There is a compelling need for new HIV biomedical prevention approaches in sub-Saharan Africa, especially for young women. Despite the availability of proven HIV prevention strategies and increasing use of antiretroviral therapy globally, more than 1.8 million new HIV infections occur each year, and women and girls in sub-Saharan Africa bear a disproportionate disease burden.
Traditionally, new HIV biomedical prevention products have been designed for use primarily in developed countries, with subsequent access — with market introduction delays up to several years — in developing countries. Adherence challenges with oral pre-exposure prophylaxis and vaginal rings used by young women in sub-Saharan Africa have led to diminished effectiveness in real-world and clinical research settings. These findings emphasize the importance of understanding the needs and preferences of end users early in the development process to ensure products and clinical plans are designed to best meet their needs and will be embraced by them.
For IAVI, understanding the needs of affected populations in local communities is critical to designing, developing, and delivering vaccines and other prevention products with the fewest barriers to access and the greatest potential for impact. As a key element of IAVI’s product development vision, we and our African Clinical Research Center partners have worked for over a decade engaging local communities at high risk of HIV infection, and are working to understand the preferences and circumstances of these target populations (in particular young women, adolescents, men who have sex with men, and other at-risk populations) to inform the plans for future product development and implementation in real-world settings.
For example, we worked with local video production crews to interview 12 women living in Kenya and South Africa, who described to us, in their own words, the cultural and economic barriers that hinder their ability to protect themselves against HIV infection. “Through Our Eyes” documents their struggles and resilience, making a clear case for including women and girls in efforts to control and eradicate HIV/AIDS (Watch the videos). In addition, we conducted qualitative research with young women, men, and health care providers in Kenya and South Africa to understand their needs and preferences for new long-acting methods of HIV prevention.