Youths abusing drugs meant for HIV emergencies

Tuesday, November 5, 2013

PHOTO | PHOEBE OKALL Ms Christine Otieno,

who works on HIV prevention at Kenyatta National

Hospital, with the drugs which health experts warn

are increasingly being abused by sexually active

youth.  NATION MEDIA GROUP

By SAMWEL BORN MAINA

In Summary

• Doctors are worried that those abusing the PEP pills do not take the full dosage, thus not only risking infection but also incubating a virus which is resistant to medication
• When PEP was first introduced as an emergency drug to prevent HIV infection in the early 1990s, it was praised as a scientific breakthrough

Kenyans are using emergency Aids medication in place of safe sex, according to health workers.

Many young people are having unsafe sex and, instead of using condoms, going to public hospitals for the so-called PEP pills.

This is a continuation of the abuse of emergency contraceptive pills, which is widespread despite its health consequences. Post Exposure Prophylaxis is an emergency treatment, mainly for health workers and victims of sexual crimes. It is usually administered to those suspected to have come into contact with HIV-infected material.

The treatment must start within 72 hours of exposure and consists of a daily dosage of six tablets taken for 28 days.

Doctors are worried that those abusing the PEP pills do not take the full dosage, thus not only risking infection but also incubating a virus which is resistant to medication.
The drugs are only available in public hospitals and are provided at no cost. It is illegal for chemists to stock them.

When PEP was first introduced as an emergency drug to prevent HIV infection in the early 1990s, it was praised as a scientific breakthrough. At the time, it was meant for health professionals who were at great risk of being infected with the virus in the line of duty. With time, it was made available to people exposed to the virus under circumstances, such as rape or sexual assault.

In the recent past, however, there has been a sharp rise in the number of people seeking the drugs, after engaging in unprotected sex especially during holidays and weekends.
Many of those asking doctors to give them the pills use them the same way others use emergency contraceptives — as an afterthought.

Many of them claim to have had “accidents” which exposed them to HIV. The accidents, according to Nyeri County Aids and Sexually-transmitted Diseases coordinator Jeniffer Kiruri, range from sexual assault or a needle prick to a torn condom.

She said that between July and September, the Nyeri Provincial General Hospital gave the pills to more than 100 patients, most of them young people of 16 years and above.
This group is one of the most at the risk of HIV infection.

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 Dr Enoch Ondari, the Kisii Level Five medical superintendent, said the health centre received requests for PEP occasionally especially during weekends.

“People do come to our facility to seek PEP services with the excuse of a burst condom. Normally, this happens during the weekends or on Monday morning,” he said.

Hospital records indicate that more men than women ask doctors for the tablets.

Dr Martin Sirengo, the head of National Aids and STI Control Programme (Nascop), said there had been an alarming rise in the number of people abusing the drugs especially after weekends.

“We cannot deny them the drug because it is available,” he said.

But to qualify for a prescription, one must undergo thorough testing and provide contact details to the doctor giving the tablets.

This procedure is meant to make it difficult for middlemen to get the drugs for free from public hospitals and resell them. 

Dr Juliana Atieno, the chief administrator at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, said the hospital was one of those that had developed strict guidelines on who should get PEP.

“Many people were coming for the drug,” she said. “We had to lay down a protocol. First, a person has to come with the partner for testing,” she said. “The partner must be traced for one to get help.”

Dr Atieno warned that the drugs should not be a licence for irresponsible sexual behaviour.

“The drug’s effectiveness might backfire if you skip a dose. Why do you have to undergo that? You have a good option of using a condom,” she said.

Ms Monica Ndegwa, the Kieni East District Public Health officer, said the uptake of the drug could be because young people wanted to take short-cuts.

“Just like in pregnancy pills, young people want to take short-cuts. My advice is, before you engage in anything, know the status of your partner,” she said.

Mrs Christine Otieno, a programme officer in HIV prevention at Kenyatta National Hospital, said the demand for the drug shoots up especially during holidays and after weekends.
“We counsel the users first. They must finish the dose, otherwise they may be resistant to ARVs in the event they acquire the virus,” she said.

According to her, some of those seeking the drug are genuine cases of rape.

“Others come with that excuse yet they did it willingly, but we cannot deny them the service,” she said