Injectable PrEP: What You Need To Know

Haein Kim is a GBGMC Intern, Daniel Kalu also contributed to this article.

HIV prevention and treatment methods have advanced over the years, improving the lives of those affected and potentially at risk individuals. Scientists have been studying newer strategies for long-acting HIV prevention and treatments which include: insertion, injection, infusion, or implantation. Today we will examine the research methods of injection also known as long-acting injectable cabotegravir (CAB LA).

Before doing so, we must first examine the oral methods of long-acting PrEP. Pre-exposure prophylaxis (PrEP) is a daily anti-HIV pill that can help reduce HIV infection amongst high risk individuals such as: men who have sex with men (MSM), female sex workers (FSW) or persons who sell sex workers, people who inject drugs (PWID), and Transgender people. However, this anti-HIV pill is only highly effective if taken twice daily consistently which may be difficult for certain individuals. Therefore, scientists began embarking on creating advanced and more effective ways to treat HIV with the least amount of barriers for patients and consumers.

Injectable PrEP involves the repeated injection of the long-acting drug antiretroviral cabotegravir (CAB LA) which can be taken bimonthly to every 6 months, depending on the individual. Injectable PrEP offers a superior efficacy to Oral PrEP in clinical trials. Researchers presented at the 23rd International AIDS Conference (AIDS 2020: Virtual) that PrEP administered as an injection every eight weeks was more effective in preventing HIV than oral PrEP in Gay, Bisexual men and Transgender women.

There are currently two trials being assessed: HPTN 083 which examines HIV-uninfected cisgender men and transgender women who have sex with men and HPTN 084 which examines HIV in uninfected women Headline findings were originally announced months ago when the HPTN 083 trials were terminated early due to fewer injections in those offered injection PrEP than those offered oral PrEP. At the time, the number of data collected only allowed the researchers to say that the injectable drugs were non inferior to the oral drugs. In other words, that, while it did seem to perform better, it has not passed a predetermined threshold enabling researchers to say it was clearly superior. The purpose of this threshold is to avert random effects.Today, Dr Raphael Landovits of the University of California Los Angeles, the principal investigator of the HPTN083 study, was able to say that bimonthly injections of the drug cabotegravir were superior in terms of preventing HIV infection to oral doses of a combination pill of tenofovir disoproxil fumarate plus emtricitabine (Truvada). Therefore, clinical research shows injectable PrEP is more effective than oral PrEP especially when it comes to maintaining adherence of the pills.

There is still much more research to be done about the injectable PrEP in order to safely distribute the drug among the wider population of HIV-infected and those at risk in the United States. Manufacturers must work in compliance with regulatory agencies to make the drug accessible and allow for feedback from users to help improve the drug. If you reside in a different country and would like to know if injectable PrEP is available in your local residence, please check your respective governmental health organization.

For more information and availability of long-acting injectable PrEP, visit the following links:

https://www.hiv.gov/hiv-basics/hiv-prevention/potential-future-options/long-acting-prep

https://www.avac.org/prevention-option/prep

https://www.prepwatch.org/nextgen-prep/long-acting-injectables/

About GBGMC:

Founded in 2018, Global Black Gay Men Connect is a group of Black, gay, bisexual and same-loving men forming a movement internationally to empower our communities, foster resilience against oppression and initiate an ever-growing platform for our collective voices to be heard. As a collective, GBGMC fosters an activist-led movement with the goal of building local power to intervene in discrimination and violence inflicted on Black Gay communities and men wherever they live. We strive to facilitate intentional involvement by engaging Black gay men across the world and developing the capacity to rapidly intervene on human rights issues surrounding mental and physical health, police brutality, immigration, and general well being.

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