reduce the risk to HIV infection as much as 2.5 – 3.0 -fold, probably higher if the subjects were all taking the medicine. But there is even better news.
For the group who received an injection of cabotegravir every two months, there were four infections, or an incidence rate of 0.21%. This is superior protection with the cabotegravir injection compared to the daily-oral Truvada.
This study is extremely important for a number of reasons. Young African women are among the groups at highest risk for HIV infection in the world. In many settings, it is difficult for women to negotiate safe sex practices (i.e. use of condoms) with their male partners.
There are also unacceptable rates of sexual violence against women by their partners. Further, in impoverished communities, sex work is used as a source of income.
Women struggling to make ends meet may have to choose between requiring their clients to use condoms or accepting clients who will pay many times more not to use them.
So the need for PrEP is urgent, but the use of oral PrEP (i.e. Truvada), can be stigmatizing. People often do not understand that the person taking HIV meds doesn’t have HIV but is actually protecting themselves from getting it.
An injection with cabotegravir that is taken every two months appears to provide unparalleled protection and circumvent other problems common with PrEP.
So now, we have shown that injectable cabotegravir can effectively protect against HIV infection in men and women with a single injection every two months.
This medicine could be a real game-changer in preventing HIV infection worldwide. Now, the biggest hurdle will be the cost of the medicine. While it is more effective than Truvada, it almost certainly will cost more.
Who will cover the costs in Africa, Asia and Latin American countries? Will insurances in the US cover the cost? Time will tell. Stay tuned!