Development Health

Injectable PrEP a milestone in HIV prevention

Injectable PrEP

Cecilia Jackson (not her real name) has been on anti-retroviral therapy (ART) since 2003 when she was diagnosed with the disease but lives a healthy lifestyle.

“Despite being HIV positive, I am healthy and I feel like a teenager because of the energy I possess. The secret is that I eat a balanced diet and do not miss taking ARVs ever since I was introduced to them. Thanks to the prevention of mother-to-child transmission (PMTCT), I had two bouncing, healthy babies after I tested positive for HIV. The eldest who was born in 2004 is going to university this year. She came out with 18 points and is going to study medicine at a university in South Africa,” Jackson said.

There are many initiatives in Zimbabwe that are meant to address HIV prevalence in the country.

In January 2022, the President’s Emergency Plan for AIDS Relief (PEPFAR) introduced the Small Grants Fund which focuses on income-generating activities that improve care, support, and economic conditions for people living with HIV/AIDS (PLWHA) and those directly affected by HIV/AIDS such as grandparents caring for grandchildren orphaned due to HIV/AIDS.

According to the AIDS Healthcare Foundation (AHF), Zimbabwe is among the countries in sub-Saharan Africa most affected by the HIV and AIDS epidemic. It notes that although new infection rates and AIDS-related mortality rates are declining, there are areas of high HIV transmission which include border districts, areas of increased populations (growth points, peri-urban settlement), small-scale mining areas, and commercial farming settlements.

AHF Zimbabwe is supporting the Ministry of Health and Child Care in establishing Centers of Excellence (COE’s). The main purpose of the COEs is to provide quality and affordable health services to People Living with HIV&AIDS (PLWHA) with complex medical conditions who are referred from across the country. The COEs are therefore established at the central and or referral hospitals in the country.

Initially, the Organization supported two Centres or Sites namely; Parirenyatwa Centre of Excellence (in Harare) and Mpilo Centre of Excellence (in Bulawayo). In 2018, the Organization commenced support for Mutare Provincial Hospital OI/ART Clinic and converted it to a COE. Each of the 3 COEs is headed by AHF-seconded Medical Directors who ensure the provision of cutting-edge medicine at these Centres.

At a visit to the Sally Mugabe Central Hospital (formerly Harare Hospital), the Spiked Online Media crew interviewed a man who identified himself as Jacob Moyo, who had come for ART at the health institution.

“When I was diagnosed with HIV, at first I fell into depression as I thought that was the end of my life. Thanks to my sister who is a nurse in Sanyati, I was told HIV is a manageable condition. My sister is also HIV-positive but is on ART and lives a healthy life like anyone else. I am an entrepreneur and I buy second-hand clothes in Mbare for re-sale in Sanyati. I collect highly active antiretroviral therapy (HAART) from here at Sally Mugabe Hospital but I tell you that taking ARVs religiously daily is a mammoth task.

“In the quest towards winning the fight against HIV and eradicating AIDS by 2030, it is important that those not yet infected by HIV take PrEP, especially the long-acting cabotegravir (CAB-LA) that is quite popular,” Moyo said.

He divulged to our reporter that he sometimes feels dizzy after taking the pills. In addition to other side effects, Moyo says he notices some swelling to his palms and face. Despite these small side effects, the entrepreneur says HIV has remained suppressed for nearly a decade to date.

Fortunate Dhliwayo, the Programmes Coordinator of the Zimbabwe AIDS Prevention and Support Organisation (ZAPSO) said PrEP is a highly effective method of HIV prevention which comes in a pill form taken daily but said the injectable PrEP has more advantages.

“A second injectable option is however still under study and its biggest advantage is that it is taken once every two months, six months, or even a year by trained healthcare workers, making it more convenient and therefore highly recommended,” Dhliwayo said.

Brienne Prusak, a Senior Communications Officer with Doctors Without Borders (MSF) said as this year marks the 20th anniversary of PEPFAR, there are new medical tools to prevent and treat HIV/AIDS compared to what was available in the early 2000s when this fight was just beginning.

“One of these tools is the injectable version of HIV pre-exposure prophylaxis (PrEP) called long-acting cabotegravir (CAB-LA). This particular form of HIV prevention is especially useful in low-resource settings like those in which Doctors Without Borders/Médecins Sans Frontières (MSF) operates. This is primarily because it only needs to be injected every two months rather than taken daily like oral PrEP pills—something that can be difficult for people who are caught in conflicts, live far from health clinics or have been displaced from their homes.

“It’s critical that this form of PrEP is rolled out as widely as possible to further curb HIV infections. Unfortunately, the pharmaceutical corporation that makes the injection, ViiV, is standing in the way of this. This means that—similar to the limited access to antiretrovirals that we saw in the early 2000s—only a lucky few have access to PrEP. More about that here:

“Our experts going to research why injectable PrEP needs to be prioritized in any future plans to tackle HIV/AIDS,” Prusak said.

CAB-LA—the first long-acting injectable approved for the prevention of HIV infection by the US Food and Drug Administration (FDA) in December 2021—is the most effective form of pre-exposure prophylaxis (PrEP) for people at high risk of HIV.

MSF is of the view that increasing access to this medicine could be a game-changer for people across the world as it only needs to be taken once every two months instead of daily, making it easier for people to adhere to and protect themselves against HIV.

The organization is also calling on pharmaceutical corporation ViiV to urgently dismantle price, registration, and possible supply barriers that are blocking people from accessing CAB-LA, the most effective form of HIV pre-exposure prophylaxis (PrEP) that exists.

About the author

Byron Adonis Mutingwende