AFRICA: A new research has revealed that adolescent girls and young women in African have a strong desire to protect themselves against HIV.
The study showed that adolescent girls and young women can and will use HIV prevention products with the consistency of it is provided to them.
This is based on the interim results of a study of two different methods, the daily use of the antiretroviral (ARV) tablet Truvada® as oral pre-exposure prophylaxis (PrEP) and the monthly dapivirine vaginal ring which is a new HIV prevention product currently under regulatory review in several countries.
Previous studies had shown that young women would find it difficult to take HIV prevention products regularly in a way that it would prevent HIV.
The study is known as REACH (Reversing the Epidemic in Africa with Choices in HIV prevention) and is being conducted at four clinical research sites in Uganda, South Africa and Zimbabwe by the National Institutes of Health-funded Microbicide Trials Network (MTN).
The interim results were reported at the 11th International AIDS Society (IAS) 2021 Conference during the official IAS press conference.
The Research
The research had a total of 247 participants who were between 16 and 21 years.
The study showed that 97 per cent of the participants used the vaginal ring and daily oral PrEP some or all of the time for six months while only three per cent of participants used neither of the products.
“Both approaches received high marks from the study’s participants: during the six months they were asked to use the monthly dapivirine ring, 88 percent said they liked it, and during the period when they were assigned to use oral PrEP, 64 percent said they liked the daily pill-taking regimen”, the abstract on the research read.
The Research team attributed the study’s findings of high product adherence and acceptability to the ongoing support measures, tailored for this population, and nonjudgmental counseling approach provided as part of the study.
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“In many ways, these results exceeded even our own expectations, yet at the same time, it is not surprising to find that these young women have the capacity and desire to protect themselves against HIV. They simply need to feel empowered and have the agency to make choices based on what they feel is right for them,” the REACH Protocol Chair, Gonasagrie Nair said .
Nair, who is also the senior Lecturer, Centre for Medical Ethics and Law, Faculty of Medicine, at Stellenbosch University in South Africa stated that the study aims to compare participants’ adherence to the ring and oral PrEP with what had been observed among young women in other trials of these products, as a way to understand whether these are feasible options for young women and whether they are willing to use either or both.
HIV Statistics among Adolescent girls and young women in Africa
In 2020, according to UNAIDS, one in four new infections in sub-Saharan Africa were in young women ages 15 to 24 years.
Statistics show that more than half of all people living with HIV are women, and in sub-Saharan Africa, women account for more than 60 percent of adults with HIV.
Rates of infection are stated to be very high among adolescent girls and young women.
About the Ring and Truvada
The Reversing the Epidemic in Africa with Choices in HIV prevention (REACH) began in February 2019 and is expected to be completed by October 2021, with final results.
Truvada is a tablet containing a combination of the ARV drugs – tenofovir disoproxil fumarate and emtricitabine and are administered as oral PrEP in girls younger than 18.
The dapivirine ring which was developed by the nonprofit International Partnership for Microbicides (IPM), would be the first biomedical prevention method designed specifically for women, and the first long-acting method.
The ring contains 25mg of the ARV dapivirine out of which about 4 mg of which is released into the vagina when used continuously for 28 days.
The ring have received a nod from the European Medicines Agency (EMA) for its use among women ages 18 and older in developing countries, and soon after, was added to the World Health Organization’s (WHO) list of pre-qualified medicines.
The research team revealed that they are seeking approval of the ring in eastern and southern Africa.
The ring have recieved its first approval from the Medicines Control Authority of Zimbabwe and the Researchers are seeking regulatory approval from the US Food and Drug Administration.
The WHO in its WHO’s updated guidelines for HIV prevention, published in March 2021, recommended the ring as an additional HIV prevention choice for women at substantial risk of HIV.
Interim results also found that Truvada as oral PrEP was well tolerated with no safety concerns
