Third floor of a building in the Santa Luzmila Urbanization a little breakThis is one of the minor scenarios where since last August 2, Peru has started to win the battle against the pandemic HIV / AIDS,
This location has Comprehensive Care Module STI Santa Luzmila II Maternal and Child Health Center. One of the 10 locations selected by the Ministry of Health (Minsa) to start free delivery of pre-exposure prophylaxis. The famous and long-awaited preppy.
PrEP is a treatment consisting of a pill made of two antiretrovirals, emtricitabine and tenofovir, that, if taken every day, can reduce the chance of getting HIV by up to 92%.
The drug combines two antiretrovirals: emtricitabine and tenofovir. Photo: Marcos Cotrina/La Repubblica
It was originally produced by the North American laboratory Gilead Sciences and marketed as Truvada as an antiretroviral to treat HIV-positive people, until in 2012 it was found to be very effective in preventing infection. Was.
Over the years, governments around the world began distributing it for free, especially to those at high risk of infection: men who have sex with men, transgender women, and sex workers. In Latin America, Brazil, Argentina, and Chile were some of the countries that followed this example.
But this did not happen in Peru, despite the fact that the number of annual infections is not only not decreasing but, on the contrary, seems to be increasing: more than eight thousand new cases in 2021 and more than nine in 2022, according to the National Center According to data from the Centers for Epidemiology, Disease Prevention and Control (CDC), thousand.
However, this year it changed.
population at risk
On August 2, on the third floor of the Santa Luzmila II Maternal and Child Health Center, doctor Felipe de la Torre and his team began distributing Preppy to everyone interested in using it, as part of a package prevention . These included HIV testing, diagnosis and treatment of STIs, hepatitis B vaccination and counseling meetings on sexual health, among other measures.
Sex workers are more likely to get HIV. Photo: File/The Republic
The same thing happened at the Mexico Health Center in San Martín de Porres. As the days passed, other establishments in Lima were added, to the extent that by the end of this edition there were ten distributing preppy, among them the Diaz de Octubre Health Center in San Juan de Lurigancho and the Centro de Salud. Mother and child in San Jose, Villa El Salvador.
It is expected to reach 30 health establishments by the end of the year and 100 nationwide by next year, according to Dr Rosa Teran of MINSA’s HIV, STI and Hepatitis Prevention and Control Department. Experts say the beneficiaries of the joint prevention package are men who have sex with other men, transgender women, sex workers and, serodiscordant couples, who are partners of people living with HIV.
Teran explains that people who come to the health center will undergo screening tests for HIV and other STIs and counseling meetings, after which doctors, based on their evaluation, will decide whether or not to start treatment with PrEP. If so, he suggests, each patient would be given a bottle of 30 pills for a month, after which they would have to undergo new controls. From the third month you will be given a bottle of 90 tablets.
The expert says that it is very important for Minasa to strengthen HIV prevention with PrEP because, like other countries, Peru is not using the main method of prevention of contagion, which is the use of condoms.
Why won’t people use condoms if the HIV/AIDS epidemic is still not over? Maybe it happened because the fear was gone?
commitment and effectiveness
For epidemiologist Carlos Cáceres, that’s exactly what’s happening.
“Earlier fear and intimidation kept people using condoms,” he says. But now with antiretroviral treatment, the fear is no longer so. But people need to understand that if you get HIV, you’ll need to be on treatment for life, unlike PrEP, which is a treatment you only use if you’re at risk.
Treatment is also directed at serodiscordant couples, in which only one partner has the virus. Photo: File/The Republic
Casares is the principal investigator of the ImPreP project, the first trial to demonstrate the efficacy of PreP, which was carried out in Peru between 2018 and 2021, at the initiative of Brazil’s Osvaldo Cruz Foundation and in collaboration with Cayetano Heredia University.
“We wanted to see how it worked in a randomized trial,” he says. This was done simultaneously in Brazil, Mexico and Peru. In Peru we recruited about two thousand people.
According to Casares, the project demonstrated that those who were committed to taking their medication in a disciplined manner did not become infected, unlike those who took half the treatment.
“The people who took the pill without any problems, without any problems, didn’t get infected,” he says. What we saw is that the most confident, most committed people were the ones who never had any problems. not done. Those who were not convinced, who said “let’s see”, were the first to stop taking it.
From that experience, Cáceres says that for this Minsa prevention program to work, they must communicate the benefits of prep to the population, clearly inform them of the minor side effects they may face, and remove all doubt. Have to try your best. may arise. among those interested.
Peru is one of the last countries in Latin America offering PrEP coverage to its population, he says. But in many other countries they have not done a good job. We want things to get better in Peru and we want to reach as many people as possible.
Where to find the preparation in Lima?
PreP can already be found in these health establishments in Lima:
- at the Díaz de Octubre Health Center, San Juan de Lurigancho.
- Mother and Child Center in Tahuantinsuyo Bajo, Independencia.
- CS Laura Collar, in Los Olivos.
- CMI Los Surenos, in Puente Piedra.
- CS Mexico, in San Martin de Porres.
- in CMI Santa Luzmila II, Comas.
- CS Caqueta in the remake.
- CMI San Jose, in Villa El Salvador.
- CMI José Gálvez, in Villa Maria del Triunfo.
- CS Alberto Barton in Callao.
(TagstoTranslate)A Bullet Against HIV