By Michael Gwarisa
Following the delivery of injectable Pre-Exposure Prophylaxis (PrEP) doses, Zimbabwe through the Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) consortium, has launched stage 2 of the CATALYST study, introducing the newly approved injectable PrEP. The study is funded by funded by PEPFER through USAID.
The CATALYST study was initially launched in 2023 where two PrEP methods — tenofovir-based oral pills and the dapivirine ring (PrEP ring) — were offered.
The CATALYST sites remain the same six sites where stage 1 was conducted. These include the SHAZ! Hub in Chitungwiza, Runyararo clinic in Masvingo, Ngundu rural health centre, The Wellness clinic in Beitbridge, Cowdray Park clinic in Bulawayo and Plumtree District Hospital.
In an interview with HeathTimes, Definite Nhamo, the Senior Programs Manager at Pangaea Zimbabwe and Deputy Lead of the CATALYST study in Zimbabwe, said the goal is to expand HIV prevention options and ensure informed choice.
The CATALYST study was initially launched in June 2023 with oral PrEP and the monthly PrEP ring being offered under stage 1. Now, with stage 2 launch, we have added an additional HIV prevention option –injectable PrEP, which works for two months before another injection is needed. We have waited for so long to have choice in HIV prevention and for us, stage 2 represents expansion in HIV prevention options.”
She added that under the CATALYST implementation science study, in stage 2, communities enrolling in CATALYST should expect to exercise choice among three biomedical prevention options namely oral PrEP, PrEP ring and injectable PrEP.
“Just like in stage 1, if none of the three options suit their lifestyle, participants can still choose to be on no method. CATALYST is an implementation science study, with this, we expect to understand how participants will exercise choice when presented with options in HIV prevention. We also expect to see how long participants stay on a chosen product and how they cycle between products and on and off study product.”
The initial stages of stage 2 will see those who enrolled on stage 1 and were waiting for injectable PrEP or those who enrolled, were initiated on oral PrEP or PrEP ring but, want to switch to injectable PrEP being offered injectable PrEP.
“We will open up CATALYST to new participants after we have given all enrolled stage 1 participants an opportunity to choose whether they want to switch to the injection,” added Nhamo.
The eligibility criteria remain the same as that of stage 1 where those already enrolled include HIV-negative women in their diversity, this includes, Adolescent Girls and Young Women (AGYW), and female sex workers, among others.
“However, for pregnant and breastfeeding populations, they can only be initiated on oral PrEP. In line with national guidance, anyone who is pregnant of breastfeeding will not have the option of the PrEP ring or injectable PrEP in CATALYST. Those who fall pregnant and are on the PrEP ring or injectable PrEP, will be counseled appropriately and they will in turn make an informed decision on whether they want to continue on the study product or not. For the PrEP ring, after delivery, an individual may choose to go back on the PrEP ring only after six weeks has elapsed post-delivery,” she said.
