Impact of long-acting therapies on the global HIV epidemic

Chandiwana, Nomathemba; Serenata, Celicia; Owen, Andrew; Rannard, Steve; Casas, Carmen Pérez; Scott, Cherise P.; Hill, Andrew; Clayden, Polly; Flexner, Charles

doi:10.1097/qad.0000000000003102

Cited by 21 publications

(12 citation statements)

References 53 publications

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“…Further studies will be needed to explore more on how preconceptions and previous experiences with injectable methods and relationship with the health system would play a role in the implementation phase of the use of LAI-ART. 7 , 11 …”

Section: Discussionmentioning

confidence: 99%

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Preference for long-acting injectable for ART and PrEP among people with and without HIV: a cross-sectional study in Argentina

Sciannameo,

Zalazar,

Spadaccini

et al. 2024

Therapeutic Advances in Infection

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Background: Little is known about the preferences for antiretroviral therapy (ART) administration methods, such as oral daily pills or long-acting injectable (LAI) options, as well as preferences for pre-exposure prophylaxis (PrEP) administration methods among people without HIV in Latin America. Objectives: This study aimed to assess the preferences for ART administration methods among people with HIV and PrEP methods among those without HIV, as well as to examine the correlations and reasons for these preferences. Design: We conducted a cross-sectional web-based questionnaire between April and July 2021, using social media accounts of a HIV non-governmental organization. The questionnaire was open to all adults living in Argentina, irrespective of their sexual orientation or gender identity. Methods: The questionnaire included questions on substance use, depression, chronic treatment, previous experiences with injectable medication, and HIV status. Those with HIV answered questions about ART adherence and their preferences for ART methods, while those without HIV were asked about condom use, awareness of PrEP, and their preferences for PrEP methods. Results: Out of 1676 respondents, 804 had HIV, and 872 did not. Among those with HIV, 91.5% expressed a high preference for LAI-ART, with significantly higher preferences among participants with higher educational levels, cisgender gay, bisexual, and queer men, younger individuals, and those with prior injectable medication experience. Among those without HIV, 68% preferred LAI-PrEP, and this preference was positively associated with previous positive experiences with injectable medication. Conclusion: The strong preference for LAI-ART suggests the potential for improved adherence and well-being among people with HIV. Additionally, the preference for LAI-PrEP among those without HIV emphasizes the importance of considering this option for HIV prevention strategies. This study highlights the need to offer diverse methods for ART and prevention to accommodate different preferences and improve health care outcomes in Latin America.

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Section: Discussionmentioning

confidence: 99%

“… 4 Moreover, in the last decade, there have been significant advances in the HIV field, with studies involving LAI options for antiretroviral administration, proving their safety and effectiveness in HIV management, both for therapy and prevention. 5 – 7 …”

Section: Introductionmentioning

confidence: 99%

Preference for long-acting injectable for ART and PrEP among people with and without HIV: a cross-sectional study in Argentina

Sciannameo,

Zalazar,

Spadaccini

et al. 2024

Therapeutic Advances in Infection

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“…Long-acting injectable PrEP with cabotegravir is given first as two initiation injections administered 1 month apart, and every 2 months thereafter. 15 The cabotegravir long-acting dosage is considered the main advantage of this PrEP modality, 35 while effectiveness of oral PrEP depends on adherence to medication, a critical factor in certain groups, such as young MSM, which are less likely to adhere to daily PrEP. 23 , 36 – 38 In descriptive choice experiment (DCE) studies conducted among sexual and gender minorities in Brazil and Peru during 2020–2021, long-acting presentations and frequency of taking PrEP were important attributes in choosing PrEP modality.…”

Section: Discussionmentioning

confidence: 99%

Preferences for PrEP modalities among gay, bisexual, and other men who have sex with men from Brazil, Mexico, and Peru: a cross-sectional study

