What is Pre-Exposure Prophylaxis (PrEP)
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection. When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently.
PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.
More on PrEP from the Clinical Team
A clinical PrEP team which comprised of an HIV physician and nurse share the process of initiating and maintaining clients on PrEP. The team noted that at the beginning of PrEP implementation, many clients were registered with the government clinic. This quickly changed as clients were transferred out to private clinics. The PrEP team noted that this was an important lesson learnt since clients are more inclined to access services in the private health sector. In regards to recruitment of clients, the team shared that this is done primarily via direct referrals from CSOs and through contact tracing. Contact tracing is done for each HIV positive patient and negative partners are then evaluated to determine eligibility for PrEP. Participants expressed satisfaction at the high-level of commitment of the PrEP team in recruiting, initiating and maintaining persons on PrEP.
The Client's Perspective on PrEP
Participants had the opportunity to speak with two male PrEP clients – one currently on PrEP and the other, preparing to start PrEP. They shared their journeys to finding out about PrEP, weighing the benefits and risks of starting PrEP and the role of CSOs and health care workers in supporting them to make the decision to start PrEP.
Participants toured the PrEP clinic and were given an overview of the organisation of the clinic and services. The staff emphasized the importance of a high level of privacy and confidentiality of client information.
CSO representatives sharing with the team
Participants interacted with representatives of civil society organisations- Society against stigmatization and hate for HIV and AIDS (SASH Bahamas), DeMarco Foundation, Care to Care, Bahamas National Network for Seropositives (BNN+), United Caribbean TRANS (UCTRANS), Samaritan Ministry and the Broadcasting Commission of The Bahamas. CSO representatives shared highlights of their response and underlined the importance of collaboration with the National AIDS Programme in ensuring HIV health care services can be accessed easily by key populations including PrEP.
Visit to Infectious Diseases (ID) Clinic
Participants visited the infectious diseases clinic at the Princess Margaret Hospital in Nassau. Participants had first hand experience on how the clinic functions and used the opportunity to interact with health care providers from the different areas within the clinic. Participants expressed appreciation for the way in which the clinic was integrated into other out-patient departments of the hospital and noted that this augurs well for anonymity.
Guyana focused on extended hours clinic in order to reach key populations- Presented by Dr. Abiola Jacobs, Government Medical Officer, National Care & Treatment Centre
Jamaica focused on a community facilitator’s initiative in support of the third 90 - Presented by Dr Alisha Robb-Allen, Medical Health Officer, Kingston & St. Andrew Health Department
Trinidad and Tobago focused on how they are prioritizing and integrating HIV services through the Family Planning Association of Trinidad and Tobago (FPATT) - Presented by Ms. Angelie Chotalal, Clinic Coordinator
Dr. Rhonda Moore, Guyana
“As I reflect on the last four days here in the Bahamas, one thing resonates with me, more than the model of care, which by the way is almost identical to that of Guyana, is the dynamic, highly dedicated team. This team does whatever it takes to get the patients the care they need".
Created with an image by Allen Dewberry Jr - "untitled image"