Related Experiment Video
Updated: Jul 23, 2025
06:07
Oral Combinational Antiretroviral Treatment in HIV-1 Infected Humanized Mice
Published on: October 6, 2022
2.4K
Preparing for long-acting PrEP delivery: building on lessons from oral PrEP.
Connie Celum1, Beatriz Grinsztejn2, Kenneth Ngure3
1Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA.
Journal of the International AIDS Society
|July 13, 2023
Summary
Long-acting (LA) HIV pre-exposure prophylaxis (PrEP) offers new options to increase coverage and effectiveness. Lessons from oral PrEP delivery, focusing on service delivery and client support, are crucial for optimizing LA PrEP implementation.
Area of Science:
- Public Health
- Infectious Disease Prevention
- HIV/AIDS Research
Background:
- Recent approvals of long-acting (LA) HIV pre-exposure prophylaxis (PrEP), including injectable cabotegravir and the dapivirine ring, necessitate optimized delivery strategies.
- Leveraging lessons from a decade of oral PrEP delivery is essential for the successful implementation of new LA PrEP methods.
Purpose of the Study:
- To outline key considerations for optimizing the delivery of long-acting HIV pre-exposure prophylaxis (PrEP).
- To adapt successful strategies from oral PrEP delivery for new long-acting formulations.
- To enhance HIV prevention coverage, adherence, persistence, and effectiveness through expanded PrEP options.
Main Methods:
- Framing LA PrEP delivery around differentiated service delivery building blocks.
- Identifying critical factors: population reach, service location, user burden reduction, and service integration.
- Incorporating community co-development for demand creation and education, provider training, and tailored adherence support.
Main Results:
- Optimizing LA PrEP delivery requires strategic planning for accessibility, user convenience, and integration with other health services.
- Effective demand creation, informed client decision-making, and comprehensive provider training are vital for successful uptake.
- Tailored adherence support and flexible service delivery models (e.g., telePrEP, pharmacy-based) are crucial for persistence.
Conclusions:
- Expanding PrEP options with LA formulations can increase coverage, adherence, persistence, and effectiveness by meeting diverse individual needs.
- Lessons learned from oral PrEP delivery regarding demand creation, client engagement, provider education, adherence support, and service models are directly applicable to LA PrEP implementation.
- Integrated service delivery models are essential for maximizing the impact of LA PrEP within broader HIV prevention and sexual health programs.
Related Concept Videos
01:18Drug Delivery: Enteral Route
518
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
518
01:24Factors Influencing Drug Absorption: Presystemic Elimination
264
The pharmacokinetic journey of oral drugs begins with a crucial first pass through the hepatic portal system, called the first-pass effect. This first pass significantly impacts bioavailability — the proportion of a drug that enters systemic circulation and is available for therapeutic action. The primary route sees the drug absorbed by intestinal membranes and then shunted to the liver via the hepatic portal vein. Here, pre-systemic elimination occurs as drugs face metabolism or biliary...
264
01:16Drug Delivery: Overview
326
The selection of a drug's delivery route depends upon its physicochemical properties, including lipid or water solubility and ionization, as well as the therapeutic requirement, such as immediate or sustained effect. These routes can be divided into three primary categories: enteral, parenteral, and topical.
Enteral delivery involves administering drugs directly through swallowing, sublingual placement, or buccal application. Orally administered drugs predominantly navigate the...
Enteral delivery involves administering drugs directly through swallowing, sublingual placement, or buccal application. Orally administered drugs predominantly navigate the...
326
01:27Insulin Formulations: Types and Delivery
232
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
232
01:18Routes of Drug Administration: Enteral
3.8K
Medications can be administered through the enteral route using liquids, capsules, or tablets.
Enteral administration involves drug administration via the mouth in two ways: orally or sublingually.
Unlike sublingually drugs, drugs that are taken orally pass through the gastrointestinal (GI) tract and get metabolized by the liver. Once metabolized, the drug is absorbed into the systemic circulation, reaching different body parts via the bloodstream. However, while passing through the stomach,...
Enteral administration involves drug administration via the mouth in two ways: orally or sublingually.
Unlike sublingually drugs, drugs that are taken orally pass through the gastrointestinal (GI) tract and get metabolized by the liver. Once metabolized, the drug is absorbed into the systemic circulation, reaching different body parts via the bloodstream. However, while passing through the stomach,...
3.8K
01:22Drug Delivery: Miscellaneous Routes
394
Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection, and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
394