The HIV+Hepatitis Policy Institute recently released an update on a 2022 report highlighting the potential impact of long-acting Pre-Exposure Prophylaxis (PrEP) on HIV prevention. According to the findings conducted by RTI International, an independent nonprofit research institute, incorporating long-acting injectable PrEP could lead to an 87% increase in the number of HIV cases averted compared to relying solely on daily oral PrEP. The analysis marks a significant update from previous estimates that only considered the effects of daily oral PrEP, showcasing the benefits of newer long-acting formulations in the fight against HIV.
The injectable version of PrEP, brand name Apretude®, was approved for use by the Federal Drug Administration in 2021 and is given through intramuscular injection every two months.
The report emphasizes the importance of adherence to PrEP as a key factor in its effectiveness. While oral PrEP is already highly effective, with estimates of 99% effectiveness if taken every day as directed, long-acting injectable PrEP offers an alternative for individuals who struggle with the daily regimen required by oral PrEP.
In an email interview with News is Out, executive director of the HIV+Hepatitis Policy Institute Carl Schmid explained how the PrEP injection can be a game changer for those who may struggle with a daily pill for various reasons.
“Now that we have the first long-acting PrEP medication, many more people can potentially benefit from the promise of PrEP, including those who have had trouble adhering to a daily pill, the unsecurely housed, and people who have confidentiality concerns,” said Schmid.
Schmid acknowledged the injectable does pose implementation issues for many clinics, but once challenges can be overcome, clinics will be able to offer this long lasting option to patients.
“We are calling on federal and state regulators to ensure that insurers must cover all PrEP medications – including new long-acting PrEP medications – without a copay so that all can benefit from the latest scientific advances in HIV prevention,” said Schmid.
“PrEP usage grows each year, but uptake is still too low, with only a third of all people who need PrEP on it and stark racial, gender and geographic disparities in access.”
Carl Schmid
Despite advances in PrEP technology, a significant gap remains in its usage among those who could benefit from it. Current Centers for Disease Control and Prevention data reveals that only 36% of the 1.2 million Americans in need of PrEP are receiving it, with notable disparities in access among Black and Hispanic individuals. According to the initial report, as of 2021, only 11% of Black individuals and 20% of Hispanic individuals who were eligible for PrEP had been prescribed the drug by their health care professional.
“PrEP usage grows each year, but uptake is still too low, with only a third of all people who need PrEP on it and stark racial, gender and geographic disparities in access,” said Schmid. “There are a number of challenges holding back PrEP uptake. People in all communities need to know that PrEP can help protect their health and where they can get it from a trusted provider. They also need to realize they can often get on PrEP at little or no cost. Uninsured people can usually find PrEP services at community health centers and sexual health clinics.”
High copays, narrow provider access, pharmacy networks and prior authorization are still barriers to wider PrEP access.
“Fortunately, there are assistance programs to help both insured and uninsured people with the cost of PrEP. Daily oral PrEP is now generic and can cost as little as $15-30 per month,” said Schmid. ”However, PrEP users will still have to pay for periodic labs, which cost more than the drug. In order to expand PrEP uptake, particularly for the uninsured, we have been urging the federal government to do more and there is legislation introduced in the Congress to create a national PrEP Program.”
For more information on the benefits of injectable PrEP and to read the full report, visit HIVHEP.org.