Promise of HIV shield for sex workers

08 April 2015 - 02:34 By Katharine Child

Would sex workers take a single pill daily if it prevented HIV infection? This is what researchers at the Wits Reproductive Health and HIV Institute are trying to determine.Truvada, an anti-retroviral pill, is proven to stop people from contracting HIV if taken daily, and two studies showed it has 86% success rate if people only take it four times a week.Technical head at the Institute, Mariette Slabbert said “we want to see if a treatment that works [90% of time] in clinical trials [if taken daily], can be given to sex workers in a real life setting”.The two year study sponsored by Bill and Melinda Gates kicked off last week.About 400 sex workers who use the Institute’’s clinics in Hillbrow and Pretoria will be offered the anti-retroviral pill during their ordinary appointment.Blood tests done every three months will determine whether the sex workers are adhering to the treatment.A trial testing the Tenofovir pill for prevention of HIV in women in three African countries failed because the women did not take the pill.But it is thought that people who believe they are at risk of an illness are much more likely to take a pill daily to prevent infection.Researchers will track reported side effects, pregnancy, and whether sex workers are less likely to use condoms when taking a preventative pill.The trial will also give 300 HIV positive sex workers ARVs regardless of their CD4 count in an attempt to prevent HIV transmission to clients.If ARVs are taken correctly, the individual is not infectious.The South African National Aids Council estimates 20% of all HIV infections are linked to sex work.Truvada is licensed in the US for use in prevention of HIV. In South Africa, its use in prevention is still awaiting approval even though an application was made to the Medicines Control Council in December 2013. Doctors currently prescribe it "off label", which describes the use of a medicine for a different purposes than for what it is registered for.Deputy Director of Desmond Tutu HIV Institute, Professor Linda-Gail Bekker said “I am afraid Council is taking an unreasonably long time to approve this indication. The data is solid... Truvada is available in our pharmacies and this is a very viable prevention intervention”.The council did not respond to queries.

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