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Add to Preferred SourcesPeople at risk of HIV in Brazil and South Africa will be among the first to benefit from a highly effective, long-acting injectable HIV preventive treatment through two large-scale operational projects funded by the global health agency Unitaid.
Long-acting cabotegravir is a new HIV prevention method that provides eight weeks of continuous protection against HIV infection through a single intramuscular injection.
This provides an alternative to oral pre-exposure prophylaxis (PrEP), which can reduce the risk of HIV infection by 99%, but only when taken as prescribed: either once a day, or before and after sex for cisgender men.
Long-acting cabotegravir addresses challenges users face with regular pills that reduce the impact of oral PrEP in real-world settings. It also mitigates fears that pills will be misinterpreted for HIV treatment and cause the user to suffer stigma, discrimination, or intimate partner violence as a result.
Unitaid will partner with Fiocruz in Brazil, Wits RHI in South Africa, and local health authorities in both countries to integrate long-acting cabotegravir into national sexual health programs, generating some of the first real-world evidence that will support wide-scale global implementation.
Despite the high protection oral PrEP can provide, uptake has been slow. United Nations‘ targets to increase PrEP coverage and reduce new HIV infections by 2020 were both missed by two-thirds. And disparities in who is accessing treatment and prevention are growing.
In Brazil, the programs will aim to reach the two groups with the highest rates of HIV prevalence: an estimated 30% of transgender people and 18% of men who have sex with men in the country are living with HIV.
Adolescent girls and young women, who will be the target of the Unitaid-funded efforts in South Africa, become infected at a disproportionately high rate. In sub-Saharan Africa, six in seven new HIV infections in adolescents occur among girls, and young women are twice as likely to be living with HIV as their male peers.
“Unitaid recognizes the game-changing potential long-acting PrEP could have in making HIV prevention a more viable option for more people,” said Dr Philippe Duneton, Executive Director of Unitaid. “But we need urgent action to ensure people everywhere can benefit. We need an adequate and affordable supply without delay. And we strongly encourage ViiV to develop a transparent access policy for long-acting cabotegravir that readily enables voluntary licenses through the Medicines Patent Pool to assure a generic pathway to broader access.”
“Thanks to Unitaid’s investments, communities in Brazil with disproportionately high rates of HIV will be among the first in the world to benefit from this new preventive treatment,” said Marcelo Queiroga, Minister of Health of Brazil. “Working within our national health system, this project will not only integrate new PrEP options into existing services, but it will also develop a model to scale up long-lasting PrEP so people across the continent and beyond can benefit.”
The South African program will include a second new long-acting HIV prevention product targeted at adolescent girls and young women. The dapivirine vaginal ring lasts 28 days, can be inserted at home and is the first HIV prevention method a woman has complete control over.
Supplies of long-acting cabotegravir and the dapivirine ring used in these projects have been donated by ViiV and the Global Fund through the South African Department of Health, respectively.