Ellen Mlambo
MIRROR REPORTER

MASVINGO – Zimbabwe has made significant strides in the fight against HIV/AIDS, but a critical gap remains – a lack of awareness among students and the general public about new HIV prevention products approved by the World Health Organisation (WHO). The Female Students Network Trust (FSNT) has sounded the alarm, highlighting the need for education and awareness campaigns to inform students about these innovative tools.
The FSNT Executive Director, Evernice Munando, emphasized that many students are unaware of the new prevention tools.

“Most students know of condoms as the prevention method. They have not heard of other methods. I urge that the health ministry and partners disseminate the information widely. Very few, maybe those taking health related studies know of the long-acting injectable Cabotegravir (CAB-LA) and the dapivirine vaginal ring,” said Munando in an interview with the Mirror.
The novel tools are approved by WHO as pre-exposure prophylaxis (PrEPs) for HIV prevention.

“These products offer additional options for HIV prevention, but it’s crucial to promote comprehensive prevention strategies, including condom use, to ensure overall sexual health and well-being,” said Munando.
The new HIV prevention methods have been described in some circles as silver bullets, while other analysts expressed concern that their use without the promotion of the condom will lead to an upsurge in STIs.

The Medicines Control Authority of Zimbabwe (MCAZ) approved the use of the dapivirine vaginal ring and the injectable cabotegravir.
The Dapivirine vaginal ring is placed into the woman’s privates for a month. It acts by releasing the antiretroviral dapivirine from the ring into the vigina slowly over 28 days.
The Injectable Cabotegravir is injected monthly for the first two months and every two months thereafter.
The advantages of these methods include the long-acting use, the discreet use, no pill-burden, and their effectiveness.
Munando complained that female students, indeed, like all women in communities, are not aware of the new HIV preventive products. She said the two new methods can have a strong impact on the reduction of new HIV infections in tertiary institutions and among young people.
“Information on HIV preventive products is not reaching out to students. Students are not aware of the dapivirine vaginal ring and the injectable cabotegravir, and it’s difficult to measure the uptake,” said Munando.

The MoHCC Director for AIDS and Tuberculosis, Dr Owen Mugurungi, said the country has not yet started implementing a national rollout of the two products.
“The CAB-LA injectable is an HIV prevention tool introduced in the form of a study. The study has not yet been completed. I can not disclose the statistics of the uptake before the completion of that study.
“What I can say is the uptake is good, we didn’t face any challenge in recruitment of participants, people are participating and the results will be announced after the study is completed,” said Dr Mugurungi.

The new products are part of the programme launched by Pangaea Zimbabwe AIDS Trust (PZAT), a member of the Maximising Options to Advance Informed Choice for HIV Prevention (MOSAIC) consortium working with the Ministry of Health and Childcare.
One of the clinics chosen for this study is Masvingo City Council-run Runyararo Clinic.
The study, which will be completed by July next year, includes the existing oral PrEP, a pill taken daily to prevent contracting HIV.
The study is to assess feasibility, acceptability, uptake, and use effectiveness until July 2025. It is targeting 11 000 HIV negative women in five countries, Zimbabwe, Kenya, Uganda, South Africa, and Lesotho.
Participants include adolescent girls and young women.
In addition to Runyararo Clinic, the study is also being carried out at Beitbridge Wellness Centre, Plumtree District Hospital, Cowdray Park Clinic in Bulawayo, Youth SHAZ-HUB Drop in Centre in Chitungwiza and Ngundu Rural Health Centre.
AIDS Healthcare Foundation (AHF) Country Program Manager, Dr Enerst Chikwati, said the methods are relatively well known in the medical field, but the general public has little knowledge of them.
“WHO has approved long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV prevention. This is a great move in the fight against HIV,” said Chikwati.

He said effective HIV prevention requires a combination of many methods, which include condoms, PrEP, voluntary medical male circumcision (VMMC), and PMTCT, among others.
He, however, warned against aggressive marketing of PrEP without emphasizing the use of condoms because in some countries, an increased uptake in dapivirine and vaginal ring resulted in an increase in STIs.
“Condoms remain a key strategy in preventing not just HIV but other STIs that are on the rise. It’s important that as we market these new methods, we continue emphasizing the importance of the Combination HIV Prevention Strategy,” said Dr Chikwati.
Munando becried the slow information dissemination from the parent ministry.
“The Ministry of Health is not taking its responsibility to disseminate information to colleges or institutional clinics. We are not sure whether it’s deliberate or they think the colleges have a mandate to do so,” said Munando.
She also added that there was sceptism over the new methods with women expressing fear that they could contract cancer. She said proper information roll-out by the Ministry will serve to allay such fear.
“When introducing a product such as a vaginal ring, it is not something they can trust to insert into their bodies when they don’t have enough information. Students require information on the dapivirine vaginal ring, especially the side effects, whether it causes cancer or not. There are perceptions and talks around that. As an organisation, we feel there is a need to carry out campaigns to raise awareness and equip students with requisite information and knowledge on HIV preventive products,” she said.
Mosaic project lead and the catalyst study core principal investigator Dr Emily Gwavava said the catalyst study, which stands for Catalyzing access to new prevention products to stop HIV is funded PEPFAR through USAID.
The study is reviewed by the Medical Research Council of Zimbabwe (MRCZ).
The PrEP products have been approved for use in Zimbabwe by MCAZ.
According to ZIMPHIA 2020, women aged 15 years and above are three times more likely to be infected with HIV than their male counterparts
Several women from Mucheke in Masvingo, where Runyararo Clinic is situated, professed ignorance about dapivirine and injectable CAB-LA.
Egnes Dongo, who is a pastor’s wife, appealed to relevant authorities to disseminate information on available HIV preventive products to the public. She said most women are infected because of a lack of information relating to preventive products.

Masvingo City Council Health Services Director Suzanne Madamombe said they are overjoyed to have been selected among six health facilities that are conducting the study.
“It is exciting that as Masvingo City, through our Runyararo Clinic, we managed to be selected among six health facilities that are conducting the program. The project is a research study that aims to evaluate the delivery of HIV prevention methods in women and girls at risk of new infections,” said Madamombe.
It’s time to bridge the information gap and empower students with the knowledge they need to make informed choices about their sexual reproductive health rights.