This World AIDS Day is a promising one with several new HIV prevention interventions for young women on the horizon.
It is in Zimbabwe's best interest to prepare for these emerging strategies now. Just last year, HIV prevalence among pregnant women aged 15-24 in Zimbabwe was a startling 10.4 percent. This number is indicative of a larger trend in southern Africa where adolescent women are up to eight times more likely to become infected with HIV than young men.
Young women's high rates of HIV are due in part to biological, social and economic factors making them more susceptible. Because efforts to promote abstinence, monogamy and the use of male condoms have not been enough to stop HIV among girls and young women, researchers have been working to develop women-initiated biomedical prevention interventions. Years of scientific exploration here in Zimbabwe and around the world are finally starting to pay off. PrEP (pre-exposure prophylaxis), microbicide gels and rings are three methods that could potentially turn around the endemic rates of HIV in young women.
Some microbicides are gel-like substances that could be used in the vagina and/or rectum to reduce the risk of IDV infection during sex. A South African microbicide study is testing whether a microbicide gel containing the antiretroviral drug tenofovir is safe and effective at reducing women's risk for HIV or genital herpes. Study results are expected in early 2015 (next quarter!). South Africa is planning for success by preparing rollout in the communities that would need new interventions most. Zimbabwe should prepare too.
There are also twin studies to determine if a monthly vaginal silicone ring with the antiretroviral dapivirille could prevent HIV in women. These studies are ongoing ill eastern and southern Africa, including right here ill Zimbabwe, conducted by the University of Zimbabwe/University of San Francisco Collaborative Research Programme. Results are expected in 2016.
If results show either the gel or ring are safe and effectively prevent HIV the world could possibly have one or more new woman-controlled methods that could help decrease HIV incidence rates and protect more women from HIV. The time is now for civil society to create demand, and for policy and regulatory bodies to consider how they could rapidly introduce new interventions.
In the meantime, there is a proven HIV prevention strategy that Zimbabwe's Ministry of Health and Child Care could begin to implement now. PrEP (pre-exposure prophylaxis) is a proven HIV prevention method that reduces risk of HIV in women and men. Those who are negative take the antiretroviral pill Truvada once a day to prevent HIV. When taken as prescribed, Truvada can reduce chances of acquiring HIV by more than 90 percent. Studies in Botswana, Kenya and Uganda have proven that PrEP can work in women. Demonstration studies are underway in several countries, including Zimbabwe, to understand the best way to rollout this new intervention and bring down high rates of new infections in young women.
Ensuring timely access to PrEP for women, will pave the way for microbicide gels and rings. Let's hold our leaders accountable: They must ensure Zimbabwe policy lives up to scientific promise.
Source: Standard issue of Sunday the 14th