Experts warn against sharing ARVs  

HEALTH  HIV/AIDS

KAMPALA - The practice among some men sharing their spouses' Antiretroviral drugs (ARVs) to treat themselves could lead to drug resistance, experts have warned.

There is also a high chance that men who take their spouses' drugs, may consume the oral contraceptives that their spouses are often given, but are not meant for men.

These, according to some experts, are drugs mostly administered to female patients who are on clinical trials. The assumption is that they are part of ARVs that can lead to hormonal imbalances.   

While briefing the Speaker of Parliament Rebecca Kadaga, on the status of AIDS response in Uganda on Monday, the Uganda AIDS Commission (UAC) said some men still fear to test and have resorted to sharing drugs with their wives, despite widespread awareness about the disease.

However, experts on Tuesday described the actions by these men as dangerous, and that this alone will make the country suffer setbacks as it strives towards having an AIDS-free generation.

 "This is very bad. If you share the drugs, it means you are using suboptimal drugs and this will not suppress the viral load in your body, hence creating resistance," said Prof Pontiano Kaleebu, the director of Uganda Virus Research Institute.

Suboptimal drugs according to Kaleebu means that one has fewer amounts of drugs in the blood than what is required. This he said also means that a person on this kind of drug arrangement can infect others with the virus.

Prior to prescribing drugs, he also explained that doctors are required to carry out an assessment of the patient's medical history to ensure that the drugs given do not damage their system.  

A medical expert on HIV/AIDS who preferred anonymity explained that when someone tests positive, it is important to find out the genotype of the virus he or she has. The genotype refers to what ARVs that strain has resistance to. This way, the infected person does not waste time on the wrong regimen.

"ARVs like any other drugs have side effects, including hypersensitivity reactions like Steven Johnson's. It is, therefore, important that a patient meets with their doctor first to see how their body may potentially react to the drugs before they start taking them," the source said.

Dr. Stephen Watiti, an HIV/AIDS advocate said self-medication especially for a man that may turn out to be negative, is a total waste of drugs.

"Do not assume that if your wife is positive you are positive. We have discordant couples. Instead, the man will put the life of the actual beneficiary of the drugs in jeopardy because her amount of drugs will be reduced, thus not adhering to their proper dosage," he said.

Watiti said every drug is prescribed to a particular person. Some may require first line treatment while others may need second-line treatment.

"This is a bad practice that men should stop. We, therefore, need to focus on how to help them (men) self-test to ensure they know their status," Watiti said, adding that women should also be empowered to refuse to share their drugs with their spouses.

Minor issue

On the contrary, Dr. Joshua Musinguzi, the AIDS Control Programme manager at the health ministry said this is a peripheral issue and that focus should be put on uptake of services that have been provided by the government.

"I have not heard of men taking their spouses' drugs before. The truth though is that men are not coming for treatment as well as women are doing and that is why we are working towards improving case findings to reduce the numbers of people that are unidentified," Musinguzi said.

Musinguzi said of the 1.3 million people living with HIV/AIDS in the country, 1.165million are on treatment, leaving a balance of 200,000 people that are still at large. However, the uptake of drugs among women is at 95% compared to 75% among men.

The ministry, he said has intensified efforts to improve testing and drug uptake among men. This is through campaigns and outreach programmes that find men in their homes and workplaces

"We have also extended working hours in the evening with our partners to ensure that men access services after work," Musinguzi said.