HIV: Even Older men can benefit from PrEP medicines — Expert

Older men who remain sexually active can benefit from HIV pre-exposure prophylaxis (PrEP), even when age-related conditions such as reduced libido and erectile dysfunction affect their sexual lives, a public health specialist, Dr Segun Oyedeji, has said.

Oyedeji, Principal Consultant with Kent Counsul Ltd, said older people should not be excluded from HIV prevention medications simply because of their age or because they are managing conditions such as diabetes and hypertension.

He spoke at the sideline of a two-day national training of media personnel on lenacapavir organised by the Institute of Human Virology Nigeria in collaboration with the National  Agency for the Control of AIDS.

He explained that some medications used in managing non-communicable diseases could affect libido and sexual function, although newer medicines may have fewer effects on sexual desire.

“Older people will benefit from PrEP pills because as you grow older, you are likely to have non-communicable diseases like diabetes and hypertension. Once you have those, you take some drugs for those conditions, and those drugs you are taking might affect your libido depending on the type of drug you are taking,” Oyedeji said.

Oyedeji, who is also a certified PrEP Master Trainer with the Federal Ministry of Health and the World Health Organisation (WHO), said sexually active older adults should have access to appropriate HIV prevention services following proper clinical assessment.

The expert, however, cautioned against viewing PrEP medications as protection against every sexually transmitted infection, stating, “PrEP pills protect against HIV, not other STIs.”’

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According to him, condoms can provide dual protection by helping to prevent unintended pregnancy while also reducing the risk of HIV and other sexually transmitted infections when used correctly and consistently.

He stressed that people should understand the specific protection offered by each HIV prevention method rather than assuming that one intervention eliminates every sexual-health risk.

Oyedeji said people seeking to commence PrEP must undergo appropriate clinical assessment, including HIV testing and kidney function tests.

“If you have an underlying kidney condition, then PrEP can further exacerbate it. So that’s why that aspect is very important,” he said.

He said people taking oral PrEP must follow the prescribed dosing schedule, while those using long-acting formulations must return for their scheduled doses.

Oyedeji advised people who may have difficulty adhering to a particular regimen to discuss alternative HIV prevention options with trained healthcare providers.

He urged anyone who believes they may have been exposed to HIV to seek medical attention within 72 hours of exposure to benefit from post exposure prophylaxis (PEP) rather than waiting.

According to him, possible exposure through unprotected sex with a person whose HIV status is unknown and sexual assault are among situations that may require urgent assessment for PEP.

The expert also urged people using hormones or undergoing other medical or cosmetic treatments to disclose their full medical history when seeking PrEP.

He said information about existing health conditions, medications and hormonal treatments would help clinicians identify possible contraindications and determine the most appropriate prevention option.

Oyedeji advised people on PrEP to exercise caution with alcohol and, where possible, avoid taking alcohol alongside medicines.

He urged sexually active people to know their HIV status and, where appropriate, have an informed understanding of their partner’s status.