Study Participants Happy They Switched from Oral PrEP to Long-Acting Injections | IAS 2025

Providing men with additional support, such as brochures, flexible scheduling, and appointment reminders, can lead to a successful start to the use of Apretude for HIV pre-exposure prophylaxis (PrEP), 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). Men who have sex with men account for 67% of new HIV diagnoses 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.

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.

As part of the phase 4 PILLAR study, researchers — led by Dima Dandachi, M.D., M.Ph., assistant professor at the University of Missouri-Columbia— evaluated the effectiveness of strategies for prescribing Apretude to men who have sex with men and transgender men. More than 201 participants from 17 sites in the United States were surveyed from May 2022 through August 2023.

Participants were randomized to either standard of care protocols for the implementation of PrEP or standard of care plus additional support, which included brochures and videos, flexible scheduling and appointment reminders.

Overall, participants said they were happy switching from oral PrEP to Apretude. The surveys revealed that the added measures of flexible scheduling, reminders and educational tools supported participants’ use of Apretude. Participants also said that the visits with healthcare professionals allowed for discussions about other healthcare issues and for more frequent testing for sexually transmitted infections.

Additionally, the long-acting PrEP helped to reduce the concern about forgetting doses. And although pain from the first injection was mentioned, 76% said they experienced no pain or mild pain from the most recent injection.

Related: Men Experience Less Stigma When Using Long-Acting PrEP | ID Week 2024

An analysis last year of the PILLAR data found that the long-acting PrEP helped to reduce the stigma of taking oral medications. Stigma and anxiety were both assessed through questions that explored perceptions around concerns and experiences with both oral medication and long-acting injections. Stigma was also assessed using the validated HIV PrEP Stigma Scale.

At baseline, 15% and 29% of participants reported experiencing stigma and anxiety with oral PrEP vs. 0% and 2% with Apretude at month 6 of the study.

The PILLAR study was sponsored by ViiV Healthcare.