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Current and Future PrEP Medications and Modalities: On-demand, Injectables, and Topicals
Matthew R Beymer1, Ian W Holloway2, Craig Pulsipher3
1Department of Health and Mental Health Services, Los Angeles LGBT Center, McDonald/Wright Building, 1625 N Schrader Blvd, Room 114-E, Los Angeles, CA, 90028, USA. mrbeymer@gmail.com.
Current HIV/AIDS Reports
|June 22, 2019
Summary
Daily oral pre-exposure prophylaxis (PrEP) for HIV prevention has low uptake. New on-demand and injectable PrEP options show promise for improved adherence and user preference.
Area of Science:
- HIV Prevention
- Pharmacology
- Public Health
Background:
- Pre-exposure prophylaxis (PrEP) is a key HIV prevention tool.
- Uptake of daily oral PrEP remains suboptimal.
- This review examines current and emerging PrEP strategies.
Purpose of the Study:
- To review available PrEP agents.
- To discuss novel PrEP modalities under investigation.
- To highlight factors influencing PrEP uptake and adherence.
Main Methods:
- Literature review of existing and investigational PrEP agents.
- Analysis of clinical trial data on acceptability and efficacy.
- Evaluation of adherence challenges with various PrEP formulations.
Main Results:
- Injectable antiretroviral (ARV) preparations demonstrate high user acceptability.
- On-demand (2-1-1 dosing) and injectable PrEP are well-tolerated and preferred by some individuals.
- Topical microbicides and vaginal rings have faced adherence challenges.
- Daily oral TDF-FTC showed lower efficacy than expected in trials.
- Emerging modalities like films, microneedles, and implants are in early development.
Conclusions:
- On-demand and injectable PrEP offer promising alternatives for individuals seeking non-daily or non-long-term HIV prevention.
- Addressing adherence and sustained use is critical for the success of all PrEP modalities.
- Further research and development are needed for novel PrEP delivery systems.
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