March 06, 2024
2 min read
Add topic to email alerts
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on .
”
data-action=”subscribe”>
Subscribe
We were unable to process your request. Please try again later. If you continue to have this issue please contact [email protected].
Back to Healio
Key takeaways:
- PrEP coverage increased by around five times when the option of long-acting medication was offered in a Ugandan study.
- At any point during the study, 56% of patients opted for the long-acting version.
DENVER — Giving patients the option of choosing long-acting PrEP resulted in a fivefold increase in coverage and a reduction in HIV incidence during the SEARCH trial in Uganda, researchers reported.
“Last year we presented results from three randomized trials in Kenya and Uganda of this SEARCH dynamic choice HIV prevention package, and we showed that … it increased biomedical prevention coverage, but this was still not high enough,” Moses R. Kamya, MBChB, MMed, PhD, MPH, professor of medicine at Makerere University, said during a press conference at the Conference on Retroviruses and Opportunistic Infections.
Data derived from Kamya MR, et al. Abstract 172. Presented at: Conference on Retroviruses and Opportunistic Infections; March 3-6, 2024; Denver.
“So, we hypothesized that if we added cabotegravir to our prevention options, we might increase coverage,” Kamya said.
Kamya and colleagues recruited patients from three randomized studies of the SEARCH dynamic choice HIV prevention (DCP) intervention vs. standard of care in antenatal clinics, outpatient departments and the community. Eligible participants had to be older than age 15 years with a reported risk for HIV.
Participants in the standard-of-care arm had access to oral PrEP and post-exposure prophylaxis (PEP) at local Ministry of Health clinics, whereas the SEARCH DCP model included a choice between oral PrEP, PEP or injectable long-acting cabotegravir (CAB-LA), with the ability to switch between or stop products over time based on preference and risk. The primary outcome was coverage time over 48 weeks, and secondary outcomes included coverage during periods of retrospectively self-assessed HIV risk and incident HIV infection.
Overall, they enrolled 984 patients — 487 to receive DCP and 497 to receive standard of care. The study showed that PrEP adherence was higher in the DCP group vs. standard of care (69.7% vs. 13.3%), a difference of 56.4 percentage points (95% CI, 50.8-62.1). The intervention’s effect on coverage during periods of HIV risk was even larger — 76.5% in the DCP group vs. 16.2% in standard of care.
After assessing patient preferences in the DCP group, the researchers found that 56% used CAB-LA at one point, 53% used PrEP and 2% PEP. They noted that 43% of people who opted for the CAB-LA option were not previously using oral PrEP or PEP, “showing benefit of adding the CAB- LA option.”
Additionally, seven patients acquired HIV infection and there was one perinatal transmission in the standard-of-care treatment group during the study (incidence rate = 1.8%), whereas no HIV infections were reported in the DCP group.
“People want product options,” Kamya said. “It is my appeal to all key stakeholders and policymakers that we make person-centered care models and access to cover a priority.”
Published by:
Sources/Disclosures
Collapse
Source:
Kamya MR, et al. Abstract 172. Presented at: Conference on Retroviruses and Opportunistic Infections; March 3-6, 2024; Denver.
Disclosures:
The authors report no relevant financial disclosures.
Add topic to email alerts
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on .
”
data-action=”subscribe”>
Subscribe
We were unable to process your request. Please try again later. If you continue to have this issue please contact [email protected].
Back to Healio
