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Venereology, Volume 4, Issue 1 (March 2025) – 3 articles

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13 pages, 582 KiB  
Opinion
Advancing Health Solutions: Practical Considerations for Multipurpose Prevention Technologies in Sub-Saharan Africa’s Fight Against HIV, Sexually Transmitted Infections, and Unintended Pregnancies
by Nyaradzo M. Mgodi, Caroline Murombedzi, Grant Murewanhema, Enos Moyo and Tafadzwa Dzinamarira
Venereology 2025, 4(1), 3; https://doi.org/10.3390/venereology4010003 - 6 Feb 2025
Viewed by 481
Abstract
Sub-Saharan African (SSA) women experience a high prevalence of HIV, sexually transmitted infections (STIs), and unintended pregnancies, necessitating effective, integrated prevention strategies. Multipurpose prevention technologies (MPTs) offer a promising approach to address these overlapping health concerns by providing single products that simultaneously prevent [...] Read more.
Sub-Saharan African (SSA) women experience a high prevalence of HIV, sexually transmitted infections (STIs), and unintended pregnancies, necessitating effective, integrated prevention strategies. Multipurpose prevention technologies (MPTs) offer a promising approach to address these overlapping health concerns by providing single products that simultaneously prevent HIV, other STIs, and/or unintended pregnancies. Given the persistent sexual and reproductive health (SRH) challenges faced by women in SSA, in this opinion piece, we explore practical considerations for MPT adoption and scale-up within the region. With this opinion article, we discuss the data on MPT development and identify key factors for successful MPT implementation in SSA. We examine the current MPT pipeline, product features, regulatory challenges, and structural, individual, and community barriers that impact MPT acceptance and usage among SSA women. Successful MPT uptake hinges on designing discreet, user-controlled products and engaging end-users, healthcare providers, and communities in product development and promotion. Structural factors such as robust supply chains, regulatory clarity, and financial support are also essential. Addressing socio-cultural norms, especially partner consent, and strengthening demand creation through community-driven, culturally sensitive strategies are critical for scaling MPTs. In conclusion, MPTs represent a transformative opportunity to reduce the burden of HIV, STIs, and unintended pregnancies in SSA. Strategic, culturally attuned approaches are essential to ensure the acceptability and accessibility of MPTs. Expedited pathways for regulatory approval, collaborative partnerships, and community-centered demand creation will be vital to realize the full potential of MPTs in advancing women’s SRH in SSA. Full article
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13 pages, 565 KiB  
Review
The Budget Impact of Adopting Oral Pre-Exposure Prophylaxis for HIV Prevention: A Rapid Review
by Enos Moyo, Perseverance Moyo, Leela Barham, Derek Mangoya, Malizgani Mhango and Tafadzwa Dzinamarira
Venereology 2025, 4(1), 2; https://doi.org/10.3390/venereology4010002 - 26 Jan 2025
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Abstract
The World Health Organization (WHO) recommended the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention in 2015. Although the number of countries with national PrEP recommendations increased from 2 in 2015 to 121 in 2019, there has been slow progress in Africa. [...] Read more.
The World Health Organization (WHO) recommended the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention in 2015. Although the number of countries with national PrEP recommendations increased from 2 in 2015 to 121 in 2019, there has been slow progress in Africa. The reason for this slow progress is that developing countries have budgetary constraints. Budget impact analysis (BIA) is an economic analysis that can help explore the affordability of oral PrEP. A rapid review was conducted to summarise the existing literature on the budget impact of adopting oral PrEP for HIV prevention. PubMed and Google Scholar databases were searched for relevant studies. Studies included in the review utilised primary data. Eleven studies met the inclusion criteria. This review reveals that most studies took a healthcare service provider perspective, targeted men who have sex with men (MSM), had time horizons of more than 10 years, used macro-costing, and performed univariate sensitivity analysis and discounting. If countries wish to perform a budget impact analysis of adopting oral PrEP for HIV prevention, we recommend that they select a target population that is most at risk of acquiring HIV. In addition, a time horizon of ten years or more should be used, and accurate values of the cost of oral PrEP and antiretroviral therapy (ART) and adherence to oral PrEP should be researched. Furthermore, deterministic sensitivity analysis should be carried out instead of probabilistic sensitivity analysis (PSA), as the degree of variability and the extent of the correlation among the parameters may not be known. Full article
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11 pages, 693 KiB  
Article
Prevalence of Human Papillomavirus (HPV) and HPV Vaccination Completion Rates Among Gay and Bisexual Men in Dar es Salaam, Tanzania
by Lucy R. Mgopa, Ever Mkonyi, Mabula Kasubi, Alan G. Nyitray and Michael W. Ross
Venereology 2025, 4(1), 1; https://doi.org/10.3390/venereology4010001 - 25 Dec 2024
Viewed by 504
Abstract
High-risk Human Papillomavirus (HPV) is a sexually transmissible virus that causes cancer. Vaccination against HPV is available up to age 45. Gay and bisexual men (GBM) are at high risk for oropharyngeal and anal cancers caused by HPV. As part of a larger [...] Read more.
High-risk Human Papillomavirus (HPV) is a sexually transmissible virus that causes cancer. Vaccination against HPV is available up to age 45. Gay and bisexual men (GBM) are at high risk for oropharyngeal and anal cancers caused by HPV. As part of a larger study of HPV prevention in GBM, we obtained anal swabs for HPV and offered HPV vaccination to GBM in Dar es Salaam, Tanzania. Participants were recruited by an outreach worker experienced with the GBM subculture using Respondent-Driven Sampling (RDS) from seeds. Eighty-three of a possible one hundred participants (mean age 26) were enrolled, tested, and given a first vaccination dose. Anal swabs were tested for twenty-eight HPV genotypes, both high and low risk for carcinogenicity, and a median of seven different HPV genotypes was found in participants. A total of 87% of participants carried at least one HPV genotype, and 76% carried at least one high-risk genotype. As a result of harassment and unanticipated risk to participants and staff at the unmarked community-based site, this study was terminated before the sample size was reached. Since a full course of vaccine was the standard of care, participants were contacted using the contact method they had provided to arrange follow-up vaccination doses at an alternative clinical site. Twenty-nine percent received the additional vaccination. A further 6% made appointments but did not attend, and another 10% would have received the second vaccination if they were incentivized to attend. The rate of HPV in anal samples was significantly higher than in our study using the same recruitment method in the same city in 2011–2012. The HIV rate was 45%. Anal HPV rates, including high-risk HPV rates, were significantly higher than in a similar population of gay and bisexual men 12 years ago. It is possible to provide HPV vaccination to gay and bisexual men in Tanzania and have approximately 45% potentially re-attend for a second dose if they are incentivized. Great care must be used to situate vaccination to avoid stigma leading to harassment, especially where homosexuality is criminalized. We infer that the high-risk harassment faced by participants and lack of incentive for the second visit depressed the return rate for revaccination. Full article
(This article belongs to the Special Issue Exclusive Papers of the Editorial Board Members of Venereology)
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