At the moment, there are very few biomedical interventions that have been shown to work to prevent HIV infection in adolescent girls and young women (AGYW). This is partly why there is considerable interest in addressing the structural drivers.
However, recent results for two antiviral approaches have been shown to be highly effective if they are used correctly: oral Pre-Exposure Prophylaxis (PrEP) and the dapivirine vaginal ring. We are working as part of the OPTIONS project to research two aspects of how these interventions might reduce infection in AGYW.
Specifically we are conducting mathematical modelling studies to estimate the impact of different levels of usage of PrEP and vaginal rings when used by different people. How much protection do they give? What impact does it have on transmission throughout the population? We are combining this modelling with economic analysis, particularly looking at elicited preferences for different interventions from Discrete Choice Experiments, as well as costs of delivery. In particular, we are interested in the interactions between risk of infection and transmission (both perceived and real), preferences and costs. These factors are unlikely to be independent (e.g. the highest risk of infection might be the most expensive to deliver to, and the least likely to want to take PrEP).
This study is ongoing.