By Lakhram Bhagirat
Guyana’s premier Lesbian, Gay, Bisexual, Transgender (LGBT) activist group, the Society Against Sexual Orientation Discrimination (SASOD) is starting its own movement in the fight against the spread of Human Immunodeficiency Virus (HIV) in Guyana.
SASOD has been advocating for the introduction of Pre-Exposure Prophylaxis (PrEP), to the most at-risk group – the LGBT community, for over three years now. However, very little has been done in that time, causing the organisation to start its own movement with the introduction of the critical medicine.
SASOD’s Managing Director, Joel Simpson, during an interview with the Sunday Times Magazine, indicated that the intention was to launch the drug during the 2019 World AIDS Week celebrations.
PrEP is a pill that can reduce the risk of contracting HIV in persons who are HIV-negative. The daily pill, under the Truvada brand, can result in 90 to 98 per cent protection against the disease and caters mainly for those whose partners are HIV-positive.
According to the Centers for Disease Control and Prevention (CDC), a pre-exposure prophylaxis is for people at very high risk for HIV to lower their chances of getting infected. A combination of two HIV medicines (tenofovir and emtricitabine) is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who is positive. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.
When taken every day, PrEP is safe and highly effective in preventing HIV infection.
With that information at hand, SASOD conducted a study on the drug and produced a report, which was submitted to the National AIDS Programme Secretariat as well as the Public Health Ministry in a move to advocate for the introduction of PrEP. The study included 47 persons from Regions Three (Essequibo Islands-West Demerara); Four (Demerara-Mahaica); Five (Mahaica-Berbice); Six (East Berbice-Corentyne) and 10 (Upper Demerara-Berbice) targeted the level of knowledge, attitudes and delivery preferences in relation to PrEP.
SASOD is considered a pioneer in the fight for human rights, especially those of the LGBT community. According to SASOD, during the study, it was revealed that while a majority of the respondents were interested in the benefits of the pill, they were concerned about the costs attached and the HIV stigma that follows when seeking information about PrEP.
SASOD has been in constant contact with the Government in relation to the introduction of PrEP, but, according to Simpson, things have been moving very slowly.
“A huge challenge when working with bureaucratic agencies like Ministries is that things are moving very slow, quite often too slow … this is critical medicine. This is an urgent medicine and we don’t feel the sense of urgency from the health bureaucrats,” Simpson related.
World AIDS Week officially starts today (December 1), and it is during this week that SASOD will officially launch its service introducing the drug on the local market.
Though, not available in Guyana, many at-risk persons have been travelling overseas and sourcing the drug as a means of protecting themselves against the risk of contracting HIV.
SASOD, in collaboration with a private clinic based in Georgetown, will be introducing the medication and is expected to sign a Memorandum of Understanding (MoU) on Monday.
“We are at a place where we decided that it is time for our communities to take action and we are embarking on a partnership with a Private Sector agency to start bringing PrEP at a reasonable cost and making it available for those who can afford to pay for the drugs. PrEP will be available at the private health clinic in Georgetown from Monday to Friday and on Saturday at SASOD’s Duncan Street, Lamaha Gardens office.
“We recognise that everybody who needs PrEP will not be able to afford it, but we also want to show that there is a great deal of demand. We want to demonstrate that it is going to be successful in the Guyanese context in preventing new infections, especially among persons who think they are at high risk for HIV and hopefully that will encourage and inspire the Government to expand their PrEP programme beyond serodiscordant couples,” Simpson said.
Government’s response
The Public Health Ministry earlier announced that it would be introducing PrEP to vulnerable groups. The Ministry’s introduction would have targeted serodiscordant couples (a situation where one partner is HIV-positive and the other is not) through a public-private partnership.
“While it is a start, it is not sufficient. It is not enough and we don’t think we can wait any longer to bring critical lifesaving medicines to our communities. So, this is one way we have decided to move ahead to bring PrEP to Guyana and to bring PrEP to a section of the population that can afford to pay the cost for the tablets,” Simpson told the Sunday Times Magazine.
While Government has trained a number of health professionals in the distribution and management of PrEP, it is yet to operationalise its plan to have those target groups catered for.
“In our view, it suggests that it would operationalise till the end of the year and it would take about six months to a year before they decide to expand and we cannot wait any longer. We have been directly advocating for PrEP for over three years now. We did research extensively and we have decided to move ahead,” SASOD’s Head noted.
A direct effort to reach out to the Ministry for an update on its programme provided futile. However, just last year Chief Medical Officer, Dr Shamdeo Persaud has since indicated that Government was cautious about introducing PrEP, since it may increase risky behaviour.
In August, Public Health Minister Volda Lawrence was quoted in the local press as saying “The Ministry stepping out in this particular venture (introducing PrEP) in terms of creating another space allows persons to have their own choice of access to services. We believe it certainly will work towards the benefit of our people. It certainly will help us in terms of reaching persons and keeping persons in the system and utilising the services available.”
SASOD’s introduction of PrEP will see the medication offered at a cost no higher than $10,000.