Torres

Nascimento

Coelho

et al. 2023

Therapeutic Advances in Infection

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Background: Pre-exposure prophylaxis (PrEP) scale-up is urgent to reduce new HIV cases among gay, bisexual, and other men who have sex with men (MSM) in Latin America. Different PrEP modalities may increase PrEP uptake and adherence, especially among young MSM. Objectives: To assess preferences for PrEP modalities among MSM from Brazil, Mexico, and Peru. Design: Cross-sectional web-based study (March–May 2018) targeting MSM through advertisements on Grindr, Hornet, and Facebook. We included MSM aged ⩾ 18 years and who reported HIV-negative status. Methods: We assessed preferences for PrEP modalities with the following question: ‘Considering that all following PrEP modalities were available, which one would you prefer considering a scale from 1 to 3 (1 = most preferred): daily oral PrEP, event-driven PrEP (ED-PrEP), and long-acting injectable PrEP’. We assessed factors associated with each most preferred PrEP modality per country using multivariable logistic regression models. Results: A total of 19,457 MSM completed the questionnaire (Brazil: 58%; Mexico: 31%; Peru: 11%); median age was 28 years [interquartile range (IQR): 24–34]. Overall, injectable PrEP was the most preferred modality [42%; 95% confidence interval (CI): 41–43], followed by daily PrEP (35%; 95% CI: 34–35), and ED-PrEP (23%; 95% CI: 23–24). In multivariable models, preferring injectable PrEP was associated with PrEP awareness in all three countries, while PrEP eligibility only in Brazil. Preferring daily PrEP was associated with younger age and lower income in Brazil and Mexico, and lower education only in Brazil. The odds of preferring ED-PrEP were lower among MSM aware and eligible for PrEP in Brazil and Mexico. Conclusions: Long-acting injectable PrEP was the preferred PrEP modality among MSM in Brazil, Mexico, and Peru, especially those aware and eligible for PrEP. Public health interventions to increase PrEP modalities literacy and availability in Latin America are urgent especially among MSM of young age, lower income, and lower education.

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“…Availability is also tempered by continued decreases in multilateral funding (e.g., PEPFAR) and patent protections that make medications prohibitively expensive. Though collaborations are forming to accelerate availability (e.g., by the International AIDS Vaccine Initiative, Scripps Research, and the US National Institutes of Health), affordable LA modalities will also require generic drug pricing and patent waivers [60,61].…”

Section: The Need To Ensure Global Availabilitymentioning

confidence: 99%

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

Philbin

Perez-Brumer

2022

Current Opinion in HIV and AIDS

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Purpose of reviewThis paper provides a critical review of recent therapeutic advances in long-acting (LA) modalities for human immunodeficiency virus (HIV) treatment and prevention. Recent findingsLA injectable antiretroviral therapy (ART) has been approved in the United States, Canada and Europe; the United States also has approved LA injectable preexposure prophylaxis (PrEP) and the World Health Organization has recommended the vaginal PrEP ring. Current LA PrEP modalities in clinical trials include injections, films, rings, and implants; LA ART modalities in trials include subcutaneous injections and longterm oral pills. Although LA modalities hold incredible promise, global availability is inhibited by longstanding multilevel perils including declining multilateral funding, patent protections and lack of political will. Once available, access and uptake are limited by factors such as insurance coverage, clinic access, labor markets, stigma, and structural racism and sexism. These must be addressed to facilitate equitable access for all. SummaryThere have been tremendous recent advances in the efficacy of LA ART and PrEP modalities, providing renewed hope that 'ending the HIV epidemic' is within reach. However, pervasive socio-structural inequities limit the promise of LA modalities, highlighting the need for cautious optimism in light of the embedded inequities in the trajectory of research, development, and population-level implementation.

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Impact of long-acting therapies on the global HIV epidemic

Cited by 21 publications

References 53 publications

Preference for long-acting injectable for ART and PrEP among people with and without HIV: a cross-sectional study in Argentina

Preference for long-acting injectable for ART and PrEP among people with and without HIV: a cross-sectional study in Argentina

Preferences for PrEP modalities among gay, bisexual, and other men who have sex with men from Brazil, Mexico, and Peru: a cross-sectional study

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

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