Developments in HIV care, particularly the advent of long-acting injectables and novel pre-exposure prophylaxis (PrEP) options, are significantly improving patient outcomes and adherence, according to Jay Holloway, PharmD, AAHIVP, a staff pharmacist with the AIDS Healthcare Foundation. These advancements offer more tools to address diverse patient needs and preferences, marking a new era in HIV management and prevention.
The Rise of Long-Acting Injectables
Holloway highlighted the impact of single-tablet regimens and injectable antiretrovirals (ARVs) like CABENUVA (cabotegravir) in simplifying treatment and improving adherence. "For single-tablet regimens, the fewer pills that a patient has to take, the better the adherence, the better the outcomes," he noted. Injectable ARVs provide a valuable alternative for patients who struggle with daily oral medication due to scheduling issues, forgetfulness, or personal preference. Patients receive an injection every two months, offering a convenient and effective means of maintaining viral suppression.
Promising PrEP Developments with Lenacapavir
One of the most anticipated developments is the PURPOSE trial, which is evaluating lenacapavir for PrEP. Initial results from the PURPOSE 1 trial demonstrated the efficacy of long-acting injectables for PrEP in cisgender women and girls. The upcoming results from PURPOSE 2 are expected to broaden the scope of PrEP options for all other populations. Holloway emphasized the importance of having a variety of tools available to meet the diverse needs of patients, including single-tablet regimens and injectables.
Addressing Health Disparities and Stigma
Holloway stressed that effective HIV care extends beyond medication access. Addressing health disparities and providing comprehensive support are crucial for improving patient outcomes. He cited the concept of "U equals U" (undetectable equals untransmissible), which means that individuals with an undetectable viral load cannot transmit HIV sexually. This understanding is vital for reducing stigma and promoting public health. Holloway quoted Black and Pink, an organization supporting incarcerated individuals living with HIV: "If you want someone to take meds to save their life, you have to give them a reason to live."
California's Strong ADAP Program
California's robust AIDS Drug Assistance Program (ADAP) ensures that individuals living with HIV can access ARVs and other essential medications at no cost. This program plays a critical role in supporting adherence and improving health outcomes for people living with HIV in the state.
