A study published in the Canadian Medical Association Journal has recommended the use of post-exposure prophylaxis for Canadians who are HIV negative and experience non occupational exposure to the HIV virus.
The study recommends that HIV PEP be made part of the standard care for people exposed to HIV even if they are not healthcare workers and should be part of the bigger strategy of eliminating the HIV epidemic.
The researchers have also recommended the use of HIV pre-exposure prophylaxis (PrEP) to protect high risk populations such as gay men, men having sex with men and sex workers.
PEP is an antiretroviral medication that is taken between 48 and 72 hours post exposure for a period of 28 continuous days. PrEP on the other hand is taken by an HIV negative person at high risk before exposure.
Recommendations for PEP and PrEP Use
Alongside the recommendations, the researchers also provided clear guidelines for firstline clinicians on who makes a good candidate for PEP and PrEP as well as which specific drug regime is most appropriate for each therapy.
The researchers recommended PrEP to be given to MSM and transgender women especially those who report having condomless anal sex, people with a sexually transmitted disease and people using PEP for non-occupational exposure.
They also recommend the use of PrEP by HIV negative partners who are part of a serodiscordant couple. The other recommended PrEP population is people who inject drugs and share injecting tools such as needles.
PEP is highly recommended for gay, bisexual men and MSMs as well as for sexual violence and rape victims.
Constant New HIV Infection Rates
New HIV infection numbers have remained constant in Canada over the last couple of years despite heightened efforts to fight the disease. There is about 2,000 to 3,000 new cases reported annually mainly among people aged between 30 and 40 years.
With the study guidelines, the researchers hope to address this constant trend despite increased HIV prevention, screening and treatment efforts in the country.
The researchers take note of the high financial costs that governments have to deal with when treating HIV infections and intimated that prevention of HIV will save them huge amounts of money in the long run.
The researchers noted that Canada has been lagging behind in the uptake of PEP and PrEP. According to the researchers,54.3% of new infections are reported among gay, bisexual and men who having sex with men (MSM).
This population is 131 times more at risk of acquiring the virus compared to other men. The researchers thus insist on targeting such high risk populations with highly effective prevention methods such as HIV PEP and PrEP.
Limited Access to HIV Prevention Medication
Though awareness of HIV PEP and PrEP is on the rise in Canada, access is still largely limited mainly due to high cost of the medication. Canadians need to pay a deductible to be able to get a public drug insurance plan. Such deductibles are too expensive for most people who are at the highest risk. The good thing is in September 2017, Ontario has added HIV PrEP into it’s public health plan.
The researchers believe that the guidelines will create much needed awareness about these two HIV prevention strategies, standardize practice and see more primary care providers help patients take the medication as required.