NAIROBI, Dec. 1 (Thomson Reuters Foundation) – Kenyan sex worker Silvia doesn’t like the big, oblong blue pill she takes with her porridge every morning.
While the daily pre-exposure prophylaxis (PrEP) tablets drastically reduce her risk for HIV, they carry stigma and even violence because of the common misconception that the drug is taken by people who already have the virus.
“I was beaten up by a customer who found the pills in my handbag. He thought I had AIDS and accused me of giving it to him and hit me on the head with a bar stool. I ended up in hospital with a blood clot, ”says Silvia, 23.
“It’s a problem. People are ignorant about the drug. I don’t want to get AIDS, but the pill is a problem … if there was a better way to protect myself, I would welcome it,” she told Thomson. Reuters Foundation and asked her not to give her full name.
With World AIDS Day marked on Tuesday, Silvia and thousands of other African women looking for a discreet, long-lasting way to protect themselves from HIV won’t have to wait much longer.
A new injectable HIV prevention drug called cabotegravir, taken every two months, has been shown to be nine times more effective at preventing HIV than the commonly used Truvada PrEP tablets for daily use, a study found last month found.
HIV / AIDS experts have described the results as groundbreaking, especially for Africa – where new infections disproportionately affect women – and more options are urgently needed to prevent HIV.
Not only will the new drug give women and girls across the region a more acceptable option, new transmissions will drop sharply, they said.
“UNAIDS has long advocated for additional, acceptable and effective HIV prevention options for women,” said Winnie Byanyima, UNAIDS executive director, of last month’s “groundbreaking study.”
“If donors and countries invest in rolling out injectable PrEP for women at higher risk for HIV, new infections can be drastically reduced.”
BURDEN OF THE PILL
Worldwide, more than 38 million people are infected with HIV, and the AIDS pandemic has killed about 33 million people since its inception in the 1980s.
According to UNAIDS, the United Nations Joint Program for HIV / AIDS, women and girls were responsible for 48% of the 1.7 million new HIV infections worldwide in 2019.
However, in sub-Saharan Africa, they accounted for 59% of new cases.
Health experts attribute the higher percentage of women and girls in Africa to significant inequalities between men and women, often making them more vulnerable to sexual violence and exploitation.
While most countries in Sub-Saharan Africa provide free PrEP to those most at risk for HIV – such as sex workers and those with an HIV-positive partner – many vulnerable women and girls are unaware of the drug or have none. access to it.
Studies also show that many women and girls find it difficult to keep up with PrEP because of the daily dosage and the discrimination they fear if someone finds out they are using it.
Mercy Mutonyi, HIV prevention officer at the Bar Hostess Empowerment and Support Program – a Kenyan sex worker collective – said taking PrEP is often not an option.
“Many women cannot always use a condom or the PrEP pill. Men will often refuse to put the condom on … and the pill carries stigma and sometimes violence, as most people think it is used to treat AIDS and not prevent it, ”said Mutonyi.
“It’s a burden for sex workers, especially if they are very mobile and need to have the pills with them, because they might be staying overnight. They should always hide it from customers as well as their friends and family. “
The single admission every two months would not only be more private, she said, but more convenient because patients currently have to go monthly to select public clinics – often far from where they live – to pick up their medications.
The HIV Prevention Trials Network trial enrolled more than 3,200 women between the ages of 18 and 45 who were at high risk of contracting HIV in Botswana, Kenya, Malawi, South Africa, Eswatini, Uganda and Zimbabwe.
Four HIV infections occurred in women who received the cabotegravir injection, while 34 were HIV infections among those who took the Truvada pills daily.
Because the risk of HIV was found to be nine times lower with cabotegravir injections than with daily oral PrEP, the study – which was expected to continue until 2022 – was completed ahead of schedule in May.
Lizzy Nkosi, health minister of the small landlocked country of Swaziland – which has the world’s highest HIV / AIDS rate with more than 27% of the adult population living with the virus, said the results of the study were revolutionary. goods.
“As a country with a heavy burden, we are humble and grateful for this development. It gives us hope that our goal of an HIV-free generation now appears achievable, ”said Nkosi.
“It is definitely a game changer. Women will have an option they can use without relying on the cooperation and approval of their sexual partners. An injection is discreet and eliminates the stigma associated with taking pills. “
For Silvia, the new drug cannot come quickly enough.
“If this injectable drug comes to Kenya, it will help many women and girls … they are more likely to take drugs to protect themselves from AIDS,” she said.
“One shot will reduce the burden. One shot can end the stigma.” (Reported by Nita Bhalla @nitabhalla; edited by Helen Popper. Mention the Thomson Reuters Foundation, the charity arm of Thomson Reuters, which spans the lives of people around the world struggling to live free or fair lives. Visit news.trust.org )