Pre-emptive ARVs can prevent HIV infection
Sunday, 9th November, 2008
Source: New Vision Online
BY CATHY WATSON
Last week, The New Vision ran a photo of a nine-year-old girl who was defiled. The sub-editor concealed the child’s face to protect her identity. But anyone could see what she was feeling: shock, bewilderment, fear.
As I studied the photo, I wondered: Did anyone offer her PEP?
PEP stands for “post-exposure prophylaxis”. “Prophylaxis” is an emergency short-term disease-specific treatment to reduce the likelihood of a particular infection.
That is quite a mouthful. But “PEP”, as we most need to know it, is a 28-day course of ARVs taken after someone has been exposed to HIV.
If started within 72 hours of the exposure (and the sooner the better), PEP is highly effective in preventing HIV infection.
The ARV drugs block the virus from infecting a CD4 cell. So the virus cannot “take root” and start replicating itself in the body.
The Ministry of Health’s “National Policy Guidelines on Post Exposure Prophylaxis for HIV, Hepatitis B and Hepatitis C” were published in November 2007. They explain that the exposure can be “occupational” — a midwife may accidentally stick herself with a used needle or a sexual assault or car accident where the blood of fellow passengers enters your wounds.
I first started thinking hard about PEP last year when I read an article about the Gender Violence Recovery Centre at Nairobi Woman’s Hospital. Since it opened in 2001, the centre had given PEP to 6,500 people: 45% of them were girls aged less than 16 and 4% of them male. I tore out the article and kept it in my bag.
Then in January, I was in Nairobi. It was the height of the post-election violence and I took a taxi to Nairobi Women’s Hospital. Clutching a Straight Talk annual report and explaining that I was a nurse, I introduced myself.
Sister Susan Maina took me around. On one bed was a man, aged 60, who had been sodomised by a gang of 11 young men. He anxiously thanked Sister Maina, who explained that he had just started PEP.
In another room was a toddler of two. Truly, sometimes our imaginations fail us: her rape had ripped her vagina through to her anus. She was on PEP and recovering from reconstructive surgery. Doctors had diverted her intestines so that her faeces emptied into a bag on her abdomen.
Then there were 14 females, aged 15 to 70, also on PEP.
As we walked around, Sister Maina said her unit had trained most hospitals in Kenya on PEP and that, as we spoke, 400 volunteers were in internally displaced people’s camps in the Rift Valley, seeking out survivors to help. Of the 7,000 some people that her unit had assisted, only two had become HIV-positive. They had probably been in the window period and already infected, she said.
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Read full article at New Vision Online
