WHO recommends long-acting cabotegravir for HIV prevention

WHO released today New guidelines This safe and highly effective preventive option calls for the use of long-acting, injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV and for people at high risk of HIV transmission. I asked each country to consider.

The guidelines, published prior to the 24th International AIDS Conference (AIDS 2022), help countries planning to implement CAB-LA as part of a comprehensive approach to HIV prevention and urgently needed operations. Promote research.

The guidelines will begin at a critical moment as HIV prevention efforts are stagnant with 1.5 million new HIV infections in 2021, the same as in 2020. In 2021, there will be 4000 new infections daily and there will be a major population (sex workers, men having sex). Men, people who inject drugs, people in prison, people who are transgender) and their sexual partners account for 70% of HIV infections worldwide.

“Long-acting cabotegravir is a safe and highly effective HIV prevention tool, but it is not yet available outside the research environment,” said Dr. Megdhati, director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Diseases Program. increase. “We hope that these new guidelines, along with other HIV prevention options such as oral PrEP and Dapivirin vaginal ring, will help accelerate national efforts to begin planning and implementing CAB-LA.”

CAB-LA is a long-acting PrEP that can be injected intramuscularly, with the first two injections being given every 4 weeks and then every 8 weeks. CAB-LA is a two randomized controlled trial of HPTN083 and HPTN084 that is safe and highly among cisgender women, cisgender men having sex with men, and transgender women having sex with men. It has been shown to be effective. Using CAB-LA reduced the risk of HIV by 79% compared to oral PrEP. With oral PrEP, adhering to daily oral medications was often a challenge. Long-acting injectable products are also acceptable and may be preferred in studies examining the community’s PrEP preferences.

Today’s press conference also marks the launch of a new coalition to accelerate global access to CAB-LA. A coalition convened by WHO, Unitide, UNAIDS and the World Fund promotes short-term and long-term access to CAB-LA, establishes drug financing and procurement, and supports the implementation of global HIV prevention programs. Identify the market intervention required to provide. Among other things, issue policy guidance.

“To achieve the UN’s preventive goals, we need to promote prompt and equitable access to all effective preventive tools, including long-acting PrEP,” WHO said. “This means overcoming significant barriers to low- and middle-income countries, such as implementation challenges and costs.”

WHO will continue to support evidence-based strategies to increase access and uptake of PrEP, including through the adoption of CAB-LA. The main actions are:

• WHO helps countries and partners safely and effectively include CAB-LA in their HIV prevention programs.
• WHO is working with Unitaid and other partners on implementation science projects to address outstanding safety issues and implementation challenges and to understand people’s preferences for CAB-LA, among other HIV prevention options. I am developing.
• WHO will work with countries, communities and donors such as the World Fund, PEPFAR and the Bill & Melinda Gates Foundation to support the incorporation of CAB-LA into programs and to enable CAB-LA in implementation science and programs. Promotes monitoring. Implemented safely and effectively for maximum impact.
• The WHO Global PrEP Network will host a webinar at CAB-LA this year to keep countries, communities and implementers up to date and raise awareness.
• In April 2022, CAB-LA was added to WHO’s list of interests for pre-qualification assessment, and WHO is working with countries on regulatory approvals.

Both oral PrEP and CAB-LA are very effective. WHO will continue to support prevention choices. CAB-LA should increase the options available and always be offered with oral PrEP. Some people may continue to choose oral PrEP, and CAB-LA may be preferred by people who have difficulty or do not want to take tablets. WHO also released new guidance on differentiated and simplified PrEP at the AIDS 2022 conference to support easier access, including community delivery.

Consistent with the previous WHO guidelines, the new CAB-LA guidelines are based on a public health approach that considers efficacy, acceptability, feasibility, and resource needs across different settings. The guidelines are designed to facilitate the provision of CAB-LA and the urgent need for operations research to address implementation and safety issues. These inform you of your decision on how to successfully deliver and scale up your CAB-LA. The guidelines are critical, including issues related to HIV drug resistance, HIV testing, service delivery models, resource requirements, pregnancy and breastfeeding safety, and the provision of CAB-LA to communities and populations not included in the trial. Emphasizes the research gap.

The guidelines also mention that young people and key people often experience challenges when accessing current PrEP services. Communities need to be involved in the development and delivery of HIV prevention services that are effective, acceptable and supportive of choice.