The Health Ministry has imposed restrictions on the prescription of preventative medication that can reduce the risk of infection from the HIV virus despite 400 new cases being diagnosed each year. While AIDS-related deaths are rare and are often the result of a late diagnosis and lack of treatment, the disease is still present.
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HIV has changed and is considered a chronic illness when diagnosed in time and when patients receive regular medical treatment and patients can live long and fulfilling lives. The most effective treatment is PrEP, which has been available in Israel for several years, but not all Israelis are aware of it, and not everyone who needs it receives it and that must change.
So what is PrEP treatment?
PrEP, or Pre-Exposure Prophylaxis, is a treatment method that reduces the risk of HIV infection by over 95% when taken consistently every day. It is intended for people at high-risk of exposure to the HIV virus who have not been infected. PrEP provides effective protection, almost like a vaccine, against HIV. So why is it not prescribed more often?
Despite its clear effectiveness, PrEP is not widely accessible, and the percentage of people receiving it remains low. This is one of the reasons why we continue to see new HIV infections worldwide, including in Israel where the Health Ministry is making it difficult to access the drug.
What causes delays in accessing treatment?
Currently, according to the guidelines of the Pharmaceutical Division of the Health Ministry, only doctors who have undergone special training are authorized to prescribe PrEP. Unfortunately, this is a limited list of doctors . The treatment itself is not particularly complex from a medical perspective and is easily monitored.
But the restrictions imposed on physicians lead to delays for many patients in receiving treatment and contribute to the ongoing increase in the rate and number of new infections. In order to make the treatment more accessible, every physician should have easy and available access to the basic information for providing PrEP.
Which groups struggle to receive treatment?
There are several marginalized groups, including the Arab and ultra-Orthodox communities, who face particularly high barriers when it comes to accessing and seeking treatment. Transgender women also face challenges to access treatment. The majority of qualified healthcare providers are located in central areas, making it difficult for residents of peripheral towns who are interested in receiving treatment. This results in the progression of the disease even among populations that may not necessarily be associated with HIV infection.
Despite the treatment being on the market for several years and its increasing global usage, the discourse surrounding it in Israel remains limited. Not everyone is aware that such treatment exists, and even if they are, they may not be aware of its effectiveness and fail to take advantage of it. There is a prevalent culture of "relying on others." Many people believe the misconception that if their partner takes PrEP, they are also protected and do not consider seeking treatment for themselves.
If my partner takes PrEP, am I protected too?
Many people believe the misconception that if their partner takes PrEP, they are also protected and do not consider seeking treatment for themselves. Each person must take the treatment themselves. Rely solely on yourself and the protection you can provide for yourself.
Whom should I contact to receive PrEP?
Family physicians are usually the natural and first point of contact for patients, and they are the most appropriate source for guidance and prescription of PrEP treatment. Therefore, the discourse in Israel needs to change, and there should be broader training and specialization for more physicians. Of course, the recommendation is to seek medical advice from specialized clinics.
First published: 12:37, 07.05.23