economist Last week there was a hopeful article Ways to break the cycle of HIV transmission, especially in younger women who have sex with older men. Much of the discussion is about PrEP
A more promising idea is to prevent girls and young women from becoming infected, preferably using methods that don’t require them to persuade men to wear condoms (which is difficult). These include three methods of PrEP that have emerged in recent years: a vaginal ring, a daily pill and a bimonthly injection.Persuading women at risk of HIV
However, using them can be a challenge.
The vaginal ring, an insertable silicone device that releases antiretroviral drugs and must be changed monthly, can reduce the risk of HIV infection by up to 50%. But “it won’t be to everyone’s liking,” Dr. Bekker admits.
Daily PREP pills containing combinations of antiretroviral drugs have been available in Africa for many years. But determining its effectiveness has been tricky because few women have consistently used it even in clinical trials. Some studies estimate that, when used correctly, these pills can reduce the risk of HIV infection by as much as 90%. But it can be difficult to take the drug discreetly at work or school, or to hide it from a parent or boyfriend.
Women worry about stigma…
The most promising option is the injectable form of PrEP. It contains a long-acting form of cabotegravir that blocks an important stage of HIV replication in host cells. It’s available as an injection, initially once a month, then every two months, and was included in the World Health Organization’s guidelines on HIV prevention last year. In a clinical trial of African women, it was nearly 90 percent more effective than oral PrEP.
The study also discusses the possibility of other injectable PrEP treatments given less frequently (every 6 months) to improve adherence.The full article is here.
