A new long-acting injectable form of pre-exposure prophylaxis, or PrEP, is now available, offering a potential improvement in access to HIV prevention for specific populations. The medication, cabotegravir – marketed as Apretude – is administered as an injection and could address barriers to consistent PrEP use.
Public health officials hope the two-monthly injection will be particularly beneficial for several groups, including women, who currently represent only 6% of individuals using PrEP in France; people who are disconnected from the healthcare system; individuals facing vulnerabilities that may prevent adherence to daily oral PrEP; those for whom taking a daily pill is difficult or requires discretion; and people with contraindications to oral PrEP.
Apretude is an intramuscular injection, requiring an initial two injections one month apart, followed by administration every two months. The availability of this new method expands the toolkit for HIV prevention.
This new option complements existing prevention strategies, which include consistent condom use, regular HIV and sexually transmitted infection (STI) screening, post-exposure prophylaxis (PEP), treatment for individuals living with HIV to prevent transmission and traditional oral PrEP.
While cabotegravir represents a significant advancement, its implementation presents practical challenges. “Its deployment requires clinical expertise and an adapted care pathway, particularly in terms of assessing indication, regular patient monitoring, HIV and STI screening, and maintaining care,” according to the French Directorate-General for Health (DGS).
The DGS is encouraging physicians interested in supporting their patients to connect with their regional sexual health committees (CoReSS). A guide for prescribers has been developed by the French Society for the Fight Against AIDS (SFLS), detailing the indications for injectable PrEP and patient follow-up procedures. A toolkit includes an application for scheduling injections, information for patients, resources for pharmacists and nurses, and a support system coordinated by the CoReSS.
Cabotegravir is an antiviral medication belonging to the integrase inhibitor class. By inhibiting this enzyme, the drug prevents HIV from inserting its genetic material into cells, thereby preventing replication and reducing the risk of viral multiplication and spread following exposure. More information about Apretude is available on the manufacturer’s website.
The FDA has also published a label for APRETUDE (cabotegravir) which details dosing and administration. You can discover that information here.
