FALLS CHURCH, Virginia — Controlling high rates of HIV is not a new issue for Zimbabwe, but medical officials have taken a big step to lower numbers. The Medicines Control Authority of Zimbabwe has tested and approved a recent long-acting vaccination called cabotegravir (CAB-LA) to prevent HIV, making it the first African country to do so.
The State of HIV in Zimbabwe
Zimbabwe has the fifth-highest HIV rate in the world, with 11.6% of people aged 15 to 49 diagnosed with the disease as of 2021. However, these numbers are currently on a downward trajectory and implementing this new preventative measure in collaboration with other methods can help improve the quality of life for many people in Zimbabwe.
Young women and girls are especially vulnerable to contracting HIV in African countries for various reasons. Women 15-24 are four times more likely to contract HIV than men in the same age range. Social norms preventing women from addressing their health, lack of health care access, age consent laws and transactional sexual relations for resources are a few factors contributing to high untreated HIV rates in Africa.
Zimbabwe introduced a plan to end AIDS and HIV by 2030 with a 90-90-90 goal. The country has already met the goal of 90% knowing their HIV status, 90% getting treatment and 90% suppressing the virus.
Poor health significantly impacts one’s socioeconomic status; in this case, contracting HIV can hinder one’s ability to support their family. Those living in poverty have a higher chance of contracting HIV. With 38.3% of people living under the poverty line in 2019, this new preventative measure must be readily available to the public in Zimbabwe.
The injection has increased hope for HIV prevention following the difficulties in Zimbabwe’s health care system in response to the COVID-19 pandemic.
How CAB-LA Works
According to the World Health Organization (WHO) guidelines released in July 2022, the injectable form of CAB-LA is pre-exposure prophylaxis (PrEP). The injection will coincide with other forms of HIV prevention, such as periodic testing, condom and safe sex education and post-exposure treatments.
The CAB-LA injections are safe every two months, requiring patients to be consistent with their follow-up injections. In addition, those ready to receive CAB-LA in Zimbabwe must test negative for HIV to avoid any adverse effects of the medication, according to WHO.
Two safety studies conducted by researchers found that the risk of contracting HIV in individuals who received the injection lowered by 79%, WHO reports. However, researchers consider that CAB-LA injection concentrations in the blood vary in different individuals when reviewing effectiveness.
Medical professionals already utilize two other pre-exposure prophylaxis (PrEP), Tenofovir-based oral medication and the dapivirine vaginal ring, according to WHO. Having a third option expands the resources needed to treat HIV in Zimbabwe.
The University of California Berkeley School of Public Health received a grant of $550,000 to research further the health care system and the usage of CAB-LA in Zimbabwe. The UC Berkeley plan aims to address high HIV rates among female sex workers in Zimbabwe and worldwide. One in three female sex workers have contracted HIV. Heightened risk and stigma in medical settings have prevented many women from seeking treatment.
The school wants to create a pharmacy-based approach to effectively administer PrEP measures and stunt HIV rates among those experiencing extreme poverty.
A Look Ahead
The next steps are to increase community awareness–especially in rural areas–to empower people to receive life-saving preventative care. Once communities understand the importance of PrEP and receive safe sex education, individuals in Zimbabwe can make informed decisions whether CAB-LA injections are the right choice for them.
Continuous support and training for patients and medical providers is essential as there is little familiarity with PrEP injections in Zimbabwe. Creating an open, judgment-free environment is vital to make individuals, especially women and young girls, feel safe in health care facilities, according to WHO.
Introducing CAB-LA in Zimbabwe allows officials to save thousands of lives and begin to focus on addressing other aspects of life contributing to poverty.
– Mikada Green
Photo: Wikimedia Commons