Tackling HIV in Rwanda: The Role of PrEP and PEP in Addressing Rising Prevalence

By Elias HAKIZIMANA.

In Rwanda, the strategic use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) has become a cornerstone of the country’s efforts to combat the spread of HIV.

However, despite significant advancements, many individuals in vulnerable age groups remain unaware of these preventive measures. This gap in awareness poses a critical challenge to the national strategy aimed at curbing new HIV infections.

Consider the case of Goreth, a 23-year-old resident of Kicukiro District. Goreth, who recently graduated from university, finds herself at a crossroads.

Despite being educated, she has never heard of PrEP or PEP. Like many young Rwandans, she is aware of HIV but is not fully informed about the latest prevention strategies available.

Her primary source of information on sexual health has been through friends and sporadic school programs, which often focus on general knowledge rather than detailed, actionable information about preventive medications like PrEP and PEP.

In a different scenario, Mutetiwabo, a 32-year-old single mother from Gatsibo District, faces her own set of challenges. As a single parent, Mutetiwabo works multiple jobs to provide for her children.

Her busy schedule leaves little time for health education or visits to clinics, unless absolutely necessary. Although Mutetiwabo is part of a high-risk group due to her economic vulnerability and the nature of some of her informal work, she remains unaware of PrEP and PEP as options for HIV prevention.

Her knowledge about HIV prevention is limited to the use of condoms, which many in her community either dismiss or inconsistently use due to various misconceptions and societal pressures.

These scenarios highlight a critical issue: despite the availability of effective preventive medications, a substantial portion of the population, particularly in high-risk groups, remains uninformed about them.

Rwanda Biomedical Centre (RBC) recognizes this gap and has been working diligently to address it through comprehensive awareness campaigns.

RBC’s campaigns focus on increasing education, testing, and support for high-risk populations.

A recent 10-day campaign launched on May 8 targeted regions with the highest HIV positivity rates, including Rwamagana, Kayonza, Gatsibo, Nyagatare, and Kigali City. The campaign aimed to raise awareness about PrEP and PEP, distribute condoms, and emphasize the importance of regular HIV testing.

According to RBC’s 2022–2023 HIV annual report, there has been a significant increase in the number of adolescent girls and young women (AGYW) on PrEP, rising from 1,695 in January 2023 to 2,936 in June of the same year.

Similarly, the number of female sex workers and men who have sex with men receiving PrEP increased from 10,078 in July 2022 to 10,789 in June 2023.

These figures demonstrate progress but also highlight the need for continued efforts to reach those still unaware of these preventive options.

Dr. Basile Ikuzo, Director of the HIV Prevention Unit at RBC, stresses the importance of improving health services and empowering healthcare providers to reach out to vulnerable groups.

“Over 300 trained health facilities are now offering PrEP to targeted groups in need,” Dr. Ikuzo notes. “For those exposed, such as in cases of accidental needle sticks or unprotected sex, we recommend they visit the nearest health facility to receive PEP medication within 72 hours to prevent new infections.” He adds.

RBC’s approach is multifaceted, encompassing not only the provision of PrEP and PEP but also broader initiatives that include formal education, life skills training, and economic support aimed at building resilience among vulnerable populations.

This comprehensive strategy is essential in ensuring that individuals like Goreth and Mutetiwabo are not left behind.

Local governments are also playing a crucial role. For example, in Nyagatare District, the Vice Mayor in charge of Social Affairs, Juliet Murekatete, highlights efforts to engage vulnerable groups through community discussions and household sensitization.

“We have registered several sex workers who have left the profession and formed development cooperatives. They have embraced the importance of using PrEP and PEP within their social networks, which we believe will help reduce new infections,” she explains.

Nationwide, the increase in PrEP availability—from 330 out of 584 trained health facilities offering the medication—alongside community efforts to educate and support high-risk individuals, marks significant progress in Rwanda’s HIV prevention efforts.

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