HIV prevention drug may not be the cure for Antigua’s AIDS woes
Limited resources preclude provision of antiretroviral medication to HIV negative persons.
ST JOHN’S, Antigua, Wednesday May 16, 2012 – In the wake of a Food and Drug Administration (FDA) advisory panel recommendation to fast-track the HIV prevention treatment drug Truvada, an infectious disease specialist has said it might not be the cure for Antigua and Barbuda’s HIV/AIDS woes, at least not yet.
HIV/AIDS Coordinator for Antigua and Barbuda, Dr Amina Fernandez, said the lack of sufficient financial resources and the culture in Antigua and Barbuda might preclude a Pre-Exposure Prophylaxis treatment option (one that prescribes antiretroviral medications to HIV negative persons who are at high risk for infection – such as Truvada) from becoming widely used in the island.
“With our limited resources we have to restrict the medicine to the people who need it the most. So if we are not able to prescribe antiretroviral medication to all persons who are HIV infected, there is definitely no way that we’re going to prescribe them to people who are not HIV infected,” the board-certified internist told the media.
According to Fernandez, the Organisation of the Eastern Caribbean States’ (OECS) Pharmaceutical Procurement Service (PPS) supplies certain HIV positive persons with free medication, but the entity does not currently authorise medications to HIV negative persons.
“In Antigua and the OECS, our medicines are provided by the Global Fund and we are governed by them in terms of to whom we can provide the medicine. As it is, we are not giving medication to all HIV infected persons. It depends on their stage,” Fernandez said.
Moreover, although the internist says drugs like Truvada can cause a “significant reduction” in incidences of infection, culturally the people of Antigua and Barbuda may not be ready for this step.
“Culturally I think that people here don’t like to take pills in general. I think it will be the same with this, they won’t take it properly. I don’t see it happening anytime soon,” Fernandez said.
The HIV/AIDS specialist warned that although the drug professes to reduce the risk of infection by 44 percent, people must be cognizant of the continued risk of infection.
“Even with taking Truvada and engaging in high risk activity from time to time, you do not have a zero risk of acquiring the virus. In people who were more than 90 percent adherent (to the medication schedule), the risk reduction was 70 percent. It was not 100 percent so they are still going to have a risk of acquiring HIV,” she indicated.
The doctor believes that the prevention plan for Antigua and Barbuda should be continued education and traditional prevention.
“Here we should continue to push for condom use and the reduction of sexual partners as opposed to medication,” Fernandez said.
The OECS PPS programme does not currently offer Truvada for HIV treatment in Antigua and Barbuda or in OECS territories.
The doctor nevertheless noted that Antigua and Barbuda does offer comparable HIV medicines, including Tenofovir Lamivudine and Emtricitabine, which are currently used as an antiretroviral drug and can be used as a Pre-Exposure Prophylaxis treatment drug.