2022
DOI: 10.1097/coh.0000000000000729
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Long-acting preexposure prophylaxis in low- and middle-income countries: key considerations for implementation

Abstract: Purpose of reviewHIV preexposure prophylaxis (PrEP) is a key tool in ending the HIV epidemic. Long-acting cabotegravir (LA- CAB) phase II/III studies revealed promising efficacy in preventing HIV acquisition. Here, we discuss key considerations for implementing LA-CAB in low- and middle-income countries (LMIC).Recent findingsPrEP roll out in LMIC is still far from ideal, and contextual factors within LMIC vary widely. Implementation science studies are urgently needed to optimize the implementation of LA-CAB i… Show more

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Cited by 3 publications
(4 citation statements)
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“…Beyond clinical science outcomes, implementation research to address programmatic considerations will be essential [ 15 ]. A safe and efficacious LAED will only be impactful if it can be delivered with DSD approaches that balance system constraints against client needs, often defined by the outcomes of acceptability, feasibility, effectiveness, cost and appropriateness [ 16 , 17 ]. In particular, consideration of whether a LAED may address some of the behavioural challenges to adherence (e.g.…”
Section: Introductionmentioning
confidence: 99%
“…Beyond clinical science outcomes, implementation research to address programmatic considerations will be essential [ 15 ]. A safe and efficacious LAED will only be impactful if it can be delivered with DSD approaches that balance system constraints against client needs, often defined by the outcomes of acceptability, feasibility, effectiveness, cost and appropriateness [ 16 , 17 ]. In particular, consideration of whether a LAED may address some of the behavioural challenges to adherence (e.g.…”
Section: Introductionmentioning
confidence: 99%
“…LAP options are being introduced in the context of static prevention funding. The costs of LAPs are considered a major determinant and threat to their implementation [ 60 ]. Stakeholders debate the lack of transparency in injectable PrEP and alternative pricing.…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, implementation strategies must carefully consider unique contextual issues such as health system strengthening and adaptability for innovative service delivery models; policy climates, inclusion in national guidelines and reimbursement systems; longterm sustainability amid limited availability of human and financial resources; and harnessing, creating, and sustaining demand for the product. [23][24][25] Low-and middle-income nations are highly diverse and therefore to facilitate the success of LA ARV availability and uptake, it is important to involve communities in the planning and implementation of LA ARV programs. This will help to ensure that programs are locally tailored, culturally appropriate, and that people with HIV or at risk of HIV acquisition have a voice in designing programs intended to advance clinical care of HIV treatment or prevention.…”
Section: Backg Rou N Dmentioning
confidence: 99%
“…Implementing LA ARVs in low‐ and middle‐income countries may be limited by several challenges including cost and infrastructure. Furthermore, implementation strategies must carefully consider unique contextual issues such as health system strengthening and adaptability for innovative service delivery models; policy climates, inclusion in national guidelines and reimbursement systems; long‐term sustainability amid limited availability of human and financial resources; and harnessing, creating, and sustaining demand for the product 23–25 . Low‐ and middle‐income nations are highly diverse and therefore to facilitate the success of LA ARV availability and uptake, it is important to involve communities in the planning and implementation of LA ARV programs.…”
Section: Introductionmentioning
confidence: 99%