The World Health Organization (WHO) released new guidelines for the use of long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV and called for countries to consider this safe and highly effective prevention option for people at substantial risk of HIV infection.
The guidelines released ahead of the 24th International AIDS Conference (AIDS 2022), will support countries as they plan for CAB-LA introduction as part of a comprehensive approach to HIV prevention and will facilitate urgently needed operational research.
“The guidelines are launched at a critical moment, as HIV prevention efforts have stalled with 1.5 million new HIV infections in 2021 – the same as 2020. There were 4000 new infections every day in 2021, with key populations (sex workers, men who have sex with men, people who inject drugs, people in prisons and transgender people) and their sexual partners accounting for 70% of HIV infections globally,” the global health agency said in a statement.
“Long-acting cabotegravir is a safe and highly effective HIV prevention tool, but isn’t yet available outside study settings. We hope these new guidelines will help accelerate country efforts to start to plan and deliver CAB-LA alongside other HIV prevention options, including oral PrEP and the dapivirine vaginal ring,” said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.
According to the global health agency, CAB-LA is an intramuscular injectable, long-acting form of PrEP, with the first 2 injections administered 4 weeks apart, followed thereafter by an injection every 8 weeks.
“To achieve UN prevention goals, we must push for rapid, equitable access to all effective prevention tools, including long-acting PrEP. That means overcoming critical barriers in low- and middle-income countries, including implementation challenges and costs,” said Rachel Baggaley, Lead of the Testing, Prevention and Populations Team at Global HIV, Hepatitis and STI Programmes at WHO.
WHO will continue to support evidence-based strategies to increase PrEP access and uptake, including through the adoption of CAB-LA.
In April this year, CAB-LA was added to WHO’s list of Expressions of Interest for evaluation for prequalification, and WHO is working with countries on regulatory approval. Both oral PrEP and CAB-LA are highly effective, the agency stated.