It is the new licence to be reckless. Female university students are increasingly abusing PrEP in their rendezvous with their older lovers, who are unwilling to use any form of protection.
The US Centres for Disease Control defines PrEP (pre-exposure prophylaxis) as the medicine people at risk of HIV take to prevent contracting the virus from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV.
We wanted to find out how easily one can get PrEP. Our investigations start in Juja, Kiambu County. Every few metres, there is a pharmacy. We are on a mission to buy PrEP, but all the pharmacies say they are out of stock.
Then we find a pharmacist who directs us to a specific shop in Thika. “You’ll find them in that pharmacy… even wholesale,” she tells us.
She then directs us to another chemist in Juja and advises us to name-drop. “Say I have sent you,” she says, giggling.
We head a few metres back, to one of the pharmacies that we had visited earlier, but the seller frowns when she sees us again.
We ask for PrEP, but the seller hesitates, until we mention the person who had directed us. But she still hesitates.
She then makes a call to a friend, whom we talk to on her phone and who directs us to his store.
He says he will sell a full dose for Sh1,500, but I ask if I could buy several at a wholesale price to sell to students, but he insists on meeting us first.
But our fixer tells us: “I know of some students who sell the drugs, it’s like a black market. But you need someone inside to get there.”
We ask for the student’s phone number but his phone had been switched off.
Many students are getting PrEP over the counter because there is still stigma associated with HIV.
Susan, a third-year student at the University of Nairobi, calls herself ‘Dora the Explora’. She was introduced to PrEP by her best friend, something she says was a ‘blessing’ to her life.
“My friend introduced me to PrEP and I will forever be grateful. I used not to party a lot, from the first year and second year but after my boyfriend broke up with me, I was devastated,” she said.
“But my friend introduced me to this man with a lot of money, and a good car. I had never dated one before and I decided to give it a try, and we planned to meet.”
A doctor at Whitman-Walker Clinic in Washington, DC, holds a handful of Truvada, the first pill recommended for HIV prevention in healthy people who are at high risk of getting HIV through unprotected sex.
Her friend advised her to take it a day before meeting the man. She had heard that older men don’t like using protection.
Taking precautions
“That night the guy refused to use protection. Yes, I had taken the pill but I was not aware that it works and he refused completely. After that, I am used to just taking precautions with PrEP. He funds my lifestyle, I can’t stop and it’s like an addiction,” she giggled.
Research shows that PrEP reduces the risk of getting HIV through sex by about 99 percent when taken as prescribed.
Just like Susan, Ivy was introduced to the “wonder drug” by a friend.
“I first took PrEP in my third year. I did not buy it; I took it from my friend’s prescription. It was not easy because I experienced diarrhoea and I did not like any second of it,” she said.
“I was not in a relationship. I was sexually active and you see dating older men while in university is the in thing. They finance your lifestyle, so it’s upon you to take care of yourself.”
She continued: “In the beginning, students used to buy PrEP but now the only thing you need to do is take an HIV test then you are given the drugs, that’s it, it has now become very easy.”
The side effects of PReP include nausea, a feeling of queasiness, unease or discomfort in the stomach, and sometimes the urge to vomit, which can last up to a few weeks.
PrEP does not prevent other sexually transmitted infections like syphilis and gonorrhoea, but for some college students, it’s a green light to have sex without protection.
“People are engaging in unprotected sex every day. What bothers me about this controversy is if you can be safe on something that other people are doing, why can’t you do it,” says Morgan, a student at Kenyatta University.
“Sometimes you meet people who lie and as much as you can take the precaution of asking them to be safe, you can’t always know.”
PrEP stops the virus from multiplying in your body once you come into contact with it, says Avert, an international charity that uses digital communications to increase literacy on HIV and sexual health.
If a person takes PrEP correctly as prescribed by a doctor, there will be enough levels of the drug to prevent you from getting HIV. According to the Mayo Clinic, PrEP is less effective when it is not taken daily. This may be because there isn’t enough medicine in your body to block HIV from taking hold and spreading.
Miriam, a medical student, says she gets calls from her friends to get them PrEP.
Get them the medication
“Because I’m a medical student, my friends and their friends ask me for advice on how they are going and whether I can get them the medication,” she said.
“It’s never easy, but I always come through for them. Who wants to see their friend get infected just because I chose not to help?”
But Dr Gideon Kiprono, with Olenguruone Sub-County Hospital, said PrEP is supposed to be a prescription medication and should be given out for free
“You get them at clinics for family planning, maternity or [other] designated places … [You] need to be tested first then the doctor will advise,” he explained.
People using the medication without being screened and without a doctor’s prescription will expose themselves to HIV, Dr Kiprono warned.
“There are some tests that need to be done before you are given the prescription. They need to get the risk behaviour, they need to do the tests to see if the kidneys are functioning well, and if there is kidney failure they are not supposed to use any PrEP medication,” he added.
“And remember that PrEP, when not taken consistently, becomes less effective at preventing HIV and it doesn’t prevent [other] STIs.”
Dr Mary Adeka, a pharmacist, said PrEP is not supposed to be sold. The drug is given out for free at all government facilities under a USAID programme for HIV.
“It should not and cannot be sold over the counter. You have to do an HIV test before starting PrEP. Counselling and guidance need to be done before so that we can have proper use of the medication,” she said.
“Anyone can take PrEP as long as you are at continuous risk of getting HIV. [There is] No danger in taking PrEP regularly because that is the way you are supposed to use it. It can only turn dangerous if you don’t keep time and skip days.” BY DAILY NATION