Related Experiment Video
Updated: Mar 29, 2026
07:18
High Throughput In Vitro Assessment of Latency Reversing Agents on HIV Transcription and Splicing
Published on: January 22, 2019
6.3K
Bridging the Gap: The PrEP Cascade Paradigm Shift for Long-Acting Injectable HIV Prevention
1Nyx Dynamics, LLC, Fairfield, CT 06824, USA.
Viruses
|March 28, 2026
Summary
Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) has high efficacy but low initiation rates. Addressing the critical "bridge period" before the first injection is key to improving LAI-PrEP uptake.
Area of Science:
- Infectious Diseases
- Public Health
- Pharmacology
Background:
- Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) offers superior efficacy and persistence over daily oral PrEP.
- Real-world data show a significant gap between LAI-PrEP prescription and initial injection, with only 52.9% initiating treatment.
- This initiation gap is linked to the 2-8 week "bridge period" required for LAI-PrEP to confirm HIV-negative status, unlike same-day oral PrEP initiation.
Purpose of the Study:
- To characterize the navigation of the LAI-PrEP bridge period as a critical implementation barrier.
- To propose a reconceptualized PrEP cascade that explicitly includes and manages the bridge period.
- To identify strategies for improving LAI-PrEP initiation success by addressing structural factors.
Main Methods:
- Synthesized data from major clinical trials (HPTN 083, HPTN 084, PURPOSE-1/2; >15,000 participants).
- Integrated findings with real-world implementation studies on LAI-PrEP.
- Examined pharmacological bases for initiation protocols and quantified population-specific barriers.
Main Results:
- The "bridge period" presents a significant, distinct implementation barrier for LAI-PrEP initiation.
- A substantial proportion of individuals fail to complete the bridge period, hindering treatment initiation.
- The study highlights the need to shift focus from individual adherence to systemic healthcare factors.
Conclusions:
- A reconceptualized PrEP cascade recognizing the bridge period is essential for LAI-PrEP implementation.
- Dedicated management strategies are required to navigate the bridge period effectively.
- Addressing this structural barrier is crucial for realizing LAI-PrEP's public health potential, especially in high-burden populations.
Related Concept Videos
01:21Intrauterine Drug Delivery Systems
127
Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
127
01:10Retrovirus Life Cycles
50.6K
Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
50.6K
01:11Oral Drug Delivery Systems: Delayed-Release Systems
139
Delayed-release drug delivery systems are specialized pharmaceutical formulations designed to postpone the release of active compounds until the drug reaches a specific region of the gastrointestinal (GI) tract, typically the intestine. These systems are essential for drugs that may cause gastric irritation, are unstable in acidic environments, or need to exert therapeutic effects locally in the intestinal or colonic regions.The core feature of delayed-release systems is the use of enteric...
139
01:27Insulin Formulations: Types and Delivery
1.1K
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...
1.1K
01:21Drug Accumulation During Multiple Dosing: Repetitive IV Injections
388
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
388
01:28Parenteral Drug Delivery Systems: Injectables, Implants, and Infusion Devices
115
Parenteral drug delivery systems play a crucial role in modern therapeutics by enabling the direct administration of drugs into the systemic circulation, bypassing the gastrointestinal tract. These systems are particularly valuable for poorly absorbed oral medications that are unstable in the digestive environment or require rapid onset or sustained therapeutic levels. Delivery is achieved through intravenous, intramuscular, or subcutaneous routes, each selected based on the drug's properties...
115