HIV prevention shot to be rolled out if approved

THE HIV prevention shot is expected to be rolled out in health facilities once the South African Health Products Regulatory Authority has approved it. This is according to Professor Saiqa Mullick, director of implementation science at the Wits Reproductive Health & HIV Institute.

Mullick said 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%.

Unitaid, a global health initiative, said long-acting cabotegravir addressed challenges users face with regular pills that reduce the impact of oral PREP in real-world settings. It also mitigates fears pills will be misinterpreted for HIV treatment and cause the user to suffer stigma, discrimination or intimatepartner violence as a result.

Mullick emphasised that one needed to be HIV negative to be eligible to take the prevention shot. She said this would give people an additional choice.

“We have an oral pill, but we know this can be difficult. People can forget to take the pill, or other things can get in the way,” said Mullick.

The trial, known as HIV prevention trials network 084, was headed by Dr Sinead Delany-moretlwe, a research professor at Wits and director of research at Wits RHI. She said researchers from the network announced last week that data from the clinical trial of the PREP regimen of long-acting cabotegravir (CAB LA) injections once every eight weeks indicated it was safe and superior to the daily oral tenofovir/emtricitabine currently used for HIV prevention among women in subsaharan Africa.

Overall, the trial enrolled 3 223 women at research sites in Botswana, eswatini, Kenya, Malawi, South Africa, Uganda, and Zimbabwe. Some 57% of the participants were under the age of 25, the average age of participants was 26, 82% were not living with a partner, 55% reported two or more partners in the past month, and 34% reported having a primary partner who is living with HIV or has unknown HIV status.

A total of 38 HIV infections occurred during follow-up, with four infections in the CAB LA arm.