HIV Prevention: Uganda to pilot new injectable PrEP

Pre-exposure prophylaxis (PrEP) has shown to be effective in recent clinical and real-world studies undertaken by the Uganda Virus Research Institute(UVRI) under the International AIDS Vaccine Initiative (IAVI) program, but several concerns remain as far as adherence, and multi-modal treatment.

According to data shared by the UVRI-IAVI program ahead of the World AIDS day, drug adherence is still a challenge amongst women and girls that are more susceptible to Human Immunodeficiency Virus (HIV), especially among fishing communities.

Numerous personal, family, social, legal and political impediments challenge access and adherence to HIV combative drugs by vulnerable women and girls. Upon, this background, the program is set to pilot a more convenient and discreet option to help adolescents and young women counter the spread of the disease.

According to Dr. Brenda Okech who is the UVRI-IAVI Director, a new injectable PrEP drug is to be tried out in a new study. The new drug is Lenacapavir which was approved by the United States Food and Drug Administration (FDA) and the World Health Organisation (WHO), it will be administered to participants only twice annually.

Lenacapavir is poised to be a game changer compared to the previously deployed PrEP options including a two-month injectable drug- cabotegravir which is given in the buttocks and Truvada which is a once-a-day pill.

Lenacapavir is is already being used to treat HIV and to prevent transmission of the virus in USA, and this will be the first time to be tested in Uganda. The injectable pill will be rolled out under a Multisite Adolescent and Young Girls (MAGY) study. The MAGY study is to be rolled out in countries such as Kenya, South Africa and Zambia.

The efficacy trial will enroll 400 young women between 18 to 25 years of age, at different sites in the country to see whether Lenacapavir achieves protection from HIV. Lenacapavir will navigate the challenges of drug adherence, and also solve the pill burden.

The UVRI-IAVI Head of Community Studies, Dr. Ali Ssetaala says HIV mutates very often which makes it hard to develop a vaccine that can combat different clones of the disease. However, he believes a breakthrough in the pursuit for the vaccine.

Despite over 20 years of study, an HIV vaccine is yet to surface, but different versions of PrEP have exhibited high levels of effectiveness in recent studies. With the existing array of prevention options will help in slowing down new infections.

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