[MONTREAL] The 24e conference on like which was just held from July 29 to August 2, 2022 in Montreal, Canada, allowed researchers working in the field to recall the innovative tools that make it possible to fight once morest this sickness.
This is the case with PrEP (pre-exposure prophylaxis) which has been in place for regarding two years in a number of countries around the world. “It consists of giving antiretroviral (ARV) treatment to people who are HIV-negative to prevent them from becoming infected. We are going to offer it to people who are very highly exposed to HIV,” says Joseph Larmarange, demographer in health public service and research fellow at the Institut de Research for Development (IRD).
“In serodiscordant couples, when the husband or the wife is infected, the other spouse can take antiretroviral treatment to avoid being contaminated”
Mireille North-Etame, ANRS
The latter also specifies that the approach will consist in targeting the vulnerable peoplespecifically sex workers, men who have sex with other men, drug users and especially young girls…
However, if the oral version of PrEP is more effective, its adoption, we learn, remains complex in Africa. At Cameroon for example where its implementation is not “systematic”, according to Mireille Mpoudi-Etame, researcher at the French Agency for AIDS Research (ANRS) and doctor at the Yaoundé military hospital in Cameroon.
“As far as I know, when it comes to HIV, we don’t routinely do PrEP in Cameroon. It is offered mainly in the context of serodiscordant couples or where there is a known risk in post-exposure such as exposure to blood or such as rape,” she says.
For example, “in serodiscordant couples, when the husband or the wife is infected, the other spouse can take antiretroviral treatment so as not to be contaminated. This is the most classic situation where prevention with ARVs is applied in Cameroon”, illustrates Mireille Mpoudi-Etame.
In addition to PrEP, the researchers also refer to self-testing carried out at the individual level, but also “a tool that always works”, according to Joseph Larmarange, namely male and female condoms.
4200 US cases every week in Africa
According to UNAIDS figures, nearly 38.4 million people were living with the disease in 2021. Similarly, 1.5 million people became newly infected and nearly 650,000 others died of AIDS-related illnesses. that same year.
With nearly 25.6 million people living with HIV/AIDS, sub-Saharan Africa remains the most affected continent. Indeed, the Montreal conference tells us that 4200 girls and women aged 15 to 25 in sub-Saharan Africa contract HIV/AIDS every week.
Aimable Mwananawe, national coordinator of the NGO IMRO of Rwanda who took part in this meeting, confirms this trend: “In Africa, the prevalence rate is the highest, which is why we focus our interventions in the target groups and among young people aged 15 to 36”, indicates- he.For best results, “we try to develop appropriate messages for the target groups most at risk of HIV. With recent research we are segmenting and focusing on high-risk groups, for example, sex workers, gay men,” adds Aimable Mwananawe.
However, the stigmatization of the target populations, the precarious economic conditions, constitute a real sprain for the implementation of the various prevention programs. According to the Aflodis Kagaba, executive director of Health Development Initiative in Rwanda, the efforts of the various actors in society must be combined if good results are to be achieved.
“We have started to target these populations, but it is complicated. In many African countries, homosexuality is criminalized. We started working in Rwanda and we have identified more than 5,000 men in this group, we also work with sex workers,” he says.
“We have also started working with the government to decriminalize drugs and to allow it to be done clinically. When the law penalizes, it is complicated to educate them. Because to do so, you have to be able to make the link between them and the health services. But we continue to educate the populations, to limit the stigmatization, ”explains Aflodis Kagaba.
“Undetectable” equals “untransmittable”
If the various specialists agree on the fact that stigmatization in the African context is an obstacle in the fight once morest HIV/AIDS, the precarious economic situation also remains another burden.
For Joseph Larmarange who has done research in several countries on the continent like the Ivory CoastCameroon, SenegalSouth Africa, Mali et Burkina Fasofaced with this difficult access to new tools such as oral PrEP, regular health checks and screening remain the beginning of the process.
“It’s entry into care for HIV-positive people, and into prevention programs for those who are HIV-negative. Knowing your status is important, but also re-testing yourself when taking risks. The most important thing is to treat positive people, and you have to convey the message that ‘i equals i’, which means that ‘undetectable equals untransmittable’”, he maintains.
According to the explanations of this researcher, this means concretely that an HIV-positive person who is under ARV treatment, today, no longer transmits the virus.
However, misconceptions regarding HIV need to be deconstructed, communicate on the developments and change the fatal perception that many people have of the disease, because the objective is not to lower the prevalence, but to obtain zero deaths and zero new infections, conclude the researchers.