Uganda rejects HIV prevention tool on moral grounds

Published: September 3, 2013

 KAMPALA, 3 September 2013 (IRIN) – Activists in Uganda, where some 400 people are infected with HIV every day, have called on the government to rethink its dismissal of an emerging prevention protocol demonstrated to be effective in a trial conducted partly in Uganda, and which has been approved by the US Food and Drug Administration. 

 The protocol in question is a form of pre-exposure prophylaxis (PrEP) involving a daily dose of two antiretroviral drugs – marketed as Truvada – taken by an uninfected person who is in a sexual relationship with an HIV-positive partner. 
 According to PrEPWatch, a website run by AVAC (Global Advocacy for HIV Prevention), Truvada "has been proven effective at reducing the risk of HIV via sexual exposure in heterosexual men and women, gay men and other men who have sex with men, and transgender women". One study among serodiscordant couples in Kenya and Uganda, found Truvada reduced HIV transmission by 73 percent, when compared against a placebo. 
 The World Health Organization guidelines issued in 2012 called for a cautious and gradual rollout. 
 Uganda has no such plans, according to Alex Ario, programme manager in the Ministry of Health’s AIDS Control Programme, who said public misunderstanding of the protocol could encourage “reckless sex”. 
 "In our discussions, the technical committee has not recommended the use of PrEP among HIV-negative people. It’s morally unfit, not right and incorrect to put people who are HIV-negative on treatment, when we have not been able to enrol those who are HIV-positive on it," he told told IRIN. 
"With the rate of new infections in Uganda, a reasonable prevention programme must be hungry – indeed very hungry – to add to its arsenal of tools any of the scientifically proven technologies…"
“People will engage in reckless sex behaviour and rush to health facilities, saying `I had sex but the condom burst’,” he added. “It will be naïve for the ministry to adopt such guidelines and policy.” 
Ario said Uganda would continue to focus on its long-standing ABC – Abstinence, Be faithful, and Correct and Consistent Condom use – as the foundation of its HIV prevention strategy. 

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