MTN-034/REACH (Reversing the Epidemic in Africa with Choices in HIV Prevention) was a Phase IIa open-label study designed to fill important gaps in information about the safety and acceptability of the monthly dapivirine vaginal ring and Truvada® as daily oral pre-exposure prophylaxis (PrEP) in girls younger than 18 and to supplement existing safety and acceptability data of these products in young women ages 18-21. Both the ring and oral PrEP must be used consistently to prevent HIV, which previous studies found to be especially challenging for adolescent girls and younger women. As such, REACH also sought to understand what kind of support they need to use the ring and oral PrEP as best they can and their preferences for each. REACH was conducted between February 2019 and September 2021 and enrolled 247 participants ages 16-21 at four sites in South Africa, Uganda and Zimbabwe, 86 or whom were under the age of 18. Results from the first two periods, when participants used each the dapivirine ring and oral PrEP for six months, found adolescent girls and young women can and will use these products consistently and there to be no safety concerns, including in girls ages 16 and 17. Results of the third six-month period, during which participants could choose to use either the ring or oral PrEP – or neither –demonstrated the importance of providing adolescent girls and young women with options and letting them make their own decisions about which method is best for them. Nearly all participants chose to use one of the two methods, with two-thirds opting for the ring, suggesting the ring would be a viable option for those girls and young women who can’t or choose not to use daily oral PrEP.
What do young women in Africa want for HIV prevention? They want choice.
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