Injection superior to oral dosage in HIV prevention-study

A laboratory technician at UNC Project
  • Instead of taking a drug through the mouth on a daily basis to prevent contracting HIV, an injection can instead be given once every eight weeks

A study has shown that long-acting Cabotegravir (CAB LA) injection used as pre-exposure prophylaxis (PEP) in HIV-uninfected women once every two months was safe and superior as compared to another drug Tenofovir taken orally and daily.

Conducted by the University of North Carolina (UNC) Project Malawi, the HIV Prevention Trials Network (HPTN 084) study which Malawi participated in enrolled 111 participants from Lilongwe and 113 from Blantyre.

It means that instead of taking a drug through the mouth on daily to prevent contracting HIV, an injection can instead be given for eight weeks in preventing the virus.

Participants in the trial had a very low HIV prevalence as only one percent of them became infected during the study indicating the effectiveness of the products.

A long-acting injectable formulation has the potential to improve the prevention effect without relying on adherence to a daily oral PrEP regimen.

“A long-acting PrEP product could offer a better choice for women at substantial HIV risk who either do not want to take or struggle with taking a daily tablet. However, adhering to the daily dosing schedule is important. Even short lapses in taking oral PrEP can reduce the protection from HIV acquisition.” read the results.  

The average age of study participants was 26 years and 57 percent were 18-25 years old, 82 percent of the women enrolled were not living with a partner, 55 percent reported two or more partners in the past month.

Hosseinipour:  It’s advanced that you can prevent people from getting HIV and so we’re very pleased with that

34 percent of participants reported having a partner who is living with HIV or whose status is not known.

Scientific Director of UNC Project Malawi Professor Mina Hosseinipour, described the findings as remarkable as it takes adherence issues away since women did not have to take a daily pill effectively preventing HIV infection.

While acknowledging that there is still a way to go before a cure is found, she nonetheless expressed confidence with the results of the survey.

“The work that we’ve done here is preventing women from getting the infection and so if you don’t have the infection, you thankfully don’t have to cure them.

“It’s advanced that you can prevent people from getting HIV and so we’re very pleased with that; but the cure is still some distance off but still hopefully we’ll be making more advances but right now we have a very effective prevention tool, we have very effective treatment that can allow people to live a normal life expectancy if they take their medications properly and so the cure is next but we still have some ways to go” she explained

Hosseinipour underscored the need for women to have choices, something discreet to enable them make their own decisions regarding their sexuality.

UNC Team at the briefing 

“Here they get the injection, their partner doesn’t have to know about it; they can know about it, but it’s entirely giving the women control; it’s really wonderful opportunity for women  to be able to make decisions about how to protect themselves.

“And sometimes the negotiation for condoms is very hard for women; also sort of the engaging the relationship status if for some reason they don’t trust their partner but want to still protect themselves this is really important,” she adds.

The HPTN 084 Protocol Co-Chairperson believes the injection will be made available at an affordable price once the Malawi government adopts it.

The product has also been found effective among men who have sex with men.

It was conducted in 20 sites in seven countries in Sub-Saharan Africa of Botswana, Eswatini, Kenya, South Africa, Uganda and Zimbabwe.