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PrEP works. Investment in more options must continue, and faster, smarter rollout must be a top priority.

Clinical trials have shown that different types of pre-exposure prophylaxis (PrEP) using antiretroviral (ARV) drugs dramatically reduce the risk of HIV infection for people who take it as directed. While PrEP won’t be right for every individual at risk for HIV, millions will benefit—if they can access this potentially life-saving option.

So far, PrEP’s implementation has been piecemeal. Meanwhile the landscape is changing as more options move through research, regulatory review or enter the market, intensifying the need to improve implementation.

TDF/FTC (brand name Truvada) was first approved for use as oral PrEP in 2012, now dozens of countries have approved it, but PrEP still has not reached many of the people who need it most. In 2019, F/TAF (brand name Descovy) became the 2nd oral PrEP product to be approved, but only for men who have sex with men (MSM) and transgender women. Efficacy studies of F/TAF among cisgender women are ongoing. Findings reported in 2020 show injectable cabotegravir is safe and effective and the product is undergoing regulatory review. For more information go to our dedicated pages on cabotegravir on and PrEPWatch.

For all these interventions and other ARVs still in the R&D pipeline, advocacy is crucial: There must be continued investment in the development of additional options, community engagement must be integrated from trial design to implementation, and improved programming must support those who need HIV prevention options the most.

Key Update

Over the weekend, we at AVAC and allies around the world witnessed history and gained hope as the results of the American presidential election (finally) got announced. News also came in that the HPTN 084 trial of injectable long-acting cabotegravir for HIV prevention in cisgender women found a high level of effectiveness at a scheduled interim data review.

November 9, 2020
What We're Reading

Countries in sub-Saharan Africa have progressively scaled up oral PrEP as part of combination HIV prevention. Initial scale-up efforts have generated progress, drawing lessons from existing HIV interventions, such as antiretroviral therapy and biomedical prevention. However, beset by unprepared health systems, scale-up has been slow. This review synthesises literature on essential considerations for PrEP scale-up, highlighting the importance of health system adaptability and responsiveness.

July 12, 2021
The Lancet HIV

Widespread adoption of WHO PrEP recommendations coincided with a global increase in PrEP use. Although the 2020 global PrEP target will be missed, strong future growth in PrEP use is possible. New PrEP products could expand the PrEP user base, and, with greater expansion of oral PrEP, further adoption of WHO PrEP recommendations, and simplified delivery, PrEP could contribute to ending AIDS by 2030.

July 12, 2021
Lancet HIV
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