Maharashtra: Give anti-HIV pills even to those who unknowingly had unprotected sex, say experts

Mumbai: According to a World Health Organisation (WHO) guideline issued in 2014, regardless of the source of exposure of HIV, the person must be administered post-exposure prophylaxis (PEP), an anti-HIV medication that must be taken within 72 hours of unprotected sex. But in Maharashtra, the medicine is only given to persons who have been pricked by infected needles and not for those who have unknowingly had unprotected sex. Now, HIV experts say, since Section 377 has been decriminalised, PEP medicines must now be available to anyone who has unknowingly had unprotected sex.

A patient at the Anti-Retroviral Therapy Centre inside JJ Hospital said, long ago, he had unknowingly visited an HIV-infected sex worker. As soon as he learnt about this, he immediately rushed to the ART centre for PEP. “I was refused the medication and was told NACO (National AIDS Control Organisation) does not have any provision allowing this medicine to be given to the common man. Only medicos or rape victims are allowed to get it. So I immediately rushed to a private hospital where a doctor wrote me a prescription and I bought it from a private clinic,” he said.

On World AIDS day, WHO had issued a guideline recommending the usage of PEP irrespective of the source to exposure, “to prevent opportunistic infections”. The guideline states that since the early 1990s, PEP has been prescribed for health workers following occupational exposure to HIV but during the past two decades, the provision of HIV post-exposure prophylaxis has been extended to non-occupational exposures, including unprotected sexual exposure, injecting drug use and exposure following sexual assault.

“Recognising the need to improve uptake and completion rates for PEP, the WHO 2014 guideline does not differentiate between exposure sources, but rather provides recommendations across all exposures. Recommendations for simplifying prescribing approaches and supporting adherence are also provided,” it reads further. “WHO had recommended PEP or emergency infection prevention for those who may have been exposed to HIV accidentally as it reduces the chances of becoming HIV-positive. The medications keep the virus from spreading through the body,” said Dr I Gilada, an HIV expert.

“Agencies such as WHO and the joint United Nations programme on HIV and AIDS (UNAIDS) keep coming up with recommendations and catchy lines every year to mark World AIDS Day. But a lot depends on what is happening on the ground,” said Dr Gilada.

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