Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

Morgan M. Philbin; Amaya Perez-Brumer

doi:10.1097/coh.0000000000000723

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Publisher: Wolters Kluwer Health
Copyright: Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
ISSN: 1746-630X
eISSN: 1746-6318
DOI: 10.1097/coh.0000000000000723
Publisher site: See Article on Publisher Site

Abstract

Purpose of reviewThis paper provides a critical review of recent therapeutic advances in long-acting (LA) modalities for human immunodeficiency virus (HIV) treatment and prevention.Recent findingsLA injectable antiretroviral therapy (ART) has been approved in the United States, Canada and Europe; the United States also has approved LA injectable preexposure prophylaxis (PrEP) and the World Health Organization has recommended the vaginal PrEP ring. Current LA PrEP modalities in clinical trials include injections, films, rings, and implants; LA ART modalities in trials include subcutaneous injections and long-term oral pills. Although LA modalities hold incredible promise, global availability is inhibited by long-standing multilevel perils including declining multilateral funding, patent protections and lack of political will. Once available, access and uptake are limited by factors such as insurance coverage, clinic access, labor markets, stigma, and structural racism and sexism. These must be addressed to facilitate equitable access for all.SummaryThere have been tremendous recent advances in the efficacy of LA ART and PrEP modalities, providing renewed hope that ‘ending the HIV epidemic’ is within reach. However, pervasive socio-structural inequities limit the promise of LA modalities, highlighting the need for cautious optimism in light of the embedded inequities in the trajectory of research, development, and population-level implementation.

Journal

Current Opinion in HIV and AIDS – Wolters Kluwer Health

Published: Mar 7, 2022

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Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

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Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV

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