Advancing use of long‐acting and extended delivery HIV prevention and treatment regimens

Delany‐Moretlwe, Sinead; Flexner, Charles; Bauermeister, José A.

doi:10.1002/jia2.26126

Cited by 3 publications

(1 citation statement)

References 22 publications

(22 reference statements)

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“…rings, films, implants, vaccines and rectal microbicides [RMs]) [ 1 , 2 ], has reinforced the need to understand how individuals make decisions regarding their preferred HIV prevention strategies. Preferences in HIV prevention strategies may also vary based on diverse socio‐cultural contexts, including the availability of PrEP modalities and healthcare infrastructure across regions [ 3 − 5 ].…”

Section: Introductionmentioning

confidence: 99%

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

Bauermeister,

Lin,

Tingler

et al. 2024

J Int AIDS Soc.

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IntroductionEnd‐user perspectives are vital to the design of new biomedical HIV prevention products. Conjoint analysis can support the integration of end‐user perspectives by examining their preferences of potential pre‐exposure prophylaxis (PrEP) products. The Microbicides Trial Network (MTN) 035 protocol examined three placebo rectal dosage forms (insert, enema and suppository) that could deliver PrEP prior to receptive anal sex (RAS).MethodsBetween April 2019 and July 2020, we enrolled 217 HIV‐negative, cisgender men who have sex with men (MSM; n = 172; 79.3%) and transgender people (n = 47; 20.7%) ages 18–35 into a randomized cross‐over trial across Malawi, Peru, South Africa, Thailand and the United States. Participants used each product prior to RAS over 4‐week periods. Participants completed a conjoint experiment where they selected between random profiles using seven features (dosage form, timing of use before sex, side effects, duration of protection, effectiveness, frequency of use and need for a prescription).ResultsEffectiveness was the strongest determinant of choice (30.4%), followed by modality (18.0%), potential side effects (17.2%), frequency of use (10.8%), duration of protection (10.4%), timing of use before sex (7.4%) and need for a prescription (5.9%). Relative utility scores indicated that the most desirable combination of attributes was a product with 95% efficacy, used 30 minutes before sex, offering a 3‐ to 5‐day protection window, used weekly, having no side effects, in the form of an enema and available over‐the‐counter.ConclusionsChoice in next‐generation PrEP products is highly desired by MSM and transgender people, as no one‐size‐fits‐all approach satisfies all the preferences. MTN‐035 participants weighed product features differently, recognizing the need for diverse, behaviourally congruent biomedical options that fit the needs of intended end‐users.

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Section: Introductionmentioning

confidence: 99%

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

Bauermeister,

Lin,

Tingler

et al. 2024

J Int AIDS Soc.

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A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation

Li,

Liu,

Nehl

et al. 2024

Current Opinion in HIV and AIDS

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Purpose of review The ’PrEP cliff’ phenomenon poses a critical challenge in global HIV PrEP implementation, marked by significant dropouts across the entire PrEP care continuum. This article reviews new strategies to address ‘PrEP cliff’. Recent findings Canadian clinicians have developed a service delivery model that offers presumptive PEP to patients in need and transits eligible PEP users to PrEP. Early findings are promising. This service model not only establishes a safety net for those who were not protected by PrEP, but it also leverages the immediate salience and perceived benefits of PEP as a natural nudge towards PrEP use. Aligning with Behavioral Economics, specifically the Salience Theory, this strategy holds potential in tackling PrEP implementation challenges. Summary A natural pathway between PEP and PrEP has been widely observed. The Canadian service model exemplifies an innovative strategy that leverages this organic pathway and enhances the utility of both PEP and PrEP services. We offer theoretical insights into the reasons behind these PEP–PrEP transitions and evolve the Canadian model into a cohesive framework for implementation.

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Adolescents and young adults with HIV and unsuppressed viral load: where do we go from here?

Rakhmanina,

Foster,

Agwu

2024

Current Opinion in HIV and AIDS

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Purpose of review Adolescents and youth living with HIV (AYLHIV) have worse outcomes at all stages of the care cascade when compared with adults, yet adolescents and youth with unsuppressed viral load are typically excluded from phase 3 studies of novel HIV therapeutic agents and emerging strategies. Long-acting agents have the potential to radically change outcomes for young people struggling with adherence to daily oral HIV medications. Recent findings 1.5 million children aged less than 15 years live with HIV and more than 100 000 acquire HIV perinatally every year. Adolescents and youth aged 10–24 years comprise ∼40% of global incident HIV infections. Rates of viral suppression among AYLHIV vary markedly from 44 to 88%, resulting in morbidity and risks of transmission to partners and infants. Virological failure is mostly due to poor adherence, and AYLHIV express high levels of interest and acceptability of alternatives to oral daily medications, such as long-acting antiretroviral formulations. Emerging data regarding their use in populations with unsuppressed viral load are encouraging. Summary AYLHIV, including populations without virologic suppression, must be prioritized for the programmatic implementation and research of long-acting HIV drugs and other therapeutic strategies to prevent morbidity and mortality and to ultimately end the HIV epidemic.

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Advancing use of long‐acting and extended delivery HIV prevention and treatment regimens

Cited by 3 publications

References 22 publications

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation

Adolescents and young adults with HIV and unsuppressed viral load: where do we go from here?

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