In South Africa, the UN agency will also introduce a vaginal ring, which is the first HIV prevention method for women that can be used independently.
UNITAID, an international medicines procurement service of UNAIDS , wants to increase the coverage of existing HIV prevention resources in low- and middle-income countries.
To this end, it will introduce the long-acting Cabotegravir injection in Brazil and South Africa, which can reach different sectors of the population through adequate and accessible supply.
The UN agency “intends to implement on a large scale the latest innovation in the prevention of the Human Immunodeficiency Virus. This is a new eight-week injection that will provide users with an alternative to daily oral pills. Expanded prevention options are expected to improve coverage for people at highest risk of HIV infection,” said UNITAID spokesperson Hervé Verhoosel.
Oral pre-exposure prophylaxis—anti-HIV medications—can prevent HIV infection in 99% of cases. However, it only works when taken as prescribed: either once a day or before and after sex for cisgender men.
Cabotegravir, which lasts eight weeks, addresses the challenges users face with regular pills that reduce the impact of oral prophylaxis in real-world settings.
They also help reduce possible fears that HIV prevention pills may be confused with HIV treatment and that the user will suffer stigma, discrimination or intimate partner violence as a result.
© UNICEF/Tsvangirayi Mukwazhi. An HIV-positive woman sits in her home with her granddaughter in Mangwe, Zimbabwe.
Make this new medicine accessible throughout the world
Although prophylaxis can be up to 99% effective, acceptance of this injection has been slow. In fact, only a third of the UN targets to increase coverage or reduce new HIV infections in 2020 were met . Inequalities in who can access such treatment are increasing .
To introduce the new injection, UNAIDS has chosen two countries with a high incidence of HIV, Brazil and South Africa.
In Brazil, programs aim to reach two of the groups with the highest rates of HIV. An estimated 30% of transgender people and 18% of men who have sex with men are living with HIV.
In South Africa, adolescent girls and young women, as a group that is infected at a disproportionately high rate, will be the target of funded efforts in that region. In sub-Saharan Africa, six out of seven new HIV infections in adolescents occur among girls. On the other hand, young women are twice as likely to be living with HIV as young men.
Long-acting prophylaxis could have a revolutionary impact , improving options and making HIV prevention an option within reach of different parts of the population.
Adequate and affordable supply must be ensured so that people everywhere can benefit without delay, says UNAIDS, which strongly encourages the pharmaceutical company producing the new medicine to develop a transparent procurement policy for long-acting cabotegravir.
This policy should allow a generic route through voluntary licenses through the Medicines Patent Fund to achieve broader access.
© UNICEF/Thoko Chikondi. UNICEF offers support to adolescent mothers with HIV during childbirth so that they have healthy babies.
HIV prevention in the hands of women
The South African pilot program will include a second new long-acting HIV prevention product.
This is the dapivirine vaginal ring, which is the first HIV prevention method for women and for completely autonomous use . Lasting for 28 days, the flexible silicone ring can be inserted without medical assistance and provides an additional discreet option to a section of the population who do not always have complete control over their sexual health.
The new products significantly expand the options offered to users, so they can take control of their health and select the method that best suits their preferences and lifestyle.
UNAIDS, an international agency specialized in creating equitable access to health innovation in low- and middle-income countries, will partner with different organizations, including Fiocru in Brazil, and Wits RHI in South Africa.
“Working closely with local health authorities, the partners will integrate the products into existing sexual health and HIV prevention services in both countries.”
