South African National AIDS Council (SANAC) Civil Society Forum welcomes the groundbreaking announcement by researchers in the HIV sector, from a clinical trial of the pre-exposure prophylaxis (PrEP) regimen of long-acting cabotegravir (CAB LA) injections data prove that it was safe and superior to the daily oral tenofovir, currently used for HIV prevention among women in Sub-Saharan Africa.
In welcoming the new innovative prevention methods, we also call for fast tracking further studies and the licencing of an injectable antiretroviral which has been proven to be more effective in preventing HIV infection in women. The importance of giving women prevention options should be a lived reality, and this innovative work done by scientists will help address the many social and structural issues, including addressing the women’s agency.
“It is so incredible to see that a long-acting injectable PrEP option has been shown to be highly effective in women. Giving women the power in options and help to prevent new infection has been the centre of women agency with the assurance of choice and overcoming the barriers related to adherence for long-term use of biomedical HIV prevention. These are exciting news for all women in their diversities,” said Steve Letsike, Chairperson of SANAC CSF and Co-Chair of SANAC.
Women in the countries where the trial was conducted and across East and Southern Africa continue to experience high HIV incidence. More effective and acceptable HIV prevention choices for women are needed especially for adolescent girls and young women. A combination of biomedical and structural interventions must be delivered with women, vulnerable and key populations at the forefront in its development.
While oral PrEP is highly effective in preventing HIV in women when taken as prescribed, some women find it difficult to take a daily tablet, and inconsistent use of oral PrEP reduces the prevention effect. This latest scientific-breakthrough has the potential to improve the prevention effect without relying on adherence to a daily oral PrEP regimen, and to increase prevention choices and acceptability among women.
It is encouraging to learn that a long-acting injectable PrEP option has been shown to be highly effective in women. CAB LA has the potential to increase choice and overcome some of the barriers related to adherence for long-term use of biomedical HIV prevention.
But, it is also important to temper expectations—there are still some important safety and implementation issues to address. It is likely to be more than a year before CAB LA will be more widely available, and even with this current implementation of PrEP that is largely not available to all. However, now that these results showing its effectiveness in women are available, plans for regulatory approval must move forward and faster.
Oral daily PrEP remains an effective prevention option for anyone at substantial HIV risk, and it has been recommended by WHO since 2015.
For media enquiries and interviews, contact:
Oliver Meth, SANAC CSF Communications Specialist on 068 352 9045 or email oliver@sanaccsf.org.za