Experts harp on HIV prevention tools to mitigate virus spread

With recent reports showing a rise in new Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) cases in the country, public health experts have called for more awareness on new and improved prevention tools to mitigate spread of the virus in line with the global campaign to end AIDS epidemic by 2030.

According to the Joint United Nations Programme on AIDS (UNAIDS), there were 1.5 million new HIV infections in 2021, one million more than the global target of 500,000, and an estimated 650,000 deaths from AIDS-related illnesses.

The statistics also revealed that over 38 million people are living with HIV/AIDS worldwide as more than 40 million people have died from AIDS-related illnesses since the start of the HIV epidemic.

As part of efforts to address the situation, help sensitise the public and HIV prevention advocacy agenda in ensuring no one is left behind in the fight against HIV/AIDS, New HIV Vaccine and Microbicide Advocacy Society (NHVMAS) has organised a two-day training in Lagos State for health journalists on new HIV prevention tools.

Programme Officer at NHVMAS, David Ekpenyong Ita, who gave a presentation on the overview of the New HIV Prevention, listed the prevention tools to include but not limited to both male and female condoms, HIV counseling and testing, microbicides for women, oral Pre-Exposure Prophylaxis (PrEP), Post Exposure Prophylaxis (PEP) amongst other prevention tools.

Oral PrEP is an antiretroviral drug, which dramatically reduces the risk of HIV infection when taken as directed especially for men and women who are at substantial risk of acquiring HIV infection while PEP is an antiretroviral drug taken as an emergency treatment after a possible exposure to prevent HIV infection.

Microbicides are products applied inside the vagina or rectum to protect against HIV transmission through sex. Ita also listed people at substantial risk of acquiring HIV infection to include: Men who have sex with men (MSM), transgender individuals, heterosexual women and men, serodicordant couples, Female Sex Workers (FSW), sexually active adolescents amongst others.

The group’s Executive Director, Mrs. Florita Durueke, spoke extensively on PrEP, long acting injectable PrEP and its accessibility in the country.

She said: “Nigeria is still struggling with PrEP access for those at substantial risk of HIV infections and trails have shown that higher adherence and consistent use of PrEP is directly linked to higher protection from the virus.

“Long acting injectables are also antiretroviral drugs given via injections that persist in the blood for a long period of time to facilitate adherence and make it easier for people to take.

“Talking about Dapivirine Vaginal Ring which is an intravaginal ring PrEP that can reduce HIV incidence among women when used with high adherence. The data showed that vaginal ring uptake is high and the ring provided 54 percent fewer HIV infections than what might be expected in the absence of the ring and it is currently under consideration for drug licensure.

“Instead, this new PrEP can be inserted, injected, infused, or implanted in a woman’s body from once a month to once a year to provide sustained protection from acquiring HIV,” she said.

Durueke emphasised on the female condom and how more awareness is needed to encourage women to start wearing the female condoms during sex to protect themselves from possible Sexually Transmitted Infections (STIs) and HIV.

The global target for PrEP by 2020 is to put about three million people on PrEP but by 2021, the number of people who were put on PrEP was about 1.5 million.

NHVMAS advocates that beyond couples in sero-discordant relationships, adolescents should be prioritised for access to PrEP. As of September 2015, WHO recommends that people at substantial risk of HIV infection should be offered tenofovir disoproxil fumarate (TDF)-based oral PrEP as an additional prevention choice, as part of comprehensive prevention. Oral PrEP is highly effective at preventing HIV when used as directed. In 2021, WHO recommended that the dapivirine ring may be offered as an additional prevention choice for women at substantial risk of HIV and, in 2022, that long-acting injectable cabotegravir (CAB-LA) may be offered as an additional prevention choice for people at substantial risk of HIV. Other products (example, multipurpose prevention products that combine antiretroviral drugs with contraception) are currently studied as additional PrEP options.

Meanwhile, HIV self-testing (HIVST) and pre-exposure prophylaxis (PrEP) are well-known, proven HIV-prevention strategies. However, global HIV programme experts note that optimising uptake of these strategies, especially among people who need them most, is a challenge.

In Nigeria, efforts to overcome this challenge accelerated when the National Agency for the Control of AIDS (NACA) launched the National HIVST and PrEP Communication Strategy on January 18, 2022.