Africa is Significant Piece in Global Aims for PrEP Utilization

It is vital to get the global society to adopt pre-exposure prophylaxis (PrEP) to help prevent the spread of HIV, and WHO has certainly taken on this task.

Back in 2015, the WHO recommended offering once-daily oral PrEP to people at substantial risk of HIV acquisition, and in the following year, the United Nations General Assembly set a global target of 3 million oral PrEP users by 2020. 

 A study published in The Lancet HIV, found that there were 626,000 PrEP users in 77 countries in 2019, after two-thirds of countries (120) had adopted WHO recommendations into national guidelines. This resulted in a 69% increase from 370,000 PrEP users across 66 countries in 2018, when 30 countries had adopted the recommendations, but fell short of its goal of 3 million oral PrEP users by last year.

Sub Saharan Africa is one region that is scaling up its PrEP usage, but the continent as a whole remains challenged by HIV. South Africa, for example, has the largest HIV/AIDS population in the world with 7.5 million people, according to the CIA World Fact Book’s latest estimate done in 2019. In addition, it has the fourth largest prevalence with 17.3% and the highest mortality with 72,000 deaths estimated that same year.

South Africa also has the largest antiretroviral (ART) program in the world. There are over 3 million people on ART according to one 2015 statistic. One can imagine if South Africa has the public health structures in place to deliver ART that the addition of PrEP should be made easier.

Renee Heffron, PhD, MPH, associate professor, Global Health, associate professor, Epidemiology, Department of Global Health, University of Washington has been working in African countries to help with understanding local cultures and developing strategies to create greater PrEP utilization.

For example, in order for PrEP to be getting out into the African communities of need, it is important to have conversations and engage people where they are locally and not just in clinics or health care settings and understand the structural barriers that prevent people from taking it.

Heffron participated on a panel at the 11th International AIDS Society Conference on HIV Science in July and made a presentation titled, Preparing for Delivery of Proven Efficacious interventions, during it. She spoke about the various therapeutics in PrEP, lessons learned about daily oral PrEP, and tied it together by talking about the importance of community health.

Contagion spoke to Heffron who provided insights into her presentation, PrEP usage in Africa, and structural barriers to greater initiation.