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HIV prevention: better choice for better coverage.

Linda-Gail Bekker1, Carey Pike1, Sharon L Hillier2,3

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Pre-exposure prophylaxis (PrEP) is a key HIV prevention method. Next-generation PrEP aims to improve adherence and accessibility, supporting global HIV reduction targets.

Keywords:
HIV preventionPrEP implantsinjectable PrEPlong-acting PrEPoral PrEPpre-exposure prophylaxis

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Pharmacology

Background:

  • Antiretroviral-based pre-exposure prophylaxis (PrEP) is an established HIV prevention strategy.
  • Current first-generation daily oral PrEP faces adherence challenges, particularly in younger populations.
  • Biomedical innovations are crucial for maximizing HIV prevention potential.

Purpose of the Study:

  • To review the challenges associated with current PrEP methods.
  • To explore the potential of second-generation PrEP agents and delivery systems.
  • To emphasize the need for diverse PrEP options to meet global HIV prevention targets.

Main Methods:

  • Literature review of first- and second-generation PrEP agents.
  • Analysis of end-user challenges impacting adherence.
  • Discussion of ongoing and future PrEP product development.

Main Results:

  • First-generation daily oral PrEP is effective but faces adherence barriers (e.g., side effects, dosing frequency).
  • Second-generation PrEP includes monthly rings, 8-weekly injectables, and potential long-acting formulations.
  • Further development is needed to optimize next-generation PrEP delivery systems.

Conclusions:

  • Second-generation PrEP holds promise for improved adherence and user convenience.
  • Meeting global HIV prevention goals requires both existing and novel PrEP options.
  • Tailoring PrEP to individual needs is essential for effective HIV prevention.