Understanding the differences between PrEP vs PEP vs ART is vital for anyone concerned with HIV prevention or treatment. South Africa has one of the world’s largest HIV treatment programmes, and knowing how these interventions work can save lives.
What Are PrEP, PEP and ART?
All three are antiretroviral (ARV)-based interventions, but they serve different purposes:
- PrEP (Pre-Exposure Prophylaxis): Taken before exposure to HIV to prevent infection.
- PEP (Post-Exposure Prophylaxis): Taken after potential HIV exposure to prevent infection.
- ART (Antiretroviral Therapy): Lifelong treatment for people living with HIV.
These options are available through public and private health services across Gauteng and the rest of South Africa.
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The Importance of Understanding These HIV Interventions
In a 2023 report by UNAIDS, South Africa had 7.8 million people living with HIV, with Gauteng accounting for nearly 25% of cases. According to the South African National Department of Health, expanding access to PrEP and PEP is key to reducing new infections.
PrEP: Pre-Exposure Prophylaxis
What is PrEP?
PrEP involves taking a daily antiretroviral pill (such as Truvada or Descovy) before potential exposure to HIV. It’s designed for people who are HIV-negative but at ongoing risk.
Who Should Use PrEP?
- Sex workers
- People with HIV-positive partners
- Men who have sex with men (MSM)
- Adolescents and young women
According to the CDC, “PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.”
Availability in South Africa
The South African government rolled out oral PrEP in 2016. It is available at selected public clinics, particularly in Gauteng, KwaZulu-Natal, and the Western Cape.
PEP: Post-Exposure Prophylaxis
What is PEP?
PEP is an emergency intervention that must begin within 72 hours after potential HIV exposure. It involves a 28-day course of ARVs.
When is PEP Needed?
- After unprotected sex with an unknown or HIV-positive partner
- Needle-stick injuries (common in healthcare)
- Sexual assault
PEP is available in most hospitals and emergency clinics throughout Gauteng.
ART: Antiretroviral Therapy
What is ART?
ART is used by people living with HIV. It involves a daily combination of ARVs that reduce the viral load to undetectable levels.
Why ART is Critical
- Improves immune function
- Prevents HIV transmission (U=U)
- Enables long, healthy lives
According to HIV.gov, “People with HIV who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting HIV to HIV-negative partners.”
ART in South Africa
South Africa offers free ART through public clinics. As of 2023, over 5.7 million people in the country were receiving ART. Gauteng leads in ART coverage, especially in Johannesburg and Tshwane.
PrEP vs PEP vs ART: Key Differences at a Glance
| Feature | PrEP | PEP | ART |
|---|---|---|---|
| Used By | HIV-negative individuals | HIV-negative after exposure | HIV-positive individuals |
| Timing | Before exposure | Within 72 hours post-exposure | Lifelong after diagnosis |
| Duration | Ongoing | 28 days | Lifelong |
| Purpose | Prevent HIV infection | Prevent HIV after exposure | Suppress virus, manage HIV |
| Availability | Clinics, public sector | Emergency rooms, clinics | Public clinics, hospitals |
Local Impact and Uptake in Gauteng
Gauteng has been at the forefront of HIV intervention uptake:
- Over 300 public sites in Gauteng offer PrEP.
- PEP is standard in emergency rooms and post-rape care centres.
- Johannesburg has some of the highest ART adherence rates in the country.
The Wits Reproductive Health and HIV Institute (WRHI) plays a major role in research and implementation of these programmes in the province.
“Scaling up access to PrEP and ART is central to our HIV response,” says Professor Sinead Delany-Moretlwe, Director at WRHI.
Frequently Asked Questions (FAQs)
Can I switch from PEP to PrEP?
Yes. After completing PEP, if you remain at risk, you can start PrEP. Consult a healthcare provider.
Does ART cure HIV?
No. ART controls the virus but does not cure it.
Is PrEP safe for long-term use?
Yes. Studies show PrEP is safe when monitored regularly by healthcare professionals.
Where can I get PrEP or PEP in Gauteng?
Most public health clinics, sexual health clinics, and NGOs like WRHI provide these services.
Understanding the difference between PrEP, PEP and ART can empower individuals to make informed decisions. Whether you are HIV-negative or living with HIV, South Africa offers accessible options to stay healthy. Gauteng continues to lead in implementing these life-saving interventions.
“We have the tools to prevent and manage HIV. It’s about ensuring access and education,” concludes Dr Pillay.
For more information, speak to a healthcare provider or visit www.health.gov.za.
