For the first time, the Health Ministry has approved a pre-exposure prophylaxis (PrEP) program to prevent HIV transmission, making Israel one of the first countries outside the US to use it. PrEP involves healthy but high-risk people taking medications that significantly reduce the risk of HIV infection or of HIV carriers getting the pills to lower the risk of them infecting others.
The subject was discussed on Tuesday in the Knesset Labor, Social Welfare and Health Committee headed by Kulanu MK Eli Alalouf. Dr. Yuval Livnat, director-general of the Israel Committee for Fighting AIDS, said that while anyone can be infected, one cannot ignore the fact that men who have sex with men are at the highest risk and the largest group at risk. While most homosexuals use condoms, those that don’t need PrEP to prevent infection, he added. Many heterosexuals who don’t use condoms are also at risk because of their habits, and they need such protection as well.
The drugs will be handed out at the various AIDS centers in hospitals and clinics that serve homosexuals, as well in health fund clinics. The ministry will soon decide whether to give the drug “cocktails” also to those who inject hard drugs and women at high risk.
Dr. Hila Elinav, an AIDS specialist, said taking Truvada (emtricitibine and tenofovir disoproxil fumarate) before having sex is effective in preventing HIV infection in people who do not use condoms. However, those who take the drug have to be under a doctor’s supervision, because it can cause complications.
Dr. Gal Wagner, a doctor in the homosexuals’ clinic at Gan Meir in Tel Aviv, added that “we have all the medical and social tools to wipe out the HIV epidemic, and these include PrEP. The US Centers for Disease Control in Atlanta endorses the use of Truveda. In November, the World Health Organization called on high-risk groups to be given the drug.”
San Francisco, which has an HIV rate similar to that in Israel, is one of the few places in the world that already has an HIV prevention program that includes giving the drug that brings down the infection risk almost to zero. The drug has already be included in the health basket in France, and it is due to be introduced in several US states.
Every week, three more homosexual men become HIV carriers, and 10 percent of homosexuals who live in TA are carriers. Experts say there is already a black market for Truvada here, and many people order it from abroad. “The gay community wants to take responsibility for their health,” said Wagner. “We need the Health Ministry to help us.”
A representative of the Gay Youth Organization, Ido Cohen, said Truvada should be made available for teens as well. Medical teams in hospitals must be trained to be sensitive to gay youths who come to get the treatment because they’re afraid they were exposed to HIV, he said.
Alalouf said that by June, there will be a working plan for dealing with the subject in the homosexual community. “I call on the Health Ministry to present details on progress. I will hold meetings with the minister and director-general on the subject.”
By JUDY SIEGEL-ITZKOVICH