A landscape view of a strategy meeting in a modern conference room in sub-Saharan Africa. The room is equipped with high-tech devices and displays data and maps. Diverse participants, including healthcare leaders, community advocates, and international health experts, are deeply engaged in a discussion about new HIV prevention methods, reflecting a professional and collaborative atmosphere. — Strategic Planning for HIV Prevention Stakeholders in sub Saharan Africa convene to discuss the rollout of new HIV prevention products showcasing collaboration and expert insights in a high tech conference setting

New USAID Study Expands HIV Prevention Options for Women and Girls in Africa

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The HIV/AIDS epidemic continues to disproportionately impact adolescent girls and young women in sub-Saharan Africa. Despite progress, this vulnerable group accounted for a staggering 77% of new HIV infections among youth aged 15-24 in the region in 2022. (UNAIDS, 2022; Bor et al., 2022) Moreover, adolescent girls and young women in sub-Saharan Africa were more than three times as likely to acquire HIV compared to their male peers last year. (UNAIDS, 2022)

Bar chart showing 77% of new HIV infections among adolescent girls and young women compared to 23% among their male peers in sub-Saharan Africa in 2022, colored in bronze and dark olive green. — This bar chart compares the percentage of new HIV infections among youth aged 15 24 in sub Saharan Africa in 2022 with 77 among adolescent girls and young women Source UNAIDS Bor et al httpswwwunaidsorgsitesdefaultfilesmedia assetUNAIDS FactSheet enpdf httpswwwncbinlmnihgovpmcarticlesPMC9485902

To address this alarming disparity, the U.S. Agency for International Development (USAID) is funding an innovative project called “Maximizing Options to Advance Informed Choice for HIV Prevention” (MOSAIC). (FHI 360, n.d.) This five-year global initiative aims to accelerate the introduction and scale-up of new biomedical HIV prevention products specifically for adolescent girls, young women, and other women at substantial HIV risk.

Flagship CATALYST Study Tests New Prevention Products

MOSAIC’s flagship effort is the “Catalyzing Access to New Prevention Products to Stop HIV” (CATALYST) study. (PrEPWatch, n.d.) It will provide and assess an enhanced service delivery package offering oral pre-exposure prophylaxis (PrEP), the dapivirine vaginal ring, and injectable cabotegravir (CAB-PrEP) at PEPFAR/USAID sites in Kenya, Lesotho, South Africa, Uganda, and Zimbabwe.

“CATALYST will generate critical real-world evidence to support the wide-scale global implementation of these new prevention options,” said a USAID spokesperson. (PrEPWatch, n.d.)

Innovative New Prevention Methods

The dapivirine vaginal ring is a female-initiated HIV prevention product that can provide protection for 28 days. (WHO, 2021) Importantly, it is the first long-acting prevention method developed specifically for women. Clinical trials found the ring reduced HIV risk by up to 35% among consistent users.

In addition, injectable CAB-PrEP is another promising new option, providing eight weeks of continuous HIV protection with just six injections per year. (Unitaid, 2022) This long-acting method addresses challenges with oral PrEP adherence and stigma concerns.

Implementation Considerations

While rolling out these new products, the World Health Organization has highlighted key implementation needs, such as: (WHO, 2021)

Providing comprehensive sexual health services alongside HIV prevention
Ensuring women receive full information to make informed choices
Addressing acceptability among key populations like sex workers
Offering adherence support and demand creation activities
Training healthcare providers on new prevention methods
Gathering further safety data during pregnancy/breastfeeding

By proactively addressing these considerations, the MOSAIC consortium – led by FHI 360 with partners like Wits RHI and AVAC (FHI 360, n.d.) – aims to maximize access to and uptake of this multi-product HIV prevention market for women and girls in Africa.

About the author

Darius Spearman is a professor of Black Studies at San Diego City College, where he has been pursuing his love of teaching since 2007. He is the author of several books, including Between The Color Lines: A History of African Americans on the California Frontier Through 1890. You can visit Darius online at africanelements.org.