HIV prevention injection will soon be available for women

Women will soon have access to a more effective HIV preventive drug that would be given in six injections a year instead of 365 daily pills.

This is after a new HIV drug study showed that long-acting injection is more effective than current daily HIV pills to prevent the disease in women.

Researchers announced this week that data from the clinical trial of the pre-exposure prophylaxis (Prep) regimen of long-acting cabotegravir injections once every eight weeks was safe and superior to the daily oral Truvada, currently used for HIV prevention among women in Africa.

Women have only had the option of Truvada for Prep, a course of drugs taken to prevent contracting HIV. Truvada is made by Gilead Sciences.

The researchers are from the HIV Prevention Trials Network. Known as the HPTN 084, the trial was headed by Dr Sinead Delany-Moretlwe, a research professor at the University of the Witwatersrand, South Africa and director of research at the Wits Reproductive Health & HIV Institute.

Speaking during a webinar, Dr Delany-Moretlwe said many women found it hard to take the pill daily which had been to their detriment. She said a shot would be far more convenient and safer for women.

“We know that adherence to a daily pill continues to be challenging, and an effective injectable product such as long-acting CAB is a very important additional HIV prevention option for them,” she said.

Pills are also not discrete and they come with social pressure because women who take them are thought to have HIV or be overly sexually active, she added. “The results from HPTN 084 are incredibly important for women in Africa where lowering HIV incidence remains a priority,” said Dr Delany-Moretlwe.

Women and girls accounted for about half of all new HIV infections in 2019, according to UNAids. In sub-Saharan Africa, five in six new infections among adolescents aged 15 to 19 are among girls.

New concept

In Kenya the case is no different, with UNAids data showing that women are disproportionally affected by HIV in Kenya with 65 per cent of those affected being women.

This comes even as the implementation of HIV cure studies, which were to begin this year at the Kenya Medical Research Institute (Kemri), were paused by international partners as the world focuses on the Covid-19 pandemic. HIV cure studies are a new concept hoped to completely eliminate the disease in the country. However, with the pandemic, most of the studies have to wait.

The suspension is to ensure that participants and researchers are safe and measures are taken to avoid cross infection.

“If the studies are to continue, it means the participants have to interact with the researchers in the site and with the pandemic, there are high chances that they could infect each other,” said a researcher who sought to remain anonymous as he is not authorised to speak to the media.

He said all the studies had been stopped until further notice. “So long as nothing is happening in Kenya as far as HIV cure studies are concerned, we have a long way to go. It is still just but a dream. We will have to wait,” he said.

However, the development of protocols for the studies is ongoing.

Other studies, including HPTN 052 for discordant couples to evaluate effectiveness of early initiation of antiretroviral therapy in transmission, are ongoing under strict adherence to public health measures.

The pandemic has not only affected the HIV studies, but also disrupted the flow of drugs in the country. The Health ministry admitted that for months, most hospitals in the country had been out of Cotrimoxazole (septrin). The disruption could increase mother-to-child transmission of HIV by approximately 1.6 times while putting at risk the lives of two million patients who depend on ARVs.