Black Woman Can Successfully be Started on Long-Acting Apretrude for HIV PrEP | IAS 2025

When prescribing Apretude to Black cis- and transgender women for HIV pre-exposure prophylaxis (PrEP), healthcare professionals were initially concerned about patients’ identification, adherence and insurance verification. But increasing staff and patient education, addressing patient mistrust, and modifying clinical flow can lead to successful implementation of the PrEP regimen, finds a new study to be presented at the International AIDS Society meeting in Kigali, Rwanda, which starts July 13. The study was also published online July 2 in the Journal of The International AIDS Society.

Approximately 1.2 million people in the United States have HIV, according to the 2022 Centers for Disease Control and Prevention (CDC).

Increasing access to PrEP is one of the key initiatives of Ending the HIV Epidemic in the U.S., which aims to reduce the number of new HIV infections by 90% by 2030. However, only 36% of people who would benefit from PrEP were accessing it, a CDC estimate shows. Barriers to access include stigma and affordability.

Developed by ViiV Healthcare, Apretude is a long-acting cabotegravir indicated to reduce the risk of getting HIV-1 in adults and adolescents. It is given by injection by a healthcare professional every two months, after two initial injections in the first month.

“Despite some considerations and strategies potentially being more relevant to Black cis- and transgender women, such as medical mistrust, miseducation and patient identification, many are widely applicable across the healthcare spectrum and broader populations, including clinical staff training, designating physical and personnel resources and appointment reminders,” researchers wrote.

Katherine L. Nelson, Ph.D., M.Ph.

Researchers in this new study said increasing the use of Apretude among Black women requires expanding awareness of the long-acting PrEP regimen in infectious disease and primary care clinics, as well as in women’s health clinics.

To assess the barriers of reaching this population of patients, researchers, who were led by Katherine L. Nelson, Ph.D., M.Ph., director of global implementation research at ViiV Healthcare, conducted a phase 4 study evaluating the implementation of Apretude to Black cis- and transgender women in clinics located in the United States, including infectious disease, primary care and women’s health clinics.

In the EBONI study, researchers surveyed and interviewed 92 healthcare professionals across 20 sites located in Ending the HIV Epidemic jurisdictions about their experiences during the initial implementation stages of starting Apretude for PrEP. Monthly monitoring calls were also conducted.

In this survey, healthcare professionals reported several considerations when prescribing Apretude for Black cis- and transgender women, including patients’ medical mistrust, miseducation or lack of education.

But researchers found that these concerns decreased during the first four months of the pre-implementation and early implementation stages of Apretude administration to Black cis- and transgender women.

The healthcare professionals surveyed said overcoming these challenges involves strategies such as leveraging staff with prior health education experience, patient education materials and building relationships with other clinics/community-based organizations. Several of the clinics surveyed also employed operational changes, including staff training, designating physical spaces for storage and injection delivery, changes to insurance and inventory management and setting up appointment reminders and scheduling processes.

“Recognizing the uncertainties of funding, it is important now more than ever to advocate for and prioritize HIV prevention and PrEP choice as this remains the most important tool in the arsenal to end HIV,” researchers wrote.

This research was sponsored by ViiV Healthcare.