OUT welcomes WHO’s support of long-acting injectable PrEP

OUT LGBT Well-being welcomes the news that the World Health Organization (WHO) supports offering long-acting injectable PrEP for people at risk of HIV infection.

On 28 July, the WHO released new guidelines advising countries to provide long-acting cabotegravir (CAB-LA) as a safe and highly effective prevention option for people at substantial risk of HIV infection.

CAB-LA is an injectable and long-acting form of pre-exposure prophylaxis (PrEP), with the first two injections administered four weeks apart, followed thereafter by a single injection every eight weeks.

CAB-LA was shown to be safe and highly effective in two landmark studies. They found that the use of long-acting injectable PrEP can be more effective than the pill form of PrEP, where adherence to taking daily oral medication may be a challenge.

The guidelines were launched at a critical moment, as HIV prevention efforts have stalled with 1.5 million new HIV infections in 2021 – the same as 2020. There were 4000 new infections every day in 2021, with key populations (sex workers, men who have sex with men, people who inject drugs, people in prisons and transgender people) and their sexual partners accounting for 70% of HIV infections globally.

“Long-acting cabotegravir is a safe and highly effective HIV prevention tool, but isn’t yet available outside study settings,” said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes. “We hope these new guidelines will help accelerate country efforts to start to plan and deliver CAB-LA alongside other HIV prevention options, including oral PrEP and the dapivirine vaginal ring.”

A new coalition to accelerate global access to long-acting injectable PrEP has also been launched. Convened by WHO, Unitaid, UNAIDS and The Global Fund, the coalition will identify market interventions needed to advance near- and long-term access to CAB-LA, establish financing and procurement for the drug, provide implementation support to global HIV prevention programmes and issue policy guidance, among other activities.

“To achieve UN prevention goals, we must push for rapid, equitable access to all effective prevention tools, including long-acting PrEP,” said Rachel Baggaley, Lead of the Testing, Prevention and Populations Team at Global HIV, Hepatitis and STI Programmes at WHO. “That means overcoming critical barriers in low- and middle-income countries, including implementation challenges and costs.”

OUT urges the South African government, health authorities and other stakeholders to work towards making long-acting injectable PrEP accessible to those who need it most. We believe that this PrEP option will improve adherence among those who find taking a daily pill a challenge and thereby make a marked impact in the prevention of HIV infections.