Current and future PrEP medications and modalities: on-demand, injectables, and topicals
MR Beymer, IW Holloway, C Pulsipher… - Current hiv/aids …, 2019 - Springer
Current hiv/aids Reports, 2019•Springer
Abstract Purpose of Review Pre-exposure prophylaxis (PrEP) is a potent HIV prevention
strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently
available and agents and modalities under investigation. Recent Findings Injectable ARV
preparations have high acceptability among users but are likely to require adherence to 8-
week interval injections. Topical microbicide gels and vaginal rings have underperformed by
intention-to-treat analyses in efficacy studies, at least in large part due to challenges with …
strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently
available and agents and modalities under investigation. Recent Findings Injectable ARV
preparations have high acceptability among users but are likely to require adherence to 8-
week interval injections. Topical microbicide gels and vaginal rings have underperformed by
intention-to-treat analyses in efficacy studies, at least in large part due to challenges with …
Purpose of Review
Pre-exposure prophylaxis (PrEP) is a potent HIV prevention strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently available and agents and modalities under investigation.
Recent Findings
Injectable ARV preparations have high acceptability among users but are likely to require adherence to 8-week interval injections. Topical microbicide gels and vaginal rings have underperformed by intention-to-treat analyses in efficacy studies, at least in large part due to challenges with adherence and/or sustained use. However, daily oral TDF-FTC also underperformed in randomized, placebo-controlled trials compared to expectations and subsequent real-world pragmatic use.
Summary
On-demand (2-1-1 dosing strategy for MSM) and injectable PrEP appear to be acceptable among participants in clinical trials. These modalities are particularly compelling alternatives for individuals who either do not want to take a daily medication (both on-demand and injectable) and/or want to take PrEP without a long commitment (on-demand). Emerging modalities such as vaginal films, microneedles, and subdermal implants have numerous advantages but are still in early stages of development.
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