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The Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) consortium is introducing long-acting injectable cabotegravir for pre-exposure prophylaxis (CAB for PrEP) alongside oral PrEP and the PrEP ring in five African countries.
MOSAIC is a five-year (2021-2026) global project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID) and is led by FHI 360.
MOSAIC’s primary goal is to empower adolescent girls, young women, and other women to prevent HIV by accelerating the introduction and scale-up of new and emerging biomedical prevention products.
Proposed countries for MOSAIC’s work include Kenya, South Africa, Zambia, Zimbabwe, Eswatini, Lesotho, Uganda, Namibia, and Nigeria.
As reported by <a href="https://spikedmedia.co.zw/fhi-360-and-partners-introduce-injectable-hiv-prevention-method-as-part-of-research-study/">Spiked</a>, South Africa and Zimbabwe are the first to welcome CAB for PrEP following regulatory approval and the arrival of the donated product on site.
The rollout is part of Catalyzing Access to New Prevention Products to Stop HIV (CATALYST), a three-year, multi-country implementation study that aims to assess the delivery of multiple PrEP methods to an estimated 11,000 HIV-negative participants.
The study is taking place across 28 public health service delivery sites supported by PEPFAR in Kenya, Lesotho, South Africa, Uganda and Zimbabwe. As of March 31, nearly 4,000 participants have been enrolled.
Dr. Atul Gawande, assistant administrator for global health at USAID, said:
<blockquote>
USAID’s commitment to cutting-edge research and development is advancing innovative solutions to some of the world’s greatest health challenges. We see that with CATALYST.
This study is supporting women and girls by expanding their options of methods for HIV prevention and by producing findings that will guide the scale-up of these prevention methods across the African continent.
</blockquote>
Dr Kristine Torjesen, director of science facilitation at FHI 360, said:
<blockquote>
CATALYST is the largest study of its kind and represents a locally-led, youth-focused implementation project in which participants have the opportunity to be among the first to learn about and try new PrEP methods.
They will also make their voices heard in how PrEP is rolled out in their communities, which is critical given that adolescent girls and young women continue to bear the brunt of the HIV epidemic in many places.
</blockquote>
The study is being conducted in two stages. Between May and October 2023, stage 1 launched across all sites in all five countries and includes tenofovir-based oral pills and the dapivirine ring (PrEP ring).
The second stage begins once CAB for PrEP has been approved by the national regulatory authority in each country and the donated product is available on-site.
Participants will be followed for one to three years to collect information about how they choose, use, switch between and like the offered PrEP methods.
The study results will offer valuable evidence to guide the future expansion and sustainability of HIV prevention options, ultimately contributing to a transformative impact on HIV prevention.
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Pindula News

FHI 360, A Global NGO And Partners Introduce Injectable HIV Prevention Method As Part Of Research Study

Zimbabwe has introduced Cabotegravir long-acting (CAB-LA), an injectable pre-exposure prophylaxis drug, to add to the HIV prevention regime in the country.
The drug is an antiretroviral (ARV) designed to suppress any infection as it occurs. It is administered to HIV-negative people who have a high risk of becoming infected with the virus.
CAB-LA is the third pre-exposure prophylaxis (PrEP) product to be introduced in demonstration sites under a study for catalysing access to new prevention products to stop HIV (CATALYST). The other two are the dapivirine ring and oral PrEP as HIV prevention choices for women.
<a href="https://www.herald.co.zw/zimbabwe-introduces-injectable-hiv-drug/">The Herald</a> reported the HIV prevention clinical officer in the Ministry of Health and Child Care’s AIDS and TB Programme, Dr Idah Moyo, as saying Zimbabweans could now access the injectable PrEP at the 15 demonstration sites.
She was speaking at a health communicators forum in Harare on Wednesday, 10 April. Said Moyo:
<blockquote>
CAB-LA is a long-term injection for pre-exposure prophylaxis that is meant to prevent the acquisition of HIV for people who are HIV-negative and are at substantial risk of acquiring HIV.
Since it is meant to prevent HIV in people who are at substantial risk, this intervention will be implemented in the demonstration sites which means we will get learning insights from those sites and that will inform the country in the rollout of the CAB-LA in the whole country.
</blockquote>
Moyo emphasized that healthcare providers should empower clients visiting the sites with knowledge.
This knowledge enables them to make informed choices from the available PrEP products.
Clients are encouraged to select a relevant and appropriate method based on their individual needs, preferences, and lifestyles.
The Medicines Control Authority of Zimbabwe (MCAZ) approved the use of the dapivirine ring in 2021.
Then in 2022, MCAZ approved CAB-LA, making Zimbabwe the first country in Sub-Saharan Africa to approve the product.
Moyo asserted that CAB-LA will be used together with other prevention methods like condoms as it does not protect anyone from contracting STIs and getting pregnant. She said:
<blockquote>
CAB-LA is an ARV which reduces the ability of HIV to replicate itself. Whilst research findings are there, the country still wants to learn more through the demonstration projects, so the learning will inform the rollout.
The healthcare providers in these 15 selected sites have been capacitated on CAB-LA so that after the implementation and demonstration projects, we learn from those to facilitate the rollout in the country. The injection is only administered by clinicians.
</blockquote>
Eligible individuals to access PrEP serodiscordant couples (where one partner is HIV negative), adolescent girls and young women, and pregnant and lactating women in relationships with men whose status is unknown, are HIV positive or have an unsuppressed viral load.
PrEP is also available for people who use and inject drugs, key populations like sex workers, high-risk men, and the transgender among others.
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Zimbabwe Introduces Injectable ARV For HIV-negative People

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