Why Ministry of Health and WHO are experimenting with PrEP HIV Vaccine

“In terms of trying to strengthen the HIV programme to reduce the impact of the epidemic, we are looking at all the recommendations that have been given by the World Health Organization (WHO), and PrEP is one of those. We are trying to get a feel of what the public thinks about PrEP, and also to do our internal piloting in various spaces, and based on the outcome of that, we would say to the Ministry of Health's wider directorate that we recommend that this be implemented in this way”

Director of the HIV and STI unit at the Ministry of Health, Dr Nicole Skyers, commenting on the PrEP (Pre-exposure prophylaxis) pill.

Jamaica is fighting a silent and growing battle against the HIV (Human Immunodeficiency Virus) due to low condom use. So can a pill help?

That is the assertion of Ministry of Health, which is currently mulling the idea of a PrEP (Pre-exposure prophylaxis) pill as explained in the article “'Magic Pill' For Ja? - Gov't Looking To Introduce Preventive Drug To Reduce The Spread Of HIV”, published Sunday October 15, 2017 by Ryon Jones, The Jamaica Gleaner.

This is on the heels of the current controversy over the human papillomavirus (HPV), which I personally suspect is an experiment as opine in my blog article entitled “Why the Ministry of Health must vaccinate Jamaican Boys and Girls against the Human papilloma virus”.

Like that vaccine, the PrEP pill would protect HIV-negative individuals (low-risk people who do not they have HIV Virus active in their bodies) from contraction of the virus and eventually developing AIDS (Aquired Immuno Deficiency Syndrome). This may be a silver bullet that prevents the further spread of HIV given the stark stats in the 2014 Global AIDS Response Report:

1.      30,313 Jamaicans were living with HIV

2.      25% unaware that they were infected

Already the Ministry of Health is conducting a quarterly HIV/AIDS/STD National Knowledge, Attitudes, Beliefs and Practice Survey in all parishes asking Jamaicans if they had previously heard about the PrEP medication and would they be willing to take the pill daily. WHO is banking on the results of 4 randomized control trials, which show the drug works best when used as directed. 

But is the PrEP pill a good idea? Or is this another experiment by the WHO (World Health Organization) using Jamaica as a proxy for a Drug Trial?

Ministry of Health, the WHO and PrEP – How to use Jamaicans to do Drug Testing

It's a well known fact that condom use in Jamaica is low.

So low in fact that legalizing prostitution may have to be considered in order to treat prostitutes, who are most at risk from such sexual encounters as noted in my MICO Wars blog article entitled “Why Jamaica must legalize Prostitution as Ministry of Health dealing with silent HIV-AIDS and STD’s Outbreak”.

Hence the reason for the PrEP pill as argued by Director of the HIV and STI unit at the Ministry of Health., Dr Nicole Skyers, quote: “Everybody knows that condom use is way below what it ought to be within our context, so you have to look to say do we do it (PrEP) with everybody or do we do it with our populations that are high at risk of HIV infection. So if you are a low-risk person, maybe PrEP is not necessarily for you”.

Still a PrEP pill, which is aimed at such high-risk persons in Jamaica, comes with some side effects:

1.      Worsening of hepatitis B infection

2.      Too much lactic acid in blood

3.      Kidney problems

4.      Severe liver problems

5.      Bone problems

This means that the PrEP pill cannot be taken by infants, children, older persons and anyone with medical complications that has resulted in them having a weakened immune system. Persons taking the PrEP daily will reduce their risk of contracting HIV by 90%.

Still, regular check-ups are still required if you are using the PrEP pill as pointed out by Dr Nicole Skyers, quote: “Persons on PrEP need to be tested every three months for HIV and STIs, and they need to have their liver and kidney functions tested”.

If the survey comes back indicating that Jamaicans are interested, then with the support of donor funding, the HIV/STI/TB Unit will recruit a consultant to conduct a PrEP pilot in 2018.

After all, the guinea pig trials need to be done under the watchful gaze of the WHO, to quote Dr Nicole Skyers: “So it's not just to say we're implementing PrEP; here is your pill. It's not that simple. We have to do a pilot to see what the best avenue is for it within our context. The WHO has two arms - where you stay on the pill every day and there is also the option of using it around exposure to that risky sexual act - so we have to determine what the best fit for our population is if we decide to go down that road”.

If this is not an experiment, I don't know what is. Still, action needs to be taken, as the silent HIV epidemic will kill many in Jamaica unless we take control of our sexual activity.