Long-acting PrEP acceptable, feasible among men, women in trial
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Key takeaways:
- Most study participants were satisfied with long-acting PrEP and said they would recommend it to friends.
- A long-acting injectable was regarded as a safer, more discreet method for HIV prevention.
Long-acting injectable PrEP is feasible and acceptable to both men and women, according to a study presented at the AIDS 2024 meeting in Munich.
As long-acting cabotegravir (CAB-LA) has recently been rolled out in Africa, researchers reported that not only did many people prefer it to taking a daily pill, but also that it could be a safer option.
“This product was a popular choice for men and women, and was feasible to deliver with a high level of satisfaction,” Christoph Spinner, MBA, executive head of the department of medicine and strategy and chief medical officer at University Hospital rechts der Isar in Munich, said in a press briefing ahead of the conference.
Early results from the ongoing SEARCH dynamic choice HIV prevention (DCP) vs. standard of care studies presented in March 2023 at CROI showed that PrEP coverage increased by around five times when CAB-LA was offered as an option. According to the data, more than half of patients opted for the long-acting option.
Jane Kabami, BNS, MPH, an implementation scientist at the Infectious Diseases Research Collaboration based in its Mbarara, Uganda, regional office, said during a press conference that although data has shown efficacy of long-acting PrEP in African populations, understanding how to increase CAB-LA uptake is important for the drug’s rollout.
“The main question that I’ve been trying to answer is on the knowledge, awareness, feasibility and acceptability of CAB-LA for HIV prevention,” she said.
Kabami and colleagues analyzed data on knowledge, awareness, feasibility and acceptability of CAB-LA among men and women aged older than 15 years in Kenya and rural Uganda participating in the SEARCH DCP study’s intervention arm, which includes a structured product choice between oral PrEP, long-acting PrEP and post-exposure prophylaxis.
Participants were permitted to switch between the products over the course of 48 weeks of follow-up and quantitative surveys were completed by those who chose CAB-LA and used it for at least 24 weeks.
Of 487 participants in the intervention arm of the study, 56% started CAB-LA during follow-up (183 women, 91 men and 79 people aged 15 to 24 years), with 72% using CAB-LA for more than 24 weeks.
Among those who opted for CAB-LA, 64% said that it was easier to take an injection and 49% said they have difficulty remembering to take pills. When 99% of participants who chose CAB-LA did so, they said they had no basic knowledge of long-acting PrEP and this was consistent across age groups.
Kabami noted that for many younger study participants, safety was a concern because “they would not want to take pills because someone will know they are taking them. You know, you’re carrying them in your bag and they are shaking, prompting people to ask ‘why are you taking these pills?’”
Among younger people who chose CAB-LA, 42% said they did not want somebody to see them taking pills and 22% chose it because friends or partners would not let them take the pills, supporting prior research suggesting long-acting PrEP could be a more discreet, safer option.
Based on the overall response of study participants — including more than 96% of participants on CAB-LA being satisfied with the decision and more than 94% saying they would recommend it to a friend — Kabami and colleagues concluded that CAB-LA, as it is further rolled out in Africa, has the potential for wide use as PrEP for HIV.
“It’s a new product,” Kabami said. “We learned ... that awareness increases during follow-up, and [CAB-LA] is highly feasible and acceptable to deliver with high levels of satisfaction among participants.”
References:
- Kakande E, et al. Abstract 6353. Presented at: AIDS 2024; July 22-26, 2024; Munich (hybrid).
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Kakande E, et al. Abstract 6353. Presented at: AIDS 2024; July 22-26, 2024; Munich (hybrid).
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