Vaginal Ring, Injectable ARVs to be added on List of PrEP Options in Uganda this Year

The Ministry of Health will this year add the vaginal ring and injectable anti-retroviral therapy cabotegravir to the list of options for Pre-Exposure Prophylaxis (PrEP) for HIV-negative individuals who are at high risk of infection.

Dr. Joshua Musinguzi the AIDS Control Programme Manager at the Ministry of Health told URN in an interview that they are currently in the process of reviewing guidelines for HIV prevention and treatment to add new innovations that could help them reduce the new HIV infection rates.

Coming at a time when Uganda is estimated to be recorded about a thousand new infections each week, Musinguzi, says that they are currently quantifying to see the supplies they will need to make these products available and the methods that they will use to roll them out this year. 

The plan he says is to first enroll small numbers of people who are most at risk of infection like sex workers and then scale it up to cover more people later.   

Studies to test the effectiveness of the two new interventions were conducted in Uganda and the methods have since been introduced in many other countries following recommendations by the World Health Organization. 

While the vaginal ring, which is supposed to be replaced monthly was recommended in 2021, CAB-LA the intramuscular injectable, long-acting form of PrEP was recommended by the global health body last year.

According to guidelines the first two injections are supposed to be administered four weeks apart and thereafter are followed by an injection every eight weeks.

Since the two methods are currently unavailable in Uganda, the only PrEP option available is the oral drugs supposed to be swallowed every day by those at risk including sex workers, people with multiple partners, and an HIV-negative partner in a discordant couple relationship.

This program was first rolled out under controlled settings and access to medicine initially HIV drug Truvada was through a few specific sites. The 2022 figures by the Ministry of Health show that oral PrEP is available in two hundred and sixty facilities in Uganda and more than 175,000 people are using it.

However, while plans to have the new products rolled out look to be in the final stages, Musinguzi couldn’t reveal whether these would be funded by the government or donors. So far, The U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR) which is one of the largest funders for HIV prevention and treatment interventions does not fund the vaginal ring for instance. Mary Borgman the PEPFAR Uganda Country Coordinator said the device is not currently approved for use in the United States and therefore they cannot fund it.

To select programs to fund in any country, she says they look at products that would have the greatest impact on the resources invested.  

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