Abstracts

87 a monthly injection, are crucial to maximizing the effectiveness of PrEP (Walensky et al., 2012, p. 1505). There are conflicting reports 1 about which regimen will evoke the greatest adherence; ultimately, all the data imply that the regimen must be determined on a case- by-case basis, depending on what is easier and better for each individual. Some of these options are commercially available but not yet in South Africa, whereas others are nearing the end of their clinical trial phases. As these options become available, they should be introduced into the existing clinics to allow each person to get a customized PrEP system that integrates best into their life. PrEP should be made available to at-risk groups because it will put the means of risk management in patients’ hands and give them some control over their experiences. Taking PrEP is a choice marginalized people can make to have control over their HIV status even when they cannot control other events. With their limited autonomy, “[PrEP] is one of the few female-controlled HIV prevention methods” (Joseph Davey et al., 2019, p. 1392). In an uneven power dynamic, PrEP may be the only way a woman can protect herself fromacquiring HIV because most methods need not be present during risky encounters. Having multiple PrEP options available to work seamlessly into the lives of those at risk allows individuals options to protect themselves without directly disrupting social norms. This opportunity will prevent added threats from their environment while letting them take control of a part of their life. Maintaining control over even one aspect of life is empowering: it is a step, however small, toward breaking down three centuries’ worth of discrimination and prejudice irrespective of gender. PrEP provides numerous benefits to individuals and to the fight against the epidemic that make it a better long-term option than continuing to push education. In addition to all the potential forms of PrEP that will be available in the next few years, this method has proved itself to be adaptable and ethical. PrEP can be used intermittently during and 1 Bekker et al., 2016; Joseph Davey et al., 2019; Henry J. Kaiser Family Foundation, 2019; Simbayi et al., 2019; Venter et al., 2015; and Walensky et al., 2012. after periods of high HIV acquisition risk and stopped when the risk disappears. The shorter and potentially intermittent time span of taking these medications puts less strain on the body than the lifetime of medication required once HIV is contracted. PrEP also requires a checkup only once every three months. This is something that can be planned, alleviating stress and avoiding HIV testing after potentially frequent risky behaviors. Furthermore, the only currently approved medication for PrEP, tenofovir, has relatively few side effects, with only about 1 in 10 patients experiencing any negative reactions (Bekker et al., 2016). At the clinical and population levels, the benefits of PrEP far outweigh any consequences of potential adverse reactions (Walensky et al., 2012). Because of this, PrEP raises no additional ethical issues than do other HIV prevention methods like condom use or male circumcision (Venter et al., 2015). PrEP has many positive traits that benefit all genders at risk of infection. Like any medication, PrEP has some downsides that can increase the risk of its use, yet none of its potential consequences is greater than its benefit. Any kind of treatment begets the potential of microbial resistance, which applies to PrEP, postexposure prophylaxis, and regular ART treatment. Microbial resistance potentially occurs if PrEP is taken at suboptimal levels, in which case only some of the viral particles will be destroyed while some will adapt to persist in an environment with low concentrations of the medicine. Luckily, tenofovir has a high barrier to creating resistance. The new forms of PrEP that are in testing do not yet have information about their abilities to prevent resistance. Microbial resistance has been reported only in those who were unknowingly infected with HIV prior to beginning a PrEP regimen. PrEP also can take one to three weeks to become effective and must be continued for four weeks after a risky encounter (Bekker et al., 2016). This delay in effectiveness makes intermittent PrEP more difficult but can be avoided by using PrEP continuously until the risk is completely gone. Another potential issue is that clinics often are busy and impersonal because they are overwhelmed with patients facing a variety of ailments (Venter et al., 2015). Although