Pangaea Zimbabwe’s consultations on the PrEP Ring and CAB-PrEP.

As Zimbabwe thinks ahead in expanding HIV prevention options, the country is in the process of adapting the WHO guidance on the dapivirine vaginal ring (PrEP Ring) and recently FDA approved long-acting cabotegravir (CAB-PrEP). With this, there are still a lot of unanswered questions around PrEP Ring. In April 2021, through The Preparing for Ring Opportunities through Market Introduction Support and knowledge Exchange (PROMISE) and the Collaboration for HIV Prevention Options to Control the Epidemic (CHOICE), PZAT conducted consultations with health care providers (HCP), potential end-users and key opinion leaders to understand the perceived needs and concerns around PrEP Ring and CAB-PrEP. The consultations were conducted to inform product introduction and rollout efforts.

HCPs welcomed the new prevention options and the possibility of expanding client choice which would likely lead to increased uptake of HIV prevention options. Service integration and synchronization of both family planning and HIV prevention was suggested to optimize resources and reduce user burden by cutting back on the number of trips one needs to make to access different services. HCPs expressed the need for training, provision of adequate tools and support materials to enable seamless service provision across multiple products. Potential end-users and key opinion leaders welcomed the need for discrete, long-acting products with concerns raised around the PrEP Ring’s modest efficacy and discomfort associated with vaginally inserted products. CAB-LA was hailed for its systemic properties and potential elimination of adherence issues. These findings are being considered as the country continues to plan to expand available HIV prevention options.

Additional stakeholder consultations, landscaping analyses, end user assessments, and introduction studies will be completed under MOSAIC (Maximizing Options to Advance Informed Choice for HIV Prevention) and learnings from these activities will be used to inform the R&D of new prevention products through MATRIX. As part of the Coalition to Accelerate and Support Prevention Research (CASPR), PZAT’s activities center on: enhancing advocacy capacity and impact at the global, national, sub-national, and community levels; preparing for next-generation PrEP options and expanding PrEP access; understanding vaccine hesitancy, improving vaccine confidence, and advocating for integration of community perspectives into vaccine delivery policies; advocating for policy change in improving research on and access to HIV prevention options for pregnant and breastfeeding people in Zimbabwe; and ensuring accurate media coverage of the HIV prevention landscape and trial conduct in Zimbabwe.