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Op-Ed

PrEP and PEP for protection in the Phl

An HIV-positive Filipino wants to know about pre- and post-exposure prophylaxis availability in the Philippines. As Dr. Jose Narciso Melchor Sescon provides needed information on this, also highlighted is the continuing slow response to face HIV in the country.

Dr. Jose Narciso Melchor Sescon – president of the AIDS Society of the Philippines and current Chief of Clinics of Sta. Ana Hospital – answers all your HIV-related inquiries. For all your questions, email josescon1@gmail.com or info@outragemag.com.

Dear Doc,

My BF is positive, and I am negative. He is a top, and I am a bottom. One time, we had sex, but the condom broke. We stopped immediately. I worry nonetheless. What do we do? I heard about PrEP, but how do I avail of these, so that maybe my BF can take it?

Mr. Worry-warts

Serodiscordant couples/partners (that is, one HIV positive and the other is HIV negative) are reminded and advised at all times to practice safer sex. To be more exact, this is to avoid exchange of body fluids so as to protect one another. Safer sex practices would mean non-exchange of body fluids, the use of protectives such as dental dams (for oral sex) or, the more convenient, the correct use of condoms. Consistent condom usage is prescribed to minimize risk of HIV transmission, as we know for a fact that there is no such thing as “full” protection.  As such, it really matters how you use condoms, what lubes you used, what type of sexual activity was exercised, and if condoms are not freshly bought, how condoms were stored prior to its usage, and so on.

Well, if condoms broke, it is best to stop the activity, withdraw from the insertion and wipe secretions. Should the couples decide to continue with the act, replacement of condoms is a must, using the right technique (squeeze the tip of the condom tip as one unrolls it down to the base of the shaft of the penis). Use water-based lubricants (only) if there is a need to lubricate to make the sexual activity more pleasant and comfortable.

Now for the PrEP, otherwise known as “pre-exposure prophylaxis” (and PEP, also known as “post-exposure prophylaxis”) from a known HIV infected individual. In the Philippines this is not yet available, but in developed countries like the USA, the FDA already approved a drug known as Truvada (Tenofovir/Emitricitabine combination) for purpose of PREVENTING HIV-1 infection; this is best combined with safer sex practices (use of condoms)

Furthermore, Truvada is also used as treatment in combination with other antiretroviral meds (ARVs). Unfortunately, in the Philippines, this cannot be sourced out through prescriptions at the local drug stores. There are notably few available antiretroviral drugs used by HIV Treatment hubs in the Philippines, and these are made accessible based on the 2010 Philippines National Guidelines on ARV use in the country.

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Fondly called Jojo, Jose Narciso Melchor Sescon is a medical doctor with specialization in obstetrics and gynecology. Spending much of his time in public health services with focus on HIV and AIDS, STI, and sexual and reproductive health, Jojo wears multiple hats, blending public health advocacy and clinical-cum-administrative work. For 12 years, he served as the Executive Director of Remedios AIDS Foundation, the pioneering AIDS service organization in the Philippines. Then in 2008, he assumed the presidency of the AIDS Society of the Philippines, which he still heads now. Jojo is also the current Chief of Clinics of Sta. Ana Hospital, and has held regional and local consultancy works for development agencies. Jojo is a self-confessed lacto-vegetarian, a raja yoga meditation practitioner, and a health/wellness buff. He also loves to share his thoughts and reflections based on learned skills/competencies and experiences. This soft-spoken soul loves taking on new initiatives/roles, and loves to talk with people about spirituality and good health.

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