- We could end the HIV epidemic within a few years. We have preparations for pre-exposure prophylaxis, but they are not reimbursed," said Dr Bartosz Szetela, a specialist in infectious diseases from the Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies at the Piastów Śląskich Medical University in Wrocław during a meeting as part of the Journalist Club for Health Promotion.
In Poland, HIV-infected patients are covered by reimbursed treatment. As assessed by Dr Bartosz Szetela, their care is exemplary. Prevention of infection looks much worse. Since 2012, drugs designed for use before exposure to risk factors (PrEP) have been available. However, their availability is poor.
- PReP is proven and effective. The patient takes one tablet a day. In practice, this fully protects against HIV infection. If someone knows that they will be at risk, they should take this preparation. In Poland, however, these drugs are still available with full payment and only in large cities. About 5 000 people are covered by PrEP counselling centres, while it should be ten times more, said the doctor.
The cost to patients is more than PLN 300 per visit. On the other hand, about PLN 140 per month has to be spent on medication. Post-exposure prophylaxis is free, but only in certain cases. Such a case is exposure to the virus in connection with professional work, for example in the case of nurses or beauticians.
- The costs are then borne by the employer. The patient must see a doctor within a maximum of 48 hours of the incident. The treatment lasts about four weeks and the medication costs about one thousand zlotys," explained Dr Bartosz Szetela.
It is much more difficult to obtain reimbursement for such treatment if the exposure was not work-related. In Poland, post-accident treatment is reimbursed by the National Health Fund, but whether there was an accident depends on the assessment made by the doctor.
Access to rapid diagnostic tests also remains a problem in HIV prevention. In theory, they could be in all doctors' surgeries. In practice, patients have to buy them themselves, from a pharmacy or via the internet. Primary care physicians also lack the capacity to order HIV laboratory tests.
HIV infections most commonly affect people between the ages of 25 and 45. More than 1 million sexually transmitted infections occur every day, according to WHO data published in 2019. World Health Organisation experts urge people to practice safe sex and use condoms during sexual intercourse. People who change sexual partners frequently should have tests to detect sexually transmitted infections. They argue that there should be greater accessibility to these tests.
Source: medexpress.co.uk