Post-exposure prophylaxis (PEP) is a way to prevent HIV infection after a recent possible exposure to the virus. PEP is one among the preventive measures against HIV/AIDS and it is even available in Rwanda. However, the question is how accessible are they? In health centres Dr Aimé Hirwa, the assistant surgeon at Ruhengeri Hospital says every health centre eligible to offer HIV/AIDS services can deliver PEP, according to the procedure required. The procedure is that first, they carry out a blood test to find out the actual status of the patient and where possible, the suspect partner is tested too. According to Hirwa, if the patient did the suspected sexual intercourses willingly, they are required to pay a minimum contribution because they are very expensive and found through the contribution of government and funders. “They have to pay between RWF 7,000 to RWF10, 000 as a minimum contribution and limit for those who expose themselves to HIV always, although we will find preventive drugs for free.” “The government of Rwanda pays between USD 100 and USD 200 for every dose of ARVs, so they have to be used responsibly. However, when a person is not capable of finding that money, he is put on drugs to save his or her life as it is the government’s task to protect its citizens,” he says. He adds that in the packet that they receive, they are also provided with medications to prevent against sexual transmitted diseases. These drugs can’t be found in outside pharmacies. “They are only accessible in public health centres and hospitals, and in some accredited private hospitals where patients have to pay for them 100%, as there is no health insurance which can pay for them,” he says. Beata Sangwayire, the HIV testing senior officer at Rwanda Biomedical Centre, says that this method is used for people who have sexual intercourse with people who may have HIV/AIDS because of the conditions they live in. “There are tests which are done, and medications that are delivered. It has been there for so long and it is helpful. It happens mostly when two people have sex and they don’t know their HIV status. It is called pre-exposure because it is taken before self-exposing to HIV, and it is called post exposure because it is taken after the act.” “There is a national guideline which stipulates the procedure to follow in order to provide access to these tablets,” she says. Dr Gallican Rwibasira a medical doctor also explains that these drugs are effective when taken at least within 48 hours although they are more effective when they are taken within four hours. “As hours pass by, the risk to being infected increases. It is also good to bring his/her sex partner to see his/her status too in order to conduct a sustainable prevention. However, when it’s not possible to bring him or her, the available one is put on drugs to save her/his life,” he says. The people who are eligible to get these drugs for free include discordant couples, pregnant women, rape victims and health professionals, who may have accidentally contracted the virus while on duty, according to Rwibasira. “We just talk with them and know their background because he/she may have unprotected sex with one partner today when last weekend he had it with a different partner. We first discuss with them and find out if it is the perfect solution,” she says. For now, the HIV prevalence in Rwanda stands at 3%, according to the recent survey of 2015. A new survey is being conducted to reveal the current prevalence of HIV/AIDS. editorial@newtimes.co.rw
