Black Women Can Successfully Be Started on Long-Acting Apretude 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 providing flexible scheduling can lead to successful implementation of the PrEP regimen, finds a new study presented at the International AIDS Society meeting in Kigali, Rwanda.

Approximately 1.2 million people in the United States have HIV, according to the 2022 Centers for Disease Control and Prevention (CDC). Black women account for about 50% of new HIV diagnoses among cisgender and transgender women in the United States.

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.

Researchers in this study said increasing the use of Apretude among Black women requires not only expanding awareness of the long-acting PrEP regimen in various clinics but also providing more flexible scheduling and partnering with specialty pharmacies.

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 in an article in the Journal of The International AIDS Society, an interim analysis of the study that was published online July 2.

Researchers, led by Zandraetta Tims-Cook, M.D., M.Ph., an infectious disease physician at Faebris Medical & Community Education in Atlanta, 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 84 healthcare professionals across 15 sites located in Ending the HIV Epidemic jurisdictions about their experiences prescribing Apretude for PrEP for Black women. The survey and interviews took place from August 2022 to February 2025.

Researchers found that within a year, clinic capacity to provide Apretude tripled, and at the same time, many clinics reported that there was a decrease in the number of total staff needed per week to incorporate Apretude into the clinic.

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 decrease, especially in the first four months. 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. Clinics reported using more flexible scheduling, including before- and after-hour appointments, drop-in visits, and partnering with specialty pharmacies.

“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 in the journal article.

This research was sponsored by ViiV Healthcare.