GeSIDA recommends promoting PrEP to everyone who could benefit from HIV prevention
The AIDS Research Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GeSIDA) has recommended making HIV pre-exposure prophylaxis (PrEP) easier for everyone who can benefit from this preventive measure against this pathology. In addition, they requested Don’t neglect the recommendation of condom use and a comprehensive approach to sexually transmitted infections (STIs).. They assessed the proposal on the occasion of the fifth anniversary of its inclusion in the National Health System (NHS). A total of 24,000 people benefited from this prevention strategy.
They therefore asked the competent administrations to consider expand access criteria and also provide this preventive treatment to more peoplegiven the good results that have already been proven. In its statement, GeSIDA identified as possible next beneficiaries people diagnosed with hepatitis C. Also those who at the time of risk assessment do not have any of these criteria, but who show a change in their situation in the near future. for example, stopping the systematic use of condoms.
To facilitate access to PrEP, which is based on hospital-dispensed drugs, GeSIDA also called for bringing these treatments closer from hospital pharmacies to the medical devices that serve these users. For example, STD clinics or other community centers such as primary health care centers or community centers.
Assignment and control
PrEP should be prescribed and monitored by a doctor experienced in treating HIV and other STIs, they warn. Except, This professional should be trained to care about sexual and gender diversity.and also to solve the problem of the phenomenon of chemsex.
In addition, the role of specialized nursing is fundamental. For this proposal to be possible, hospital and non-hospital units must be staffed. As well as sufficient resources to adequately meet demand and monitor users. The goal is to reduce waiting lists to access PrEP.
This study group emphasized the importance of proper monitoring of people who should receive PrEP. This should include taking a complete medical history, including toxic habits and sexual behavior. In addition, eanalytical assessment before appointment – to exclude pre-existing HIV infection, to assess the serological status of hepatitis A, B and C viruses, or to assess renal function–. In addition, they emphasized the need for comprehensive screening for other STIs, emphasizing the importance of proper adherence to therapy, initiation of hepatitis A, B and HPV vaccinations when appropriate, and assessment of drug tolerability and possible effects. adverse events, and periodically review indications for continued PrEP.
PrEP for other STIs
Unlike what happened with HIV, Over the past two decades, the number of STI diagnoses has increased. among us. Especially gonorrhea, chlamydia and syphilis, and more recently hepatitis C among men who have sex with men (MSM). For this reason, GeSIDA insists that “PrEP is part of a program that also includes a combination of measures such as condom promotion, sexuality education, substance use assessment, early detection and treatment of STIs and information updating.” recommended vaccines,” emphasized its President Rosario Palacios.
Today It is still unclear whether the use of PrEP contributes to the increase in the incidence of STIs. GeSIDA emphasized. For example, a study conducted in various centers providing this drug in Spain did not find a significant increase in the incidence of some STIs, such as gonorrhea, chlamydia and syphilis.
Although there are conflicting results from different studies regarding the possible increase in the incidence of STIs in PrEP users, Systematic STI screening allows for early detection and treatment of other STIs.. It may even reduce their transmission. That’s why GeSIDA recommends getting tested for syphilis, chlamydia and gonorrhea every three to six months. Additionally, screening for hepatitis C every six and 12 months, depending on each person’s risk.
HIV situation in Spain
More than 40 years after its introduction, despite significant advances in diagnosis and treatment, Today, HIV continues to be a major public health problem.. The rate of new diagnoses is similar to other Western European countries. Although higher than the average for EU countries. According to recent official data from the “Update on the continuum of HIV care in Spain, 2021–2022”, there are an estimated 136,000 to 162,000 people living with HIV in Spain. In 2022, there were 2956 new HIV diagnoses, of which 46.8% were late diagnoses.
Important figures that clearly indicate what to say about HIV and AIDS It’s not a matter of the past but quite the opposite. “Something that requires an ambitious response in the present and future. We are talking about a disease for which there is still no known cure and which continues to raise new questions for us four decades after its discovery,” added the GeSIDA President.
Unprotected sex between men ranks highest among transmission routes in the global data set. Therefore, this group is a priority for prevention programs. Likewise, people from other countries accounted for nearly half of new HIV diagnoses in 2022. Their distinctive characteristics make it necessary diversify prevention programs to adapt them to needs this group. This is a very heterogeneous social and cultural group. Particularly vulnerable, GeSIDA concluded.
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