and trial projects for Truvada as PrEP have got underway in Uganda.
The proportion of adults getting infected with HIV in Uganda has risen in recent years. The 2011 Uganda AIDS Survey estimated HIV prevalence among adults aged 15-45 years at 7.3 per cent, up from 6.5 per cent recorded in the 2004-05 HIV/AIDS Sero Behavioural Survey. The Uganda AIDS Survey showed an increase in voluntary HIV testing in Uganda over the past 6 to 7 years. The increase in new infections highlights the need to refocus the response towards prevention.
Dr. Samuel Kabwigu a Researcher from Makerere Joint Research Centre conducted the trials among 4,758 sero–discordant couples (where one partner is HIV negative and the other positive) in Uganda and Kenya.
He says that the trial showed that Truvada and Tenofovir reduced the risk of infection in the HIV negative partners of positive people in Kenya and Uganda. Truvada reduced the risk by 75 per cent and Tenofovir by 67 per cent.
In his presentation, Dr. Samuel Kabwigu disclosed that there was also evidence that PrEP reduced HIV infection in gay men and transgender women by about 44 per cent. This evidence came from a trial that was conducted in six countries; Brazil, South Africa, Ecuador, Peru, Thailand and US.
He said that the Ugandan trials were conducted in Mbarara, Gulu, Kampala, Mbale, Mubende among other districts, and couples enrolled would be followed up in the first month of enrolment, and reviewed in the third month. Thereafter they will be followed up every three months for 24 months, and HIV pregnant mothers on PrEP will be monitored monthly throughout pregnancy and the baby for one year.
Jane Kijumba, a trial participanat from Mubende District said that “PrEP should be for women alone, especially women with HIV positive partners and maybe sex workers because men don’t want to use condoms, and when they are positive they will force their women into unprotected sex. Men even pay sex workers a lot of money to have unprotected sex with them. Women are the ones always in trouble,” said.
Dr. Samuel Kabwigu said that a total of 82 HIV infections were observed during the trial, 17 among those assigned Tenofovir, 13 among those assigned to Truvada, and 52 among those assigned the placebo pill. This showed that in the group who received Truvada there were 75 per cent fewer HIV infections compared to the group receiving the placebo pill.
The two Drugs that are marketed under the US phamarceutical company Gilead Sciences
Members from Kabembe Kitajunge Mukono District attending training on Pre Exposure Prophylaxis
PLHIV members attending a session on PMTCT and Pre Exposure Prophylaxis in Mukono District
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