According to UNAIDS, since 2010, the annual global number of new HIV infections among adults (15 years and older) has remained static, at an estimated 1.9 million with key populations accounting for 45% of all new HIV infections in 2015.
In some countries and regions, infection rates among key populations are extremely high. HIV prevalence among sex workers varies between 50% and 70% in several countries in southern Africa.
In Zambia, National AIDS Strategic Framework (NASF) reports that there are 46, 000 new infections in 2016 with most new infections happening among this population. With these statistics, several strategies such as condom use and treatment as prevention have been promoted among key populations.
However, HIV prevention needs change during a person’s lifetime and that a combination of interventions targeted at key populations are needed to halt the HIV epidemic.
CIDRZ with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and U.S Centers for Disease Control and Prevention (CDC) has moved a step up in its effort to ensure everyone has equal access to quality health care especially HIV services by introducing Pre Exposure Prophylaxis (PrEP) services to HIV uninfected Key populations.
The programme that started in February 2018 under the Pharmacy unit intends to initiate 236 people on PrEP in 2018 in Lusaka and 1197 for Lusaka and Western Provinces in 2019.
Muhau Mubiana of CIDRZ explains, “Introduction of PrEP in Zambia is yet another step towards achieving the 90-9-90 strategy. PrEP is a program that brings a paradigm shift from focusing only on HIV positive clients but also on the HIV negative at substantial risk of HIV infection”.
“High numbers of new infections become a motivating factor for Health care providers like me to drive and support implementation of new innovations intended to reduce HIV infection in our country. In my own words, PrEP is not only for the socially acceptable community but the marginalized population. It is an Extended Service Delivery that touches the lives of marginalized communities. The program comes as a restoration of the right to health care to the vulnerable and marginalized population. Everyone has the right to be prevented from HIV infection provided they are considered to be at substantial risk”.
In order to reach out to these at risk populations, CIDRZ conducted a training targeting 55 health care providers and 28 PrEP beneficiaries. For health care providers, the training was to impart them with the necessary skills to offer friendly services to key populations.
For PrEP beneficiaries, the training was to equip them knowledge as advocates for good health behavior and act as linkages to facility care among their peers in their respective communities. The beneficiaries will be involved as PrEP Champions after having being on PrEP for the past one month.
Carol 33, a PrEP Champion shared her experience “When I first learnt Pre Exposure Prophylaxis(PREP), I had my fears that probably if I accepted to be initiated on the drug after testing negative for HIV, it would turn out as a way of actually infecting me with HIV. However, after intensified counseling and learning of the benefits and how that I was actually protecting myself from contracting HIV, I decided to agree to be initiated on PREP.”
“It is a good initiative to involve us the direct beneficiaries, because sex work is a job that is stigmatized and that makes it hard to go to the health facility and access services. Therefore, using a sex worker to reach out to another sex worker will create demand and uptake of services such as HIV testing and PrEP. To many, this will seem like a way to promote careless behavior but I tell you that our work really puts us at risk and we too need to have access to quality health care just like anybody else who is not doing our kind of business”
And Lwazo Akunfuna, a Clinical Officer at Kabwata health facility had this to say “This is a good initiative as the demand for the service is already there and will greatly impact on the fight against HIV. Key populations have the highest HIV rates in the country but the most difficult to reach and to see that CIDRZ has even managed to get some to access HIV services and become champions is commendable. These are people that we live with in our communities and offering them these services contributes to the well being of the community and Zambia as a whole and subsequently reduce the prevalent rate of HIV”.