I'd guess most folks here don't know the Dominican Republic was the first Caribbean country to use PrEP, the HIV vaccine treatment, and has been using it since 2107.
Reducing the risk of infection of the Human Immunodeficiency Virus (HIV) by more than 90%, in a preventive way, is the main objective of the use of a new pilot treatment that is carried out in the Dominican Republic since 2017, called PrEP (pre-exposure prophylaxis, by its acronym in English).
The commercial name of this medicine approved in 2012 by the United States Food and Drug Administration (FDA) is Truvada (brand developed by Gilead Sciences of tenofovir and emtricitabine).
The use of this preventive medication is for people who do not have HIV. The effectiveness of PrEP is further enhanced when other prevention measures such as condoms are used.
"PrEP is not for people who already have HIV but for those who do not have it and have had a test that is negative," said epidemiologist Robert Paulino, of the Center for Integrative Research and Guidance (COIN).
Population with HIV
According to the United Nations Office for HIV / AIDS (UNAIDS), by 2017 in the Dominican Republic 67 thousand people were living with HIV, of this amount, 50 thousand are diagnosed, while about 17 thousand do not know that they have the virus.
"Not everyone can access this program, it has a cap of people per province. What we are looking for with this study is to see if the country has the resources to supply the vulnerable population with this type of preventive medicine, "said Dr. Santo Rosario, executive director of COIN.
He said that currently this drug is in experimental stage in the country.
The use of PrEP is being implemented in the United States since 2012, focusing on the population at greatest risk to contract the virus. In Europe and Asia, this new drug has also been offered, in Latin America, Brazil and Mexico were two of the first countries to implement it as a prevention strategy. While in the Caribbean, the Dominican Republic was the first to offer the drug in 2017.
The first PrEP implementation pilot was carried out at the initiative of the Ministry of Public Health, through the General Directorate of STI / HIV Control (Digecitss), the Centers for Disease Control and Prevention (CDC), PEPFAR, the Center of Orientation and Integral Research (COIN), the Ibero-American University (Unibe) and the Pan-American Health Organization (PAHO / WHO).
So far 170 people are part of the HIV prevention program at the COIN, which is located on Aníbal de Espinosa street # 352, in Villas Agrícolas, Distrito Nacional. In the next months it will expand towards Puerto Plata and La Romana.
As explained by the COIN epidemiologist, Robert Paulino, the treatment consists in the administration of antiretroviral drugs (which are used in the treatment for HIV infection), in people who could have some risk contact and who have had a test of HIV that demonstrate that they are negative for the infection. PrEP is a prevention strategy to prevent the proliferation of the disease and must be used with adequate clinical follow-up.
PrEP can cause some side effects such as nausea, loss of appetite or headaches. These usually improve over time, once your body gets used to the drug. But most people do not experience any.
"PrEP is not a panacea, it is not the solution to the elimination of HIV, the solution is for people who have the virus to be diagnosed and take their medication so that it becomes undetectable and can not infect other people," he emphasized. Dr. Rosario.
He said that the use of this preventive drug is only effective to prevent the spread of HIV, so it is necessary to use condoms to prevent other sexually transmitted diseases.
Those interested in participating in the program have to go to the COIN to make the corresponding evaluations, on Monday, Wednesday and Friday.
This pilot is financed by the National Program to Fight AIDS, the Ministry of Public Health and the COIN. Patients do not have to pay for exams that are performed, nor for medicines, care is offered free of charge.
Who should use PrEP?
The candidates with priority to access this program are those who are at risk of contagion, those who are having sex outside of a relationship with different people without the use of condoms, sex workers, those who use injected substances, among others. .
• You do not use condoms frequently.
• You have a sexual partner with HIV (sometimes called serodiscordant, serodifferent, magnetic, or mixed status couples).
• You have a sexual partner at high risk of contracting HIV (for example, if you have anal or vaginal sex with other people without a condom, or are injecting drug users).
• You have anal or vaginal sex with many partners, especially if you do not use condoms regularly.
• You recently had another STI (such as chlamydia, gonorrhea or syphilis).
• You perform sex work that includes vaginal or anal sex.
• You have injected drugs, shared needles, or have been under treatment for drug use in the last 6 months.
If you are in a high risk group for HIV contraction and you are pregnant, trying to get pregnant, or breastfeeding, PrEP can help you and your baby avoid HIV infection.
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