HIV: "They wanted to sell PrEP so you can have sex without a condom. It's not. You don't buy a car to go 180mph"

HIV: “They wanted to sell PrEP so you can have sex without a condom. It’s not. You don’t buy a car to go 180mph”


On the occasion of World HIV Day, it’s time to review the situation. According to Health, there are more than 13,600 people using pre-exposure prophylaxis (PrEP) in Spain.

PrEP is issued at ‘checkpoints’ where users’ health is checked.SHUTTERSTOCK

“I’ve always had secure relationships, but PrEP It guarantees me double protection. I do this for my physical and mental health.” This is how Juan, 49, answers why he uses this tool. Pre-exposure Prophylaxis (PrEP) for HIV. “Minimize the risk of contaminationUntil 30 June 2022, 2.786 new notifications were received to the Ministry of Health. HIV diagnoses In 2021, it represents a rate of 5.89 per 100,000 people (a figure pending correction due to delay in reporting).

Since November 2019, PrEPa combined infection prevention strategy. “I was… Available since 2016however Late to be covered by the National Health System (SNS). In particular, many users access it by paying for therapy; That’s no longer the case today,” says Lucio J. García-Fraile Fraile, assistant physician in the Department of Infectious Diseases at La Princesa University Hospital’s Internal Medicine Department in Madrid.

With this therapy, it is aimed to put one more obstacle to the disease. HIV infections. “This is the daily intake of a single pill of Tenofovir disoproxil fumarate and Emtricitabine (TDF/FTC). in people at risk of infection. PrEP is part of a package of pharmacological and non-pharmacological measures aimed at preventing HIV, called the combined prevention strategy,” explains García-Fraile.

In May of this year, all autonomous regions had implemented PrEP in their regionsAccording to a report from the ministry of Carolina Darias. The estimated number of users receiving PrEP at that time was 13,652. people, according to the notice provided by the communities.

“I use it PrEP for half a year One of the main reasons for this is that hospital access is more agile and private.“There was only one center in Madrid before, but since June we have had several hospitals with distribution points; This helped more people apply,” adds García-Fraile.

Prophylaxis delivery is an action that goes beyond giving pills. “You have to understand that those who want the drug are healthy people. a study is done HIV, hepatitis and STIs Prescriptions are written at the first visit and at the second visit after the infection is ruled out,” says the doctor. “Then they go to the hospital every three months and undergo STI screening and periodic health checks.”

Around PrEP derived from myths and legends. “Some people, morally, They wanted to sell the pill so you could fuck bareback. But this is not. Yes, there are people who do this. But not for those who are applied from health institutions. I give the car as an example, a car is not bought to do 180 km / h. Although there are people doing it in the opposite direction along the highway”, García-Fraile makes this clear.

Another of the tags It encourages stigma against groups that use condoms and increases the risk of sexually transmitted infections because they give up using condoms.. And they point to a direct relationship with the increase. sexually transmitted diseases in last decade. Jorge Garrido, executive director of Apoyo Positivo and member of Fexits (Sexitally Transmitted Infection Experts Forum), points out. “These infections were already on the rise before the advent of PrEP.. Now, with controlled distribution, there is a window of opportunity to treat them”.

Garrido insists There is much more to PrEP than a pill to “prevent infection”.as it spreads. “Many more topics are covered in the consultation. There are other phenomena that can be considered to learn about this intrinsic increase, from sexual practices to situations where you are exposed to a greater risk than others, for example, sexually transmitted infections. more Not necessary, With the scans made every three months, more are detected by taking them under control.Garrido remembers.

Who gets PrEP and why?

it should be taken into account that Each person has different reasons for use and they can quit whenever they want.. “It would encourage people to buy it. It would bring a better result.” Control against STIs. Especially for the younger generation who are more comfortable,” says Juan. HIV stills of the movie starring Tom Hanks and Denzel Washington from the 80s and 90s of the last century, but still in his dreams, Philadelphia.

García-Fraile summarizes various profiles of patients who, for one reason or another, use or do not use prophylactic medication. “There is people who stop taking PrEP once they have established a stable relationship. Monogamy is a cause. Others, when they won’t have regular sex for a while: one user told me he was leaving because he was going to town to work for an opposition”.

Also, although there are monogamous couples, It is recommended to use if one of them does not have undetectable HIV in their blood.. “Once it’s clear that it’s not HIV, the couple can do without PrEP.

Take prophylaxis to avoid an incurable infection

It’s not about experiencing that panic, HIV is killing it. It’s also not nice to have a lifelong illness. Like I said, it’s a physical and mental issue. It’s about being able to relax during and after intercourse,” says Juan, admitting that in some cases he had to demand it. post exposure pill“And it goes bad. The condom breaks and you go to the hospital and tell them what happened. They give the medicine and it should work for the first 48 hours, then two months waiting for the test result.”.

From Gesida, at its annual convention this week, The rate of new HIV diagnoses in Spain is similar to other Western European countriesAlthough it is above the average of European Union countries. According to the latest official data, between 130,000 and 160,000 people are living with the virus in Spain, of whom 25% are not diagnosed or their virological status is not properly monitored.

about numbers infections in SpainAs García-Fraile comments, “medication from the moment of transmission means protecting the patient and their environment, and the use of prophylaxis is two key factors”.

infectious disease doctor clear PrEP is here to “literally revolutionize the way you defend yourself against the undesirable.”: getting an infection”. But he emphasizes: “You must understand that this is a pharmacological measure to prevent the acquisition of HIV and is complementary to other factors present. Well, What measures do we currently have to prevent HIV transmission?: to know what happened first; second, get tested for HIV before starting PrEP, you should know if you have it; and third, It should be understood that the condom protects against most STIs and should be available.. This should be taken into account because there are STIs that increase the risk of contracting HIV when exposed.”

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