For the past four months, Benjamin Sana has been regularly attending the Oasis Clinic in Ouagadougou, Burkina Faso, where he sees a doctor who gives him a full check-up.

The doctor and peer educators also check whether Mr Sana has any questions regarding his pre-exposure prophylaxis (PrEP) regimen. PrEP is taken by people who are HIV-negative but at higher risk of infection, and has proved to be very effective at keeping people free from HIV.

“Two plus one plus one,” answers Mr Sana, referring to when he needs to take the pills—two pills two hours before sex, then one the day after and one again the following day or one a day until his last sexual encounter. After his check-up, the 34-year-old gay man said, “PrEP protects me and I feel reassured.” He still uses condoms and lubricant, but when he doesn’t he said he feels safer.

Mr Sana is one of 100 men taking part in the PrEP pilot project at the Oasis Clinic, run by the Association African Solidarité (AAS). Health clinics in Côte d’Ivoire, Mali and Togo are also taking part in the pilot project, which has been running since 2017.

Camille Rajaonarivelo, a doctor at AAS, said that PrEP is part of a combination prevention approach that also involves trained peers from his community. The project will gauge adherence to treatment and whether participants take PrEP correctly, she explained.

“The final aim of this pilot project is to scale up and roll out PrEP nationally once the authorities give the green light,” she said. 

The study aims to evaluate whether the preventive option gains traction and how feasible it would be to roll it out nationally and regionally. Financed by the French National Agency for Research on AIDS and Expertise France in partnership with Coalition PLUS and three European health institutes, the pilot project will provide data and ascertain if the treatment lowers the number of new HIV infections among gay men and other men who have sex with men.

Burkina Faso does not penalize homosexuality, but stigma against it is high. As a result, gay men and other men who have sex with men often hide their sexuality and tend to avoid health services. HIV prevalence in Burkina Faso among gay men and other men who have sex with men stands at 1.9%, more than double the rate among the general population.

The first definitive results of the PrEP pilot project in Ouagadougou should be available in 2020. Mr Sana said that many of his friends had shown interest in taking PrEP. “Because the pilot project has limited participants, a lot of people have been turned away,” he said.

He believes that PrEP will save lives, especially those of young men. “Nowadays, young men take a lot more risks and they don’t protect themselves,” Mr Sana said. Ms Rajaonarivelo agreed and added that this applies to young men and young women. “I am stunned to see new cases of HIV every week,” she said. “We have to beef up HIV prevention and awareness again.”