Durban — These findings have emerged as the injectable PrEP becomes available in South Africa and Kenya. Both these countries have high coverage of PrEP.
This is according to a study done by international researchers including a group from the University of Cape Town.
PrEP is a medicine that can help prevent HIV and is said to lower the chances by 99%. Injectable cabotegravir received regulatory approval in South Africa in December last year and is pending approval in Kenya.
The study suggested that further efforts are needed to increase the choice and accessibility of various PrEP in these countries – options that will benefit the well-being of pregnant and post-partum women and their infants.
UCT epidemiologist and co-author of the study Dr Dvora Joseph Davey said the data suggests that the availability of choices to meet personal preferences is essential to improving the overall acceptability of HIV prevention methods among pregnant and post-partum women.
“HIV incidence remains high among cisgender women of reproductive age in SA and Kenya, including during pregnancy and post-partum. Pregnant women without HIV are at elevated risk of HIV acquisition due to structural and socio-cultural factors that may result in high-risk scenarios, including not knowing the HIV status of partner(s), engaging in condomless sex and having multiple sex partners,” said Davey.
He explained that from September 2021 to February 2022, the researchers surveyed 394 pregnant and post-partum women enrolled in oral PrEP studies in South Africa and Kenya. They evaluated oral PrEP attitudes and preferences for long-acting PrEP methods. Of the 190 women surveyed in South Africa, 67% were post-partum. Of the 204 women surveyed in Kenya, 79% were post-partum.
The participants (75%) reported oral PrEP use within the last 30 days. The findings showed that 49% of the participants reported negative oral PrEP attributes, including side effects (21% South Africa, 30% Kenya) and pill burden (20% South Africa, 25% Kenya).
The study, published in the Journal of the International Aids Society, found that most of the participants (75%, South Africa and Kenya) preferred a potential long-acting injectable over oral PrEP most frequently for a longer duration of effectiveness in South Africa (87% South Africa, 42% Kenya) versus discretion in Kenya (5% South Africa, 49% Kenya).
Davey said the study found that 85% of the participants may prefer oral PrEP over a long-acting vaginal ring, primarily due to concern about possible discomfort with vaginal insertion (82% South Africa, 48% Kenya).
Davey said significant predictors of long-acting PrEP preference included past use of injectable contraceptives, disliking at least one oral PrEP attribute and recent infrequent PrEP use.
Nafisa Wara, a medical student at the David Geffen School of Medicine at the University of California, Los Angeles, and lead author of the study, said: “In our study, few pregnant and post-partum women reported a theoretical preference for the vaginal ring (dapivirine vaginal ring), which reduces the risk of getting HIV by approximately 30% over oral PrEP, which may be due to unfamiliarity with the method as well as its lower efficacy.”
Based on the results of this study, Wara said further work is necessary to assess the feasibility of incorporating long-acting modalities into existing antenatal PrEP provision at the health facility level in South Africa and Kenya that prioritises identified preferences of pregnant and post-partum women, such as services being free of charge or being easily accessible in antenatal and post-partum care.
WhatsApp your views on this story to 071 485 7995.
Daily News