The Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) consortium is introducing long-acting injectable cabotegravir for pre-exposure prophylaxis (CAB for PrEP) alongside oral PrEP and the PrEP ring in five African countries.
MOSAIC is a five-year (2021-2026) global project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID) and is led by FHI 360.
MOSAIC’s primary goal is to empower adolescent girls, young women, and other women to prevent HIV by accelerating the introduction and scale-up of new and emerging biomedical prevention products.
Proposed countries for MOSAIC’s work include Kenya, South Africa, Zambia, Zimbabwe, Eswatini, Lesotho, Uganda, Namibia, and Nigeria.
As reported by Spiked, South Africa and Zimbabwe are the first to welcome CAB for PrEP following regulatory approval and the arrival of the donated product on site.
The rollout is part of Catalyzing Access to New Prevention Products to Stop HIV (CATALYST), a three-year, multi-country implementation study that aims to assess the delivery of multiple PrEP methods to an estimated 11,000 HIV-negative participants.
The study is taking place across 28 public health service delivery sites supported by PEPFAR in Kenya, Lesotho, South Africa, Uganda and Zimbabwe. As of March 31, nearly 4,000 participants have been enrolled.
Dr. Atul Gawande, assistant administrator for global health at USAID, said:
USAID’s commitment to cutting-edge research and development is advancing innovative solutions to some of the world’s greatest health challenges. We see that with CATALYST.
This study is supporting women and girls by expanding their options of methods for HIV prevention and by producing findings that will guide the scale-up of these prevention methods across the African continent.
Dr Kristine Torjesen, director of science facilitation at FHI 360, said:
CATALYST is the largest study of its kind and represents a locally-led, youth-focused implementation project in which participants have the opportunity to be among the first to learn about and try new PrEP methods.
They will also make their voices heard in how PrEP is rolled out in their communities, which is critical given that adolescent girls and young women continue to bear the brunt of the HIV epidemic in many places.
The study is being conducted in two stages. Between May and October 2023, stage 1 launched across all sites in all five countries and includes tenofovir-based oral pills and the dapivirine ring (PrEP ring).
The second stage begins once CAB for PrEP has been approved by the national regulatory authority in each country and the donated product is available on-site.
Participants will be followed for one to three years to collect information about how they choose, use, switch between and like the offered PrEP methods.
The study results will offer valuable evidence to guide the future expansion and sustainability of HIV prevention options, ultimately contributing to a transformative impact on HIV prevention.
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