Forty-year-old Thulisile Nkosi* rigorously counts the drugs in her bottle earlier than handing over a couple of to her good friend.
”The tablets within the bottle are 28, so after I give her, I make certain I’ve some left till my subsequent appointment.”
The drugs are PrEP — pre-exposure prophylaxis — the every day remedy that forestalls HIV an infection when taken accurately. Nkosi usually shares them together with her good friend.
“I don’t ask a number of questions, I simply give her drugs as she asks,” she says. “We drink alcohol collectively, sharing is caring, I’m being neighbourly, I don’t need to make her really feel insecure.”
“It’s regular right here in our group to share PrEP therapy, as a result of we’re defending one another.”
PrEP stokvels
Throughout Soweto, Finetown and Orange Farm, individuals who use PrEP have fashioned casual “stokvels”, the place members pool assets to assist one another.
Stokvels are often money-saving golf equipment. However in these southern Johannesburg communities, PrEP customers are quietly buying and selling drugs amongst themselves – sharing with mates who’ve missed clinic appointments, amassing on behalf of others and reselling.
“This method is a backup plan for sufferers who’ve missed their appointments to gather their month-to-month provide, and are scared to go and begin the process from scratch,” explains one consumer from Finetown who requested to not be named.
“They could be afraid as a result of they’ve already engaged in dangerous sexual behaviours, or nurses will scold them for lacking their appointment and embarrass them in entrance of different sufferers.”
The chance in sharing drugs is skipping doses, which undermines the safety PrEP affords.
Dangerous enterprise
Mamello Mokoena, a prevention and therapy literacy promoter on the Remedy Motion Marketing campaign, warns that PrEP solely works when taken as prescribed, and customers should keep away from skipping their every day dose.
“PrEP must be taken at the least seven days earlier than partaking in unprotected intercourse for the remedy to work,” she explains.
“Even after these seven days, one doesn’t cease taking PrEP. A person on PrEP should get their prescription refilled, and get a medical check-up, together with HIV-testing, within the first three months of taking the therapy.”
The system retains individuals away
Well being-e Information spoke to individuals who take PrEP, who talked about a number of obstacles to accessing the drug constantly, and avoiding the clinic.
Some talked about clinic appointments clashing with work schedules.
“The slow-moving queue is boring as a result of amassing PrEP shouldn’t be an extended course of,” one consumer says. One other stated her associate refuses to let her take PrEP as a consequence of stigma.
In Soweto, 21-year-old Tshepiso Sithole* says she was given PrEP on the clinic after receiving a destructive HIV check.
“I wasn’t there for PrEP however household planning, so after experiencing unintended effects from household planning, I used to be scared to take PrEP and gave it to my good friend,” she says.
“This can be a frequent development amongst my mates. We accumulate PrEP for one another and even pay one another to go get some.”
Sithole says she labored at a school from 2024 to 2025, the place a cell clinic would offer PrEP and household planning companies to college students weekly.
“My male mates who have been finding out on the school would accumulate drugs for our feminine mates, as a result of the workers on the cell required the younger ladies to be on household planning to get PrEP,” she says.
South Africa’s PrEP tips state that anybody who identifies themselves vulnerable to HIV an infection could request PrEP, and don’t record household planning as a requirement.
“This development didn’t cease after I left the faculty. Even now, a few of my male mates nonetheless go to the clinic to gather PrEP to resell or to provide to their girlfriends.”
Sithole says she would additionally go and accumulate PrEP if considered one of my mates has an emergency and wishes a provide, or promote it to whoever wants it.
Combined messages from well being our bodies
The South African Nationwide AIDS Council says it’s not conscious of individuals exchanging PrEP remedy. “Even civil society organisations haven’t reported the behaviour to the council,” says SANAC’s Nelson Dlamini.
“Nonetheless, because the council, we can be partaking with the Division of Well being, as they’re the managers and implementers of the remedy.”
Dlamini confused that PrEP use must be monitored intently and that it’s unlawful to promote the remedy as it’s accessible without cost at authorities well being amenities.
Chairperson of the Civil Society Discussion board of the Johannesburg AIDS Council, Tshepo Lekwape tells Well being-e Information it has anecdotal stories of individuals “sharing or pooling PrEP remedy, significantly the place entry obstacles exist. We shouldn’t have verified prevalence knowledge, as this isn’t a formally tracked observe.”
Each Dlamini and Lekwape say they may have interaction with the well being division and different companions to lift consciousness about this observe, in addition to work with the group to focus on the dangers of sharing HIV prevention medication.
“Inconsistent use or use by somebody with undiagnosed HIV can contribute to drug resistance,” warns Lekwape. “Medicines distributed outdoors the formal provide chain could also be expired, counterfeit, or saved incorrectly.” – Well being-e Information
