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A dialogue with young women in Kenya on women-initiated HIV prevention options and Sexual Reproductive Health and Rights.

In September 2021, WACI Health led a team of young women on a dialogue on women-initiated HIV prevention options and Sexual Reproductive Health Rights (SRHR). Globally, these discussions are ongoing given the approval by WHO in July 2020, for the Dapivirine Vaginal Ring (DPV-VR) as an additional prevention choice for women at substantial risk of HIV infection as part of combination prevention approaches. Read more here. This news has since been considered a milestone in the quest to provide women with expanded choices for HIV prevention. Young women (aged 15-24), and adolescent girls (aged 10-19) in particular, account for a disproportionate number of new HIV infections. In sub-Saharan Africa, despite making up just 10% of the population, one out of every five new HIV infections happens among Adolescent Girls and Young Women (AGYW). In the worst-affected countries, 80% of new HIV infections
among adolescents are among girls, who are up to eight times more likely to be living with HIV than adolescent boys. It is estimated that around 50 adolescent girls die every day from AIDS- related illnesses. Dapivirine Vaginal Ring is intended for prevention of New HIV infection via vaginal sex in HIV Negative women 18 years and older. The Vaginal Dapivirine ring contains an antiretroviral drug
called Dapivirine which is released slowly over the course of one month directly to vaginal tissues to help protect against HIV at the site of potential infection. Little of the drug is absorbed elsewhere in the body resulting in low systemic uptake. There are studies underway
examining the safety of a combined Dapivirine-levonorgestrel ring that would protect against HIV infection and unwanted pregnancy, as well as different vaginal rings that combine antiretroviral and other medications to prevent STIs. “Unlike other HIV prevention methods like use of condoms, this female controlled innovation gives full control to women to look after their safety,” she says. Biological and social factors contribute to high rates of infections among women. “The high number of infections among women does not mean they have riskier sexual behaviors compared to men” Gloria Mululu, Program Officer WACI Health The Dapivirine Ring (DVR) in Kenya and many other countries in sub-Saharan Africa, initiative by advocates are ongoing thus calling for updating of ARV guidelines and Essential Medicines List to include Dapivirine Ring as other Regulatory national processes and approval are ongoing to
ensure access. The ring has currently been approved for use in Zimbabwe. This dialogue meeting resolved to have a campaign that looks at holistic needs of adolescent girls and Young Women’s HIV prevention and SRHR, Multipurpose HIV prevention, Protection of AGYW against Gender-based violence (GBV), and Inclusivity of women in all their diversities. “While a lot has been done to curb new HIV infections in the country, all stakeholders should move in and address the barriers to access HIV prevention options/tools by Adolescents, Girls and Young Women and be allowed to make a choice on which methods work for them. Dapivirine Ring is a game changer in women’s HIV prevention options. AGYW needs training as champions to lead on advocacy efforts towards country policy update and regulatory initiatives towards Dapivirine Ring access” Patricia Jeckoniah, Technical Advisor, Policy and Partnerships, LVCT. The vaginal ring is a complimentary prevention method in addition to other safe sex practices especially when women cannot access or use PrEP. It does not prevent infection from other sexually transmitted diseases or from pregnancy. “Four decades since the outbreak of HIV, the country has registered great strides in efforts to combat the virus. However, not much progress has been made around adolescents and young women, and time has come where scientists must include this demography as they develop HIV preventive methodologies. This subset is privy to Sexual Gender Based Violence (SGBV), and the young women movement must be well coordinated so that they are present in all spaces where their voices must be heard. They should be given opportunities to share their ideas about HIV mitigation, dealing with intimate partner violence amongst other issues related to SGBV. Further, the movement must ensure that girls are at the table every time their issues are being discussed, be ready to be mentored and ready to mentor other girls, especially in the rural communities. They must also be part of the research so that there is their representation in data gathering.” Faith FAO. Calling for safeguarding of the gains made in the fight against HIV new infections as we fight Covid 19, there is a need to invest around girls. There is a need to invest in capacity building, programs, exposure and money available to ensure that organizations can conduct their
activities. There is also a need to see how resources that are coming in are targeted to adolescent and young women programs towards building their capacity.

“For most adolescent girls and young
women, the availability of the ring
widens the pool of preventative options
to choose from. Young women are
diverse and have varied preferences.
The ring will improve the uptake and
access of HIV prevention products,”
Joyce Ouma, AVAC Fellow.

With- Me, in- me is an AGYW led campaign demanding expanded choice for HIV prevention for
AGYW and Sexual Reproductive health and Right (SRHR), Multipurpose HIV prevention tools,
protection against Gender-based violence (GBV), and Inclusivity of women in all their
diversities. The campaigns highlight challenges as faced by AGYW living with and impacted by
HIV and enhance the awareness among Health providers, policymakers, and youth-serving
organizations about the existing disparities.
“The greatest aspect about the Ring is its bodily autonomy. Nobody needs to know you are
using it hence giving you the power to be in charge of your own protection. This is a plus for
every woman and especially if you have started to develop trust issues with your sex partner”
Joyce Ng’ang’a, Policy advisor WACI Health.
For more information check this Reading Material


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