The HIV Prevention Horizon

Segment Description: Colleen Kelley, MD, MPH, associate professor at the Emory University School of Medicine, describes what's on the horizon in HIV prevention.

Interview Transcript (modified slightly for readability):

Kelley: There are a couple of exciting things to think about when we consider HIV prevention both around pre-exposure prophylaxis or PrEP. There's a regimen using tenofovir and emtricitabine, but only used around the time of sexual activity. This on demand PrEP has been used pretty widely in Europe and is beginning to be used more in the United States. This is called to 2-1-1 PrEP where you take 2 pills of tenofovir emtricitabine 2 to 24 hours before sex, a pill 24 hours after sex, and then a fourth pill 48 hours after sex. That's called on demand or event driven PrEP, or 2-1-1. Prep. We're going to see more and more use of this in the United States. We're going to have to think about how we monitor folks on this regimen, how people are using it, versus choosing to use daily PrEP and how we can best kind of support those folks to use this regimen effectively for prevention.

The other exciting thing on the horizon that we won't have an answer for for the next couple of years, is injectable Cabotegravir that's currently in clinical trials, in the HPTN-083 clinical trial here in the US and in clinical trials internationally as well. In that study, we are comparing injectable Cabotegravir that's delivered every 8 weeks in intramuscular injection versus oral tenofovir emtricitabine for PrEP. And that's delivered on a daily basis, oral tenofovir emtricitabine. If that is shown to be as effective as oral PrEP or oral tenofovir emtricitabine, that will also be a very exciting option for people that don't want to take a pill every single day. They can just have an injection every 8 weeks for prevention. So those are the two things that I think are most exciting and likely to change our practice in the near future.