A novel approach to prevent HIV infection will be studied by ICAP in Mozambique’s Gaza Province, in collaboration with the World Health Organization (WHO) and with funding from the Bill and Melinda Gates Foundation. The study will assess the use of pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition by female partners of miners during periods of increased risk of infection.
Oral PrEP is an efficacious HIV prevention intervention that involves the use of antiretroviral drugs to reduce the risk of acquiring HIV infection. In 2012, the WHO released recommendations on the use of PrEP for HIV-serodiscordant couples and men who have sex with men, and called on countries to undertake demonstration projects to assess the feasibility of PrEP implementation and scale-up.
To assess whether PrEP would be considered as a potential HIV prevention tool in Gaza, ICAP will conduct a feasibility study using quantitative and qualitative methods to assess the knowledge, understanding, and perceptions of PrEP among migrant miners’ female partners, miners themselves, and health care providers. The study will explore the willingness of female partners to take periodic PrEP during the time when their partners are visiting home, and will assess possible structural and individual level barriers to accessing PrEP in this setting.
Gaza Province is located on Mozambique’s border with South Africa and has the highest HIV prevalence in the country—25 percent, compared with a national prevalence of 11.5 percent. It is a source of migrant labor for South Africa’s mining industry, with many men from the province working in mines across the border for extended periods of time, only returning home for family visits during holidays such as Christmas and Easter. With such long separations from their families, it is common for migrant miners to engage in sexual activity with other women beyond their sexual partners in Gaza—including sex workers—which puts both themselves and their partners back home at risk of contracting HIV. It is during these periods of home visits that the feasibility of using PrEP will be explored.
To recruit study participants, ICAP will collaborate with The Employment Bureau of Africa (TEBA), a labor recruitment organization for mines in the region. This collaboration builds on ICAP’s previous work with TEBA in Lesotho, where recruitment offices were used as point of care to provider miners and their families with much-needed TB/HIV services.
“The findings from this pilot study, the first phase of this effort, will inform the design of a larger-scale HIV prevention study on the periodic use of PrEP in this population,” said Dr. Wafaa El-Sadr, ICAP’s director, hopefully offering another option for this population at risk, and contributing to future HIV prevention strategies in Mozambique.”