Why is Roll-out of Long-acting PrEP Agents so Slow?

Details

• Alternative Title:
  Current Opinion in HIV and AIDS, 2025, v. 20, no. 1: Why is Roll-out of Long-acting PrEP Agents so Slow?
• Journal Article:
  Current Opinion in HIV and AIDS
• Personal Author:
  Patel, Rupa R. ; Mayer, Kenneth H.
• Description:
  Injectable cabotegravir for HIV preexposure prophylaxis (PrEP) is effective, yet global implementation has been slow. We review factors which have contributed to the delayed roll-out of this medication.
  
  Fifty-three countries have approved cabotegravir for HIV prevention yet roll-out has been slow. Cabotegravir made up 2.5% of all U.S. PrEP prescriptions in 2023 and is very slowly increasing after FDA approval in 2021. Medication has not been available outside of implementation science studies in Africa and Asia. There is a lengthy process for generic medication production despite agreements signed in 2021; the first available generic dose is not anticipated until 2027. In the United States, where some of the cabotegravir medication costs can be covered under individual insurance plans, high costs and medication acquisition pathways for health centers have been complex, contributing to national implementation delays. The intensity of the staffing required for medication acquisition, insurance paperwork filing, process documentation, billing, injection administration, appointment scheduling, missed appointment monitoring and client follow up has burdened healthcare organizations.
  
  Injectable cabotegravir PrEP has not reaped its potential to be an alternative in those for whom adherence to a daily PrEP pill is challenging. Lessons learned regarding cabotegravir medication acquisition pathways and clinical delivery strategies can inform the rollout of future HIV prevention long-acting agents.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Pre-Exposure Prophylaxis
  • HIV Infections
  • Anti-HIV Agents
  • Pyridones
  • Diketopiperazines
• Keywords:
  • cabotegravir
  • HIV preexposure prophylaxis
  • long-acting antiretrovirals
• Source:
  Current Opinion in HIV and AIDS, 2025, v. 20, no. 1
• DOI:
  https://doi.org/10.1097/COH.0000000000000899
• ISSN:
  1746-630X ; 1746-6318
• Pubmed ID:
  39633538
• Pubmed Central ID:
  PMC11879253
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  48-53 (12 pdf pages)
• Volume:
  20
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/261882/cdc_261882_DS1.pdf
• File Type:
  [PDF - 466.73 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c3e3a6bbe8b2abde7b567a3804f8137be80cae64574e543155dcfbc6ec6394537bd20f29c7bdef3199f935d1aa3affbeea71c392d53b3b3b09ccd4f9deec0dc6