Brazil and South Africa will be the first countries to have injectable HIV prevention

Brazil and South Africa will be the first to implement the use of long-acting preventive treatment against HIV. The system works like the existing Pre-Exposure Prophylaxis (PrEP). But this time the daily pills will be replaced by six annual injections.

PrEP is a preventive treatment, authorized since 2012, which can reduce the risk of HIV infection by more than 90% (some studies point to up to 99%). But for that, it must be taken daily. Currently, about one million people have access to oral pre-exposure prophylaxis worldwide, including in Brazil, where the pills are available through the SUS.

An injectable version of PrEP will start to be administered soon and the trial will begin in Brazil and South Africa. “Brazil was one of the countries chosen because of its history in the fight against AIDS”, explains Maurício Cysne, director of external relations at Unitaids, an agency linked to the UN that finances the implementation of the project. He recalls that the Latin American country, which already has one of the largest AIDS programs in the world, has always been “open to having a national AIDS prevention policy.”

Cabotégravir, the name of the main molecule used in long-acting PrEP, guarantees protection against HIV infections for eight weeks, thanks to an intramuscular injection. It is presented as an alternative for those who do not want to take daily pills.

“Same effectiveness”

“This treatment has the same effectiveness (as oral PrEP). What changes is only the scope”, points out Cysne. “The project, which is being led by FioCruz in Brazil, is for injectable PrEP to be made available free of charge in the national health system”, she explains.

However, he points out that, like oral PrEP, it is not a vaccine that will be distributed to everyone. The objective is to target populations considered most vulnerable to the epidemic. In the case of Brazil, this group is formed by trans people and men who have sex with other men. In South Africa, the first target audience will be teenagers and younger women, parts of the population have higher rates of contamination.

“These most vulnerable populations suffer from a lot of stigma and discrimination and they don’t seek services, whatever they may be, including health. This makes it very difficult for the national health system to reach these people”, says Cysne.

The director of external relations at Unitaids recalls that Brazil still registers 40,000 new HIV infections a year and that more than 10,000 people still die annually from AIDS.