The United States Foods and Drugs Administration recently approved the use of an injectable drug to prevent HIV, a development towards eliminating the disease. The pre-exposure prophylaxis (Prep) which goes by it brand name Apertude is approved for at-risk adults and adolescents who weigh at least 35 kg to reduce the risk of sexually acquired HIV. It is administered to HIV-negative people only. “Today’s approval adds an important tool in the effort to end the HIV epidemic by providing the first option to prevent HIV that does not involve taking a daily pill,” Debra Birnkrant, the Director of the Division of Antivirals in the FDA’s Centre for Drug Evaluation and Research, was quoted by US media. The development comes at a time when Rwanda has piloted the administration of PrEP pills which has reached more than 196 health facilities countrywide. The PrEP pill is also taken by HIV-negative people to protect them from infection in case of exposure and research conducted in other countries shows that it can reduce the risk of contracting HIV by 92-99 per cent. Male and female users have to take the pills seven days and 21 days respectively, before the substantial risk, this is while Apertude, after the initial two injections, is administered one month apart, then every two months after that. Dr. Basile Ikuzo, Director for HIV prevention at Rwanda Biomedical Centre (RBC), said this is a commendable development, however, there is still a line of procedures that have to be met before Rwanda starts to think of securing and administering the drug. “Even though it was approved in the US, the drug has to be assessed and approved by the World Health Organisation so that any other country can start using it,” he said. The PreP pill is expensive, and Rwanda has made it available free of charge to people at high risk of exposure based on some eligibility criteria, he said. 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. The third group is gay people because they are at high risk of contracting the virus or they do not know their HIV status. 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, according to Jocelyne Emery Ingabire, Associate Director of Community Outreach at Health Development Initiative (HDI). Hence, emphasising the priority access to PreP for those people that fall under the categories highlighted above. A 2019 report by RBC in 2019 show that 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.
