Rwanda is piloting the possibilities of making HIV-prevention pills—which are currently only accessible to key populations in the country—available to all. The pilot for pre-exposure prophylaxis (PrEP) is at its early stage but has reached more than 196 health facilities countrywide, according to Rwanda Biomedical Centre (RBC) PrEP is pill taken by HIV-negative people to protect them from infection. Taking pills can stop the HIV virus from establishing an infection in a person who has been exposed. In Rwanda, not everybody can access these pills. Those who do are selected based on eligibility criteria and have to fall under a certain category or group of people. “These current target groups are, discordant couples where the partner who is HIV negative takes them to avoid contracting the virus, the second group is for female sex workers because they have multiple sexual partners and their condom use is low,” said Jean Pierre Ayingoma, Key Population Strategic Officer at RBC. The third group, he added, is gay people because they are at high risk of contracting the virus or they do not know their HIV status. The pilot process which started last year in just ten health facilities in Kigali will determine the effectiveness affordability and accessibility of the drug in Rwanda. “We started with these people because they are at substantial risk of contracting the virus more than others, but once the pilot phase is over…our plan is to see how we can roll out these pills in pharmacies and more health centres so they can be accessible to everyone,” Ayingoma said. While no study about the drug has been conducted in Rwanda, various research elsewhere has shown that when used properly the substantial risk it can reduce the risk of contracting HIV by 92-99 per cent. Male users have to take the pills seven days before the substantial risk and female 21 days. Ingabire Emery Jocelyne Associate Director, a Community Outreach at Health Development Initiative (HDI), said 60 per cent of new HIV infections are key populations—groups at increased risk of contracting HIV. “So, it was crucial to start with these groups. For example, HIV prevalence in female sex workers is 35.5 per cent, 4.3 per cent in gay people and three per cent in the general population,” she said. For these people to access PrEP pills, she explained, we have programs under which we identify these people, and we record them and know who they are. It is through these programmes that they can get help in accessing the pills in different health centres, she said. Sage Semafara, the Executive Secretary at Rwanda Network of people living with HIV, welcomed the prospects of a universal rollout of these drugs. According to the 2019 report by RBC, the prevalence of HIV among adults in Rwanda was three per cent. This corresponds to approximately 210,200 adults living with HIV in Rwanda with more women (3.7 per cent) than men (2.2 per cent) living with HIV.
