Young women in Africa want choice in HIV prevention

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February 25, 2022

Nearly all adolescent girls and young women in a new study accepted one of two HIV prevention products they were offered. The young women were given a choice of a monthly vaginal ring or daily medication, and only 2% turned down both.

The Reversing the Epidemic in Africa with Choices in HIV Prevention (REACH) Study is the first HIV prevention study to incorporate the concept of informed choice into its design. Spilhaus Clinical Research Site (CRS), a part of Bixby’s University of Zimbabwe-UCSF Clinical Trials Unit (CTU), was one of the sites for the study, and led locally by CTU PI Mike Chirenje, MD, and CRS Leader, Felix Mhlanga, MBChB, MMed.

All the girls and women in the study used both pre-exposure prophylaxis (PrEP) medication and the dapivirine vaginal ring, each for 6 months. The study’s findings suggest that the monthly ring could be a viable option for people who don’t can’t or don’t want to take daily PrEP. The people who chose PrEP over the ring were among those who had used it most regularly during the 6-month period when they were assigned to use it. The participants received frequent support and counseling to meet their needs. The support focused on helping them use their assigned or chosen product as best they could while also ensuring they made their own decisions.

These findings offer hope for greater HIV prevention—one in four new HIV diagnoses in sub-Saharan Africa were in young women ages 15-24.