Affiliation:
1. ViiV Healthcare, Research Triangle Park, NC, USA
Abstract
In 2020, the HIV prevention clinical trials, HPTN (HIV Prevention Trials Network) 083 and 084, reported that long-acting injectable cabotegravir (CAB-LA) for HIV prevention was statistically superior to daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for pre-exposure prophylaxis (PrEP) in cisgender men and transgender women who have sex with men, and cisgender women. However, clinical efficacy does not translate to real-world effectiveness and clinical practice as evidenced by current global use of oral PrEP. There are ~626,000 users of PrEP, which is significantly below the 3 million goal set by UNAIDS for 2020. Implementation will be key to ensuring that CAB-LA reaches those who desire to use it. We describe the Layer Plus Approach for CAB-LA for PrEP dissemination and implementation. The “Layer” is focused on integrating CAB-LA into existing PrEP models of care and understanding the best delivery channels that could be established in existing programs. Important implications of layering include preparing health professionals to provide CAB-LA, improving access for potential users, and addressing existing PrEP structural and facility barriers. “Plus,” which accounts for the existing disparities in PrEP access and use, means expanding CAB-LA to reach individuals for whom HIV prevention options have not been accessible or who have lapsed on oral PrEP. Implications for Plus include the development of new structures, systems, policies, and processes. A key aspect to the Approach is building collaborations to aid successful implementation. The Layer Plus Approach is a simple but strategic framework or a tailored approach to guide dissemination research and implementation.
Subject
Nursing (miscellaneous),Public Health, Environmental and Occupational Health
Reference12 articles.
1. AVAC. (2020). PrEP works. Investment in more options must continue, and faster, smarter rollout must be a top priority. Retrieved from https://www.avac.org/prevention-option/prep
2. AVAC. (2021). An advocates’ primer on long-acting injectable cabotegravir for PrEP: Understanding the initial results of HPTN 083. Retrieved from https://www.avac.org/primer-long-acting-injectable-prep
3. Using Implementation Science to Better Integrate Novel Long-Acting Injectable Therapy Into Routine HIV Care
4. HIV Prevention Trials Network. (2020, November 9). HPTN 084 study demonstrates superiority of CAB LA to oral FTC/TDF for the prevention of HIV [Press release]. Retrieved from https://www.hptn.org/news-and-events/press-releases/hptn-084-study-demonstrates-superiority-of-cab-la-to-oral-ftctdf-for
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献