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Why is the "anti-HIV" pill so difficult to access in Switzerland?

This content was released on November 30, 2018, 13:00

Two hands hold a blister pack with blue pills in it

Emtricitabine, one of the "PrEP" medicines.

(Britta Pedersen / DPA / AFP)

Switzerland was a pioneering country in the prevention of AIDS. But today she lags behind in other countries. "PrEP", an effective cure for prevention, is hard to get. Physicians are forced to recommend their patients to buy it abroad.

A person infected with HIV today is no longer being sentenced to a certain death. And with effective treatment, there is no longer a risk that the virus will be transmitted in sexual contact.

This is not new: already in 2008 the information was called the "Swiss statement"external connection published. Like a bombexternal connection At that time he had the opinion of the Federal Commission on AIDS (since the 2012 Federal Commission on Sexual Healthexternal connection) and the Clinical and Therapeutic Commission of the Federal Public Health Officeexternal connection (BAG) to "Schweizerischen Ärztezeitung".

But even ten years later, the spirit of AIDS continues to scare people, and there are always misunderstandings. Hence, HIV positive people are still often discriminated against. By mid-November, Aidshilfe Switzerland recorded 122 cases of discrimination in various areasexternal connection, a new record.

The chart shows discrimination on the surface of 2018

Graph: reported discrimination by 2018

Aidshilfe Switzerland launches a new campaign under the motto "Together for love and lust, together with fears", to better communicate its message to the population.external connection, The main message is: "HIV-positive people with a suppressed viral load – that means they take antiretroviral therapy and can be tested regularly – do not transmit the virus," writes Aidshilfe.

Campaign & # 39; Together Against Fear & # 39; with the spirit as & # 39; i & # 39; in & # 39; HIV & # 39;
(Aidshilfe Switzerland)

But even before the campaign was officially launched on the World AIDS Day on December 1, controversy has already begun. So there is some sort of problem trivialization. "One of them suggests that Aidstherapie is understood as a" pill after that "and undermines other campaigns," quoted Tages-Anzeigerexternal connection Immunologist Beda Stadler.

Alexandra Calmy does not understand the controversy surrounding the Aidshilfe Switzerland message. The director of HIV-AIDS in hospitals at the University of Geneva does not believe the campaign encourages people to give up condoms, but to convey the correct and important message.

"I'm shocked to see the fears that still prevail over HIV-positive people today, and while patients live well with therapy, they suffer from the climate."

The 1980 AIDS epidemic trauma seemed to have permanently affected collective memory. Even today in the movie tragic story tell people who are affected by this disease. "Science has made faster progress than public opinion," says Calmy. They complain of lack of information.

"PrEP", a small revolution

Together with therapies, prevention has also advanced. The drug "PrEP" ("prophylaxis before exposure") is one of the most important advances in this area. Its efficiency has been demonstrated in several studies. But in Switzerland it's hard to get it.

"To date, HIV medicines in Switzerland have not been approved as preventative treatment," the Federal Council (State Government) interpellation of the Social Democratic National Council Angelo Barrileexternal connection, Consequence: Physicians who prescribe this, citing another reason and at their own risk.

"Nobody can spend almost 900 francs a month on this treatment, so we have to be creative and look for alternative options."

Alexandra Calmy

End of bid

Under these conditions, health insurance can not take over the drug. In addition, it is offered in Switzerland at high prices: 899.30 francs costs 30 pcs of tablets, one of which must be taken one day. Generics are unavailable because their introduction was blocked by the Federal Patent Court.

For comparison: In France, the generic medicine, which also takes over health insurance, costs less than 180 euros for 30 tablets, in Germany it is less than 80 euros and an online package is available for 40 euros, such as Aids Group Geneva One Message was written.

The group estimates that "this price forces people to buy online, with all the dangers they are doing to their health". The organization refers to those who suffer from a physician at a reliable and cheaper drug.

To be forced to move abroad

Calmy recommends that her patients get pills abroad, for example in France or Germany: "No one can spend almost 900 francs a month on this treatment, so we have to be creative and look for alternative options."

This is also the solution Beat found for himself. When the Bernese 32-year-old received a recipe from her doctor, she goes to Germany and buys "PrEP". As a Man Who Has Sex With Men (MSM)external connectionIt belongs to a group of people who have a higher risk of infection. "I was in constant fear, even if I did a regular test," he says.

Since Beat runs "PrEP", he feels safe. However, this does not mean that you will risk without hesitation or completely abandon the use of condoms.

"I do not always believe what my sexual partners say, how can I be sure she takes drugs properly, and I know that I can calm down if I have sex without protection?"

Treatment also includes quarterly screening for other sexually transmitted diseases (STDs) such as syphilis, gonorrhea or chlamydia. Another factor that calms the rhythm.

"The relationship to sexuality has changed"

At homosexual dating sites, users are now being asked to give their HIV status: negative, negative with "PrEP" positive or positive undetectable. So on the Grindr platform:

HIV status on gay platform Grindr

"Cure PrEP" has played an important role in male relationships and I think it has changed the relationship with sexuality, "says 32-year-old Gilles. However, he decided not to undertake any preventive treatment although he was a member of the MSM risk group.

"I do not feel like a medicine, unless that's absolutely necessary," he says. He feels that the cure is not good for his body. Twice is more careful about it.

Most of the men with whom they keep contact are eating "PrEP", says Gilles. "This creates some social pressure that encourages people to seek treatment, some men have no connection with someone who does not, and those who want unprotected sex become more common," says Gilles,

Good numbers

Calmy points out that interested in "PrEP" should first of all receive healthcare professionals. "It's an effective drug with very few side effects, we know very well and we know how to use it perfectly." Although medical monitoring is necessary, there are no special conditions to be met in order to receive a prescription.

In general, HIV is also declining in Switzerland. In 2017, BAG recorded 445 new cases, 16% less than in 2016. In addition to projection projection, Calmy believes that the use of "PrEP" also contributed to this case number crash. "It's a good protection for people, where the condom is not always an option," says an expert.

Fictional name

(Transportation from French: Christian Raaflaub)

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