Africa: Time to Embrace HIV Prevention Tools While We Wait For The Cure

Lima, Peru — allAfrica’s Sethi Ncube is in Lima, Peru, for the 5th HIV Research for Prevention Conference, HIVR4P 2024, reporting from the only global scientific conference focused on the challenging and fast-growing field of HIV prevention research.

Here Ncube shares her thoughts on HIV cure vs prevention…

The global fight against the HIV epidemic has witnessed great progress over the past decades. However, there’s one harsh truth scientists are reminding us of at the 5th HIV Research for Prevention Conference (HIVR4P 2024) – we don’t know when or if there will be a cure for HIV. The scientists say the virus is very “clever”, and mutates quickly blocking efforts to create the long-awaited cure.

The key positive takeaway for me from the HIVR4P 2024 is that people must not die while waiting for a cure when powerful preventive tools already exist. It’s time for all, especially those in vulnerable communities, men who have sex with men, trans and gender-diverse people, sex workers, and people who inject drugs, to take up these cool prevention methods as they become available.

we don’t know when or if there will be a cure for HIV

One of the most promising developments highlighted is the twice-yearly injectable PrEP drug, lenacapavir. In the recently conducted PURPOSE 1 and PURPOSE 2 trials, the drug demonstrated remarkable efficacy in preventing HIV acquisition. PURPOSE 1 showed a 100% reduction in HIV acquisitions among cisgender women in Africa, while PURPOSE 2 showed a 96% reduction across multiple countries, including South Africa and Uganda.

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Lenacapavir is a game-changing leap in HIV prevention. For people in under-resourced areas, the convenience of taking a biannual injection as opposed to a daily oral medication could be revolutionary. It offers a practical and stigma-reducing option, especially for women who have historically faced barriers to adherence to traditional PrEP. As Beatriz Grinsztejn, President of the International AIDS Society (IAS), noted, these findings could transform HIV prevention for all genders.

When women find a product comfortable or enjoyable to use, they are more likely to stick with it

Alongside lenacapavir, more long-acting tools are coming to the forefront. The much-talked-about dapivirine vaginal ring, already approved in 11 African countries, offers women a discreet, woman-controlled HIV prevention method. Some women who were involved in its trial told researchers that they like it because it’s ‘hot’ and this is important because researchers have been emphasizing that incorporating pleasure into HIV prevention methods can boost adherence. When women find a product comfortable or enjoyable to use, they are more likely to stick with it consistently.

Now, new data from South Africa suggests that a three-month version of the ring, compared to the monthly version, could significantly improve both convenience and cost-effectiveness. This product could be especially essential for women in rural or under-resourced areas where access to frequent clinics is challenging.

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