Imagine having to go to a discreet place or looking over your shoulder every time you must take oral pre-exposure prophylaxis (PrEP) for fear of stigmatization, being labelled as promiscuous, or experiencing abuse from your intimate partner. These are some of the challenges AGYW face daily as they try to take oral PrEP for the prevention of HIV infection.
To mitigate these challenges, Populations Services International (PSI) and Population Solutions for Health (PSH), with support from PEPFAR through USAID, and in collaboration with the Ministry of Health and Child Care (MOHCC) is implementing a demonstration project in 8 districts under the $101M Going the Last Mile for HIV Control (Last Mile) Program in Zimbabwe. The goal is to assess the acceptability and feasibility of introducing the Dapivirine Vaginal Ring (DPV-VR) as an HIV prevention method among AGYW at high risk of HIV infection. Preliminary findings show high acceptability of the DPV-VR with over 80% of AGYW offered either DPV-VR or oral PrEP opting for the ring.
The ring gives me privacy because it is inserted and no one can see it, unlike pills,” says a 23-year-old woman from Insiza
As one component of a comprehensive and integrated HIV prevention, and sexual and reproductive health package, eligible AGYW have been receiving the flexible silicone Dapivirine vaginal ring and wearing it for 28 days before replacing it with a new one. Clients have been given the choice for provider-assisted DPV-VR insertion at the clinic or self-insertion in their safe spaces, in a self-care approach. To date, 1,137 eligible adolescent girls and young women have accessed the life-changing ring to protect themselves from HIV infection. This intervention brings urgency, choice and hope for AGYW who may not be empowered to negotiate safer sex.
I am thankful for the ring. Using daily pills was difficult for me as I could forget to take them sometimes. Unlike the oral PrEP, once the ring is inserted in me, I don’t have to worry about taking anything for 28 days. After the 28 days, I will just call the health care worker through the DREAMS (Determined, Resilient, Empowered, AIDS free, Mentored, and Safe) Facilitators for removal and insertion of a new ring. I am so happy about this ring and plead with PSH & MAC (Matabeleland AIDS Council) to continue providing these services beyond the 6 months period of the demonstration project as it really works for me,” said one of the AGYW using DPV-R for PrEP.
This young female consumer is one of the many young women enjoying good health to this day, thanks to the HIV and SRHR prevention, treatment and care services provided through the Last Mile program.