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SEE WHO COULD BENEFIT FROM PRE-EXPOSURE PROPHYLAXIS (PREP) WITH APRETUDE

Since 2015, the World Health Organization (WHO) has proposed that people at substantial risk of HIV-1 should be recommended PrEP as an additional preventative measure.[1]

The WHO consider long-acting cabotegravir to be a highly effective PrEP option and recommend its use as part of a comprehensive approach to HIV prevention.[2]

People more likely to be exposed to HIV-1 include:

Image of single cisgender man on mobile phone as a key population at substantial risk of HIV-1, labelled as: cisgender men who have sex with men (MSM)

Men that have sex with men

are up to 28x more likely to acquire HIV compared to people of the same age and gender identity[3]

Explore efficacy data in this key population

Image of single Transgender woman smiling as a key population at substantial risk of HIV-1, labelled as: transgender women (TGW) who have sex with men

Transgender women

49x higher risk of acquiring HIV vs the general population in developed countries[4]

Explore efficacy data in this key population

Image of single cisgender woman smiling as a key population at substantial risk of HIV-1, labelled as: cisgender women (CGW)

Cisgender women and girls

represent 46% of new HIV infections worldwide[5]

Explore efficacy data in this key population

Other key populations:[3,5]
  • Sex workers and their clients
  • Migrants
  • People who have condomless sex with multiple partners,

Uptake of, and adherence to, daily oral PrEP is generally low. Numerous factors limit optimal use of oral PrEP[6–8]

Contributing factors to the low uptake of PrEP[8–10]

Adapted from Sidebottom D et al. 2018, Jaspal R et al. 2016, & Ogello V et al. 2023.

Adherence to daily oral PrEP (tenofovir disoproxil fumarate/emtricitabine [TDF/FTC]) is associated with PrEP effectiveness,[11–16] yet adherence has been reported to range from 12–72% across trials conducted in populations at high risk of HIV acquisition.[11,12,17–20]

APRETUDE could help alleviate some of the challenges of daily oral PrEP

Adherence you can confirm[21]
  • A long-acting injection every 2 months after initiation, administered by a Healthcare Professional.*
Regular touchpoints with individuals in your care[21]
  • APRETUDE injection schedule provides regular opportunities to check in on and support PrEP users
A route of administration that clinical trial participants preferred over daily tablets[22,23]

2592/4566 cisgender men and transgender women who have sex with men entered the HIV Prevention Trials Network (HPTN) 083 open-label extension (OLE), where participants were able to choose their preferred PrEP option to complete the study with.**

2592 participants entering the HPTN 083 OLE phase were offered a choice of CAB LA or TDF/FTC for HIV PrEP, which showed:[22]

  • Most participants 96% (n=2488/2592) chose APRETUDE over daily oral TDF/FTC (4%; n=104/2592)
  • Of those who chose APRETUDE, the top reason was “prefer injections / don’t like pills” (71.3%; n=1774/2488)

2472 participants entering the HPTN 084 OLE phase were offered a choice of CAB LA or TDF/FTC for HIV PrEP which showed:[23]

  • Most participants 78% (n=1931/2472) chose APRETUDE over daily oral TDF/FTC (22%; n=536/2472)
  • Of those who chose APRETUDE, the top reasons was "prefer injections" (77%; n=1903/2472)

Want to find out more about APRETUDE?

View our resources page to get more information about APRETUDE
Montage of lifestyle pictures of couples.

* An optional oral lead-in may be used prior to the initiation of APRETUDE to assess the tolerability of cabotegravir. The recommended oral lead-in dose is 1 cabotegravir tablet (30 mg) once a day for approximately 1 month (at least 28 days). Initiation injections should be administered on the last day of oral lead-in, if used, or 3 days thereafter.[21]

** At a planned interim review, an independent data safety and monitoring board recommended the study be unblinded. The protocol was amended as an OLE in which participants were offered the choice to complete the study with open-label APRETUDE or daily oral TDF/FTC. The US sites transitioned to OLE before other regions, so the analysis was limited to US participants; 1,698 enrolled, of whom 803 (47.2%) had regimen choice data available.[22]

HIV-1, human immunodeficiency virus type 1; HPTN, HIV Prevention Trials Network; OLE, open-label extension; PrEP, pre-exposure prophylaxis; TDF/FTC, tenofovir disoproxil fumarate/emtricitabine; US, United States; WHO, World Health Organization.

References:

  1. World Health Organization (WHO). WHO expands recommendation on oral pre-exposure prophylaxis of HIV-1 infection (PrEP). Available at: https://apps.who.int/iris/handle/10665/197906. Accessed: April 2024.
  2. World Health Organization (WHO). WHO implementation tool for pre-exposure prophylaxis of HIV infection: provider module for oral and long-acting PrEP. Available at: https://www.who.int/publications/i/item/9789240097230. Accessed September 2024.
  3. The Joint United Nations Programme on HIV and AIDS (UNAIDS). UNAIDS Global AIDS Update 2022. Press release. Available at: https://www.unaids.org/sites/default/files/media_asset/2022-global-aids-update_en.pdf. Accessed: April 2024.
  4. Kimani M et al. Journal of the International AIDS Society. 2019,22:e25323.
  5. The Joint United Nations Programme on HIV and AIDS (UNAIDS). UNAIDS Global HIV & AIDS Statistics Factsheet. 2023. Available at: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf. 
Accessed: April 2024.
  6. NAM AIDSMAP. Nearly a million have started taking PrEP worldwide – only a third of UNAIDS’ 2020 target. Available at: https://www.aidsmap.com/news/feb-2021/nearly-million-have-started-taking-prep-worldwide-only-third-unaids-2020-target. Accessed: April 2024.
  7. Poteat T et al. Poster presented at IDWeek. 19–23 October 2022. Virtual and Washington, USA. 2085.
  8. Sidebottom D et al. BMC Infectious Diseases. 2018;18:581.
  9. Jaspal R et al. Cogent Medicine. 2016;3:1256850.
  10. Ogello V et al. AIDS Behav. 2023;27:65–74.
  11. Van Damme L et al. N Engl J Med. 2012;367:411–422.
  12. Marrazzo J et al. N Engl J Med. 2015;372:509–518.
  13. Molina J-M et al. N Engl J Med. 2015;373:2237–2246.
  14. Grant RM et al. N Engl J Med. 2010;363:2587–2599.
  15. Anderson PL et al. Sci Transl Med. 2012;4(151):151ra125.
  16. Baeten J et al. N Engl J Med. 2012;367:399–410.
  17. Corneli AL et al. J Acquir Immune Defic Syndr. 2014;66(3):324–331.
  18. Landovitz RJ et al. N Engl J Med. 2021;385(7):595–608.
  19. Delany-Moretlwe S et al. Lancet. 2022;399(10337):1779–1789.
  20. Landovitz RJ et al. N Engl J Med. 2021;385(7):595-608. (Suppl Appendix)
  21. Cabotegravir Pre-exposure Prophylaxis (PrEP) Global Data Sheet. October 2021.
  22. Clement ME et al. Presentation at the 30th Conference on Retroviruses and Opportunistic Infections (CROI). 19–22 February 2023. Seattle, Washington, USA. 994.
  23. Delany-Moretlwe S et al. Presented at IAS 2023. 23-26 July. Brisbane, Australia. 5998.

PM-GB-CBT-WCNT-240006 November 2024

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