New World Health Organization (WHO) guide recommends countries to use the new, unsold game-changing drug as pre-exposure prophylaxis (PrEP) for HIV and as part of a comprehensive approach to contain the virus spread.
Those who use most of the PrEP drugs on the market, must remember to take their pills every day, what is a bigger challenge for preventive medicine.
“Long-acting cabotegravir is a safe and highly effective tool for HIV prevention, but still remains an effective and safe tool for HIV prevention,” said Meg Doherty, Director of the WHO Global Program on HIV, Hepatitis and Sexually Transmitted Diseases. not yet available outside of research facilities.
The drug was approved in the US last December and the UK the following month.
Important time
Key population groups – including sex workers, men who have sex with men, intravenous drug users, people in prison, transgender people and their partners – account for 70% of HIV infections globally last year.
Moreover, 4,000 new infections occur every day in 2021, also in that group.
As HIV prevention efforts stalled, new guidelines were published ahead of the 24th International AIDS Conference (AIDS 2022) – officially started on Friday – with 1.5 million new HIV infections last year, equal to 2020.
“We hope these new guidelines will help advance national efforts to begin planning and delivering CAB-LA along with other HIV prevention options, including PrEP,” said the WHO official. drink and put dapivirine vaginal ring”.
Game changer
CAB-LA is a long-acting, intramuscular form of PrEP.
The first two injections are given four weeks apart, followed by one injection every eight weeks.
In randomized controlled trials, antiretrovirals have been shown to be safe and highly effective in transgender women, transgender men who have sex with men, and transgender women who have sex with men. .
Together, these landmark studies show that the use of CAB-LA reduces the risk of HIV infection by 79% compared with oral PrEP, where adherence to daily oral medication is often a challenge, according to WHO.
Long-acting injectable products are also acceptable and are sometimes preferred in studies that examine community preference for PrEP.
© UNICEF / Soumi Das
A woman is tested for HIV in Uttar Pradesh, India.
Coalition forces
The United Nations health agency also formed a new coalition to accelerate global access to the drug.
Summoned by WHO, Unitaid, UNAIDS and the Global Fund, the coalition will identify the interventions needed to promote near- and long-term accessibility to CAB-LA, establish financing and drug procurement, and issue policy guidance. , and other operations.
“To achieve the United Nations prevention goals, we must advance,” said Rachel Baggaley, WHO Population, Prevention and Testing Team Leader at Global Programs on HIV, Hepatitis and STIs. fair and expeditious access to all effective prevention tools, including PrEP. .
“That means overcoming important barriers in low- and middle-income countries, including challenges and costs of implementation.”
Main action
WHO will continue to support evidence-based strategies to increase access and uptake of PrEP, such as through the adoption and inclusion of CAB-LA in HIV prevention programmes.
It is also working with Unitaid and others to develop projects that address outstanding safety issues and implementation challenges.
And the WHO Global PrEP Network will host a webinar to provide updates on CAB-LA to raise awareness.
In April, it was added to the WHO list of Expression of interest for prequalification by health authorities.
Prevention options
Both PrEP and oral CAB-LA are highly effective.
The new CAB-LA guidelines are based on a public health approach that considers effectiveness, acceptability, feasibility, and resource needs in a variety of contexts.
They are designed to help deliver CAB-LA and urgently needed operational research on addressable and secure implementation, and will inform decisions about how to successfully deliver and scale CAB- LA.
The guidelines highlight important research gaps, and also acknowledge that accessing PrEP services is currently a challenge for some.
“Communities must participate in the development and delivery of effective, accepted and supported HIV prevention services,” the WHO stressed.
