Long-acting injectable PrEP is a big step forward in HIV prevention

From The Conversation, co-authored by Dr. Darrell Tan

One year ago, the United States approved a new injectable drug that prevents HIV.

After successful clinical trials, long-acting cabotegravir was found to be almost 100 per cent effective at preventing HIV. It was approved in the U.S. on Dec. 20, 2021, for use as HIV pre-exposure prophylaxis (PrEP). This approval means that eligible individuals can now receive this medication every eight weeks to prevent sexually-acquired HIV infection.

However this new drug, which would help address some of the ongoing challenges with HIV prevention for those who remain at high risk, is still not available in Canada.

HIV in Canada

The number of new HIV infections has not changed much over the past couple of decades and approximately 13 per cent of people living with HIV in Canada are undiagnosed. This demonstrates the need for more HIV prevention strategies.

While long-acting injectable PrEP is new, oral PrEP — a pill taken either daily or around sexual activity — was approved in the U.S. back in 2012. Canada only approved oral PrEP in 2016. And we are once again falling behind the U.S. on making injectable PrEP available here.

Oral PrEP already reduces the risk of HIV by almost 100 per cent when taken consistently, but recent clinical trials show that injectable PrEP is even more effective. The main advantage of injectable PrEP is that going for injections every two months is a lot easier to remember than taking pills every day, or taking pills before and after sexual activity. The switch from oral pills to injectable shots means that individuals can more easily maintain adherence, which impacts the overall effectiveness of PrEP as HIV prevention.

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