NEW: ‘Long-acting injectable cabotegravir will give women more options’

Fatima Bulla-Musakwa

STAKEHOLDERS at the forefront of HIV/AIDS epidemic interventions are celebrating the introduction of Cabotegravir long-acting (CAB-LA) in Zimbabwe, saying it will address gender inequalities for women at high risk of contracting the virus.

CAB-LA is an injectable pre-exposure prophylaxis drug for HIV/AIDS.

There are more women than men suffering from the epidemic, with 750 000 out of 1,3 million people living with HIV as at the end of 2022 being females of 15 years and above.

The HIV prevalence rate among adolescent girls and young women aged 15 to 24 years also stands at 4,4 percent.

In addition, the HIV incidence rate stands at 0,26 percent among adolescent girls and young women aged between 15 to 24 years.

This is 3,4 times more than the rate of their male counterparts.

Against this background, the introduction of CAB-LA to add to the HIV prevention regime for women could be a mitigation measure they have been looking for.

“Pre-exposure prophylaxis (PrEP) will help in addressing inequalities especially for women, as it is an additional choice for prevention when exposed to HIV as a result of gender power relationships such as intimate partner violence that puts women at higher risk of contracting HIV.

“We embrace PrEP as the AIDS epidemic continues to evolve. It is still a feminised epidemic, and the more choices for HIV prevention methods the better as there is no one size fits all,” said Ms Tendai Westerhoff, an HIV advocate and national director for the Pan African Positive Women’s Coalition-Zimbabwe.

Government has since announced the introduction of the injectable, marking a milestone in efforts to prevent new HIV infections.

Speaking at a health communicators forum in Harare on Wednesday, the HIV prevention clinical officer in the Ministry of Health and Child Care’s AIDS and TB Programme Dr Idah Moyo said assessments at the 15 demonstration projects could take up to a year before a countrywide roll-out begins.

“We interact with people who will be receiving the interventions, so it means we will be getting perspectives from the recipients of care, and insights from the providers of care, to see if there are any learnings, issues to be addressed before rolling out to the whole country,” she said.

The drug becomes the third product to be made available after dapivirine ring and Oral PrEP as HIV prevention choices for women.

Designed to suppress any infection as it occurs, the ARV drug will be offered to HIV-negative women at substantial risk of HIV as part of a comprehensive prevention approaches.

Brilliant Program Community Engagement and Advocacy co-lead Ms Martha Tholanah said having a choice of products to use for HIV prevention is empowering for women.

She noted that the existence of the product needs to go hand in hand with accessibility and choice.

“I see the three, CAB-LA, Oral PrEP and the vaginal ring, as different tools in a toolbox. The good thing is they are offering women choices,” she said.

“So, a woman can decide which one suits her based on her personal circumstances, preference and discussion with her healthcare provider.

“There have to be motivated and skilled personnel to help with delivery of CAB-LA and other PrEP products and confidentiality is a must.”

Ms Tholanah has openly lived with HIV for more than two decades.

CAB-LA will be offered to individuals of 18 years and above, as an injectable given every two months.

Ms Phyllis Mavushe, who was born with HIV, said having the injectable increased options for uptake of PrEP, especially to promote adherence, including among women who could be confronted by their partners for taking other visible options like pills.

“So, it helps especially on issues of disclosure, because when we are talking of intimate partner violence, they are able to take their treatment without having to disclose.

“This is because where there is intimate partner violence, we know issues of agreement on protection are difficult, most of the times they are at risk, they are vulnerable.

“With pills if they are seen by their partners at times it becomes an issue. But now with the injectable, it’s one jab and you are good to go, there is no need to be having confrontations with a partner,” said Ms Mavushe.

Since its implementation in 2016, the country has made significant strides with about 217 461 people being initiated on PrEP.

Zimbabwe also recorded the ninth-highest number of new initiations among the 120 countries that are reporting on Oral PrEP.