The US President's Emergency Plan for AIDS Relief is currently taking comments on its draft 2021 "Country Operational Plan" guidance. This is a critical framework for determining what gets paid for and programmed in the 2021-22. The COP guidance says that PEPFAR programs should start to explore new prevention tools including the dapivirine vaginal ring (DVR) and long-acting injectable cabotegravir (CAB-LA), along with oral PrEP. This is great news. Countries and other funders should follow suit. BUT the draft guidance says,
"Oral PrEP should be offered to all women at high risk of HIV infection but for
those who decline or are unable to adhere to daily dosing, the DVR, when widely available may
be offered as part of a comprehensive prevention program with thorough counseling, adherence
support, and education on risk reduction." I've added my voice to the COP guidance feedback survey to let PEPFAR know that all people should choose the strategies that work for them, without needed to "decline" or showing that they cannot adhere. I've helped PEPFAR be "pro-choice"!