By Starphel Sithole
Geographical and barriers are associated with poorer HIV-related health outcomes. Health facilities like Kaluluma, Mnyanja in Kasungu and Lobi, in Dedza district under the Citizen Science Community Led Monitoring and Advocacy (CS-CLMA) project experiences the long-distance challenge in the (Pre-exposure prophylaxis) PrEP uptake.
PrEP is for persons who are HIV negative and are at risk of being infected with HIV. Injectable PrEP with CAB is highly effective at protecting people from HIV acquisition and is for people who are at high risk including adolescents and breast-feeding mothers. To access injectable PrEP, you must at least weigh 35 kg.
Speaking during the Community Consultative Group (CCG), the District Supervisor for Dedza Clement Phiri said that people from hard-to-reach rural areas fail to access (PrEP) due to long distances to health facilities which is contributed by lack of outreach or mobile clinics in rural areas.
‘The CS-CLMA research findings for the first quarter findings reveal that there is a low demand and uptake of PrEP among the priority population (Female sex workers, Men having Sex with Men) as Dedza District Hospital is the only one facility that offers PrEP because of lack of trained service providers in other facilities like Family Planning Association of Malawi (FPAM) in the district.’
‘Among other factors, there are also knowledge gaps among Health care workers and recipients of care around PrEP issues and lack of community-based demand creation affect its uptake.’ Phiri lamented.
According to data from Dedza district, for male only 70 were newly initiated and 87 were retained. For females, 108 were newly initiated and 157 retained.
Kasungu District Supervisor, Joseph Nthondo said that only Bua and Kasungu District Hospital are the only 2 facilities that offer PrEP in Kasungu which requires people to travel long distances.
‘On the two facilities that offers PrEP, FPAM has a stock of PrEP but do not administer because the service providers have not been trained on PrEP.’ Nthondo said.
For Kasungu District data shows that only 493 people were newly enrolled whereas 215 were retained on PrEP.
The National CCG chairperson, Dr Damison Kathyola said that CLM should be seen to be driven by the communities who are key in the project hence the project should bring more community-based interventions to create demand and PrEP awareness.
A July 2021 journal by Benjamin R Bavinton and Andrew E Grulich states that health systems must be PrEP-friendly and allow PrEP to be prescribed in settings already attended by large numbers of HIV-negative individuals who are at risk.
