2018: Kenya women join world in search for HIV prevention tools

By Gatonye Gathura

The search for a HIV stopper has entered a new phase this year with thousands of Kenya women volunteering in about half a dozen clinical trials.

More women than males are participating in several HIV drug trials locally despite what researchers say is strong opposition from their men.

Having pioneered in new HIV prevention technologies last year Kenyans are playing an even bigger global role in stopping HIV in 2018 and beyond.

In May Kenya became the second county in the continent, after South Africa to roll out a daily HIV prevention pill and self-testing kits.

Currently an estimated 13,000 Kenyans are on the daily prevention drug called PrEP roughly popping down about 390.000 pills a month.

“But adherence can be problematic especially for a daily dose,” say HIV expert Dr Kenneth Ngure of Jomo Kenyatta University of Agriculture and Technology.

To overcome the adherence problem, Dr Ngure says alternatives delivery options are already being tested in Kenya and elsewhere.

At a recent media briefing in Nairobi organized by the Kenya Women Medical Association (KMWA) Dr Ngure said such trials involve long lasting injectables, implants, vaccines, viginal rings and microbicides.

“Because females are at higher risk of HIV infection than males most prevention tools under development are targeting women,” says Dr Christine Sadia, chairperson KMWA.

Of about 70,000 new HIV infections in Kenya annually, Dr Sadia says almost half are among women aged 15-24.

“These young girls must be protected and more importantly allow them make own informed choices.”

But new evidence shows most Kenyan men are opposed to their women participating in HIV research without their consent.

In a study published two weeks ago and led by Dr Ngure, men said their women should not take part in HIV research without express permission from the man.

The research among discordant couples in Thika, Kiambu County, sought the couples’ opinion on whether a woman who becomes pregnant while on PrEP should continue with the study and who makes the final decision.

‘I’ said most of the men. While many women appreciated the social support that comes with their male partner they preferred to make own decisions.

Ethics, however the study says do not allow the man to insist making the decision against the wishes of the woman.

“It will however be important to work for a middle of the road solution whenever possible,” says the study published last month in the journal Reproductive Health.

 

Planned and ongoing HIV drug trials in Kenya

  1. Injectables

CABOTEGRAVIR or (CAB) Study

This is examining the safety and effectiveness of a two month long lasting injectable drug for HIV prevention as compared to the daily oral PrEP.

Currently the study is recruiting 3,200 HIV-uninfected, sexually active women from Kenya, Uganda, Botswana, Malawi, Swaziland, South Africa, and Zimbabwe.

  1. Viginal Ring

REACH Study – Also called dapivirine ring it is similar to the viginal rings already being used for contraception except that it contains the ARV drug dapivirine. The ring releases the drug for at least one month.

The study will begin at the middle of this year with 300 sexually active adolescent girls from Kenya, South Africa, Uganda and Zimbabwe. It will assess the safety and acceptability of and adherence to the vaginal ring as compared to oral PrEP.

  1. Antibodies

Antibody Mediated Prevention Study – AMP

Antibodies, substances that protect the body against diseases, are to be infused through a drip into a healthy individual every two months to see whether the person will develop ability to fight HIV.

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The study is currently enrolling 1,500 sexually active, HIV uninfected women from Kenya, Botswana, Malawi, Mozambique, Tanzania, South Africa and Zimbabwe.

  1. Contraceptives

Evidence for Contraceptive Options and HIV Outcomes – ECHO Study

This study involving 7,800 sexually active women from Kenya, South Africa, Swaziland, Zambia is evaluating whether three contraceptives in use: the injectable Depo-Provera, the implant Jadelle and the IUD Copper T increase the risk of users in contracting HIV.

Results expected at the end of this year.

  1. Vaccine

HIVconsv Study

Recently the Kenya Aids Vaccine Initiative completed a safety and efficacy trial among 72 HIV uninfected male and female volunteers in Kangemi, Nairobi. Called HIVconsv results are being used to plan for larger studies.

  1. Multipurpose

SCHIELD Study

In November USAID awarded $4.8 million to Research Triangle Park of the US to develop a dual-purpose drug delivery device for both HIV and pregnancy prevention. The study will be done in Kenya and South Africa.