ARVs you take to stop infection can change lives, but where are they?

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I am Moses Supercharger. I am a musician, radio presenter and a dedicated husband to my beautiful lady. I am a father and an HIV activist. And one more thing – I am HIV-positive.

I have been so since 1994.

I have been in love with my lady since 2000. She is HIV-negative and I have endeavored to keep her negative all these years. We have five lovely children, one of whom we had after I became HIV-positive.

Fortunately, all the five children are HIV-negative and healthy. Yes, you heard that right – my wife and children do not have HIV.

My wife and I are what medical professionals call a sero-discordant couple. This is where one partner is HIV-positive and the other negative.

It has been reported that 74,400 (60%) of the 124,000 annual new infections in Uganda occur in stable relationships between HIV discordant couples.

I take my antiretroviral (ARVs) medications daily to control the amount of virus in my blood, which has substantially reduced my risk of infecting my lover.

So, my treatment is my partner’s prevention.

Risky

Even though this is effective prevention, it has its challenges. It puts the burden of prevention on the HIVpositive partner.

Many people may choose not to initiate or remain on treatment or may have challenges accessing treatment.

Condoms are another effective means of preventing infection. But the fact that we had a child after I got infected with HIV is proof that there are seasons in our lives when we have not used condoms.

Many times, we weighed the risk of infection with our desire to have another child. We were willing to take that risk.

Fortunately, my lover has remained HIV-free.

But this is risky because among some couples, the HIV-negative partner has eventually been infected with HIV.

Our options in HIV prevention have now expanded, and this is why I recommend Pre-exposure Prophylaxis (PrEP) as another tool for sero-discordant couples.
 

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PrEP is a prevention strategy, where an HIV negative person takes ARVs to reduce the risk of HIV infection.

Additional layer of protection

Part of the evidence for PrEP comes from the Partners PrEP trials in Ugandan and Kenyan sero-discordant couples.

This study showed that using PrEP can reduce the risk of transmitting HIV to the partner by as much as 90% when taken as prescribed.

Additional studies in other groups have showed similar results. PrEP could change the lives of many couples in Uganda.

For couples where the positive partner has already started treatment, PrEP provides an additional layer of protection for the HIV-negative partner. But, most importantly, for couples where the HIV-positive partner is not ready to start treatment, PrEP could be the game-changer.

And for couples who are experiencing condom fatigue and others who want to have children, this could also change their lives.

What is gov't doing?

PrEP puts the power of prevention in the hands of the HIV-negative partner. I am not saying that we should throw condoms away, but if we are to be honest, we have all gone through seasons where we did not use condoms.

And for those who are HIV-positive like I am, there have been seasons where you just couldn’t take your drugs as prescribed.

And yet we continued to have sex with our spouses throughout such seasons. But what is the Government doing to make sure PrEP is an option for couples like us?

Besides hearing about the ground-breaking PrEP research results in 2012 and knowing there is a demonstration study to see how it would be implemented, there isn’t anything else I have heard about PrEP in Uganda.

In Kenya, they have a blueprint showing how PrEP can be targeted to specific groups, including sero-discordant couples in different regions in the country. This is what Uganda needs – leading from the front.

Kenya has set the pace. Uganda must follow suit.

This World AIDS Day (which was Monday 1 December), I would like to hear more about what the Government’s plans are to roll out PrEP – as an intervention that could change the lives of thousands of Ugandan couples.


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