Out of 10 HIV-positive people in France, 3 are women. Several associations deplore their lack of information, particularly with regard to treatments or PrEP, an antiretroviral drug that prevents the transmission of HIV.
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“There is a real need to find solutions to protect women’s sexual health. »
The doctor Radio Djebbar, scientific coordinator within the association Sida Info Service (SIS) immediately announces the color on the occasion of the new edition of the Petits Déjeuners de l’Écoute, on June 20, 2022. On the menu of the day: promoting the use of PrEP for women, a preventive treatment to prevent the transmission of HIV.
Women represent 30% of new people infected with HIV in Franceaccording to the Epi-Phare report of June 2021 in collaboration with the National Health Data System (SDNS).
First observation: they are poorly informed about the treatments available to protect themselves against HIV: only 3% of women are on PrEP.
What is PrEP?
Behind this barbaric name that may mean nothing to you, PrEP, acronym for Pre-Exposure Prophylaxis, is an HIV prevention strategy. It is taking an antiretroviral drug continuously or intermittently to avoid being infected with HIV.
This treatment is usually for people who are not infected with HIV but who, during their sexual intercourse, do not systematically use a condom. This usually concerns men who have sex with men, transgender people, sex workers exposed to unprotected sexpeople with multiple sexual partners, intravenous drug users or even people from regions with a high prevalence of HIV (sub-Saharan Africa, Guyana, etc.).
Be careful, however, not to confuse PrEP with TPE (Post-Exposure Treatment), which is to him an anti-HIV triple therapy, prescribed after taking a risk. TPE is a treatment that must be followed for a month and started no later than 48 hours after the risk.
To return to PrEP, it comes in a tablet that combines two molecules active against HIV: emtricitabine and tenofovir disoproxil. The drug is called Truvada but it is often its generics that are delivered by pharmacies.
It exists two schedules for taking the drug:
- Continuously : in other words, one tablet to be taken at the same time every day. However, a delay of 2 hours is possible in case of forgetfulness.
- On demand : 2 tablets to be taken, at most 24 hours and at least 2 hours, before sexual intercourse, then a third tablet the next day, and a fourth the day after.
Women are less informed about PrEP
Although PrEP has been available in France for six years, its prescription and use are unequally deployed among the audiences who could benefit from it, particularly among women.
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This lack of knowledge on the part of women about this antiretroviral treatment can be explained by several factors. Already, now, the use of PrEP by women is much less documented than for men. This lack of scientific study on the subject impacts its generalization among patients.
Also, they do not have access to discontinuous intake unlike males. The fact that they have to wait seven days before being protected and that they lose this protection after two days of forgetting to take the treatment, greatly reduces the attractiveness of PrEP and therefore its use within the female population.
However, many women with vulnerability and precariousness factors could qualify for this preventive treatment against HIV, for example sex workers, certain migrant women or even transgender women. For Élise Godec, health project manager for the women’s busthey must be made aware of this as soon as possible:
“Most women in precarious situations are unaware of the existence of PrEP or do not think that it is intended for them, for lack of public awareness on the subject. Also, they are in such precarious situations that their sexual health is far from being their priority. »
Can side effects be triggered by taking PrEP?
Also, as noted by the SIS association, women, once they have learned about the treatment, fear its side effects. Generally, the two molecules present in PrEP, emtricitabine and tenofir disoproxil, are well tolerated by patients but like any drug, they can trigger some side effects in the first few weeks, such as nausea, diarrhea, abdominal pain or headaches. Inconveniences that nevertheless disappear quickly.
Also note that alcohol, poppers, recreational drugs, antidepressants, contraceptives and other hormonal treatments have no impact on PrEP. The latter has no known action either on the libido or on sexual performance. Sure, PrEP is not incompatible with the condom, on the contrary! It only protects against HIV, not STIs.
When taking this treatment, do not use drugs that are toxic to the kidneys, as well as take long-term nonsteroidal anti-inflammatory drugs (Ibuprofen, Profenid, Voltarene…).
Who to turn to for access?
In France, PrEP is authorized and reimbursed by social security since 2016. Initially, the first prescription could only be made by a doctor practicing in a hospital department caring for HIV-positive people, or in a CeGIDD (free center for information, screening and diagnosis) hospital. But since April 15, 2021, general practitioners are authorized to make the first prescription as well as the renewal of PrEP.
You can also turn to associations fighting against HIV/AIDS who will refer you to health professionals.
What should be done to make women better informed?
To raise women’s awareness, the Sida Info Service association recommends networking structures involved in the fight against AIDS but also in the protection of women, such as feminist associations, migrant women, sex workers or representatives transgender people. SIS also calls for retrospective and prospective studies in the female population to finally shed light on the use of PrEP in women.. Doctor Radia Djebbar concludes:
“This deficiency around PrEP for women must be grasped as soon as possible by public health policies. »
Pour Nicolas AragonPresident of the association Superserowe must act quickly: more than 80% of the people who seek his help to be accompanied in these HIV prevention treatments are heterosexual women. According to him, to finally move the lines on the subject, we must urgently deconstruct the prejudices around AIDS:
“To begin with, we must stop stigmatizing HIV as being a disease only carried by homosexual people. To move forward, we must fight against discrimination and the invisibilization of HIV-positive people in our society. »
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Featured Image: © Klaus Nielsen – Pexels
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