HIV has been a global problem for years now, with about 38.4 million people living with the virus as of the 2021 United Nations statistics.
Multiple attempts at developing a vaccine for the virus has been disappointing over the years as prevention measures in early campaigns consisted of abstinence, being faithful, and condoms.
Oral PrEP has worked well for many, particularly for men who have sex with men in high income settings and for serodifferent couples (couples in which one person has HIV and the other does not).
PrEP administered via a vaginal ring is another safe option that’s been developed. It’s not yet clear how many people will want to use it as it becomes more widely available.
Now that injectable PrEP is an option, it’s poised to make an enormous difference in HIV prevention.
The injectable form of PrEP called cabotegravir (CAB-LA), which is given through the buttocks and can last for two months, has been proven more effective than the oral medication.
Another injectable drug, lenacapavir (still in clinical trials) would only need to be given once every six months and would be easier to inject because it only needs to go into the skin.
In many ways, injectable PrEP seems like a perfect solution, however some public health officials and healthcare workers have worried about the pain and any swelling due to the injection itself.
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CAB-LA is, however, expensive going for over $22,000 per person per year in the US.
The drug manufacturer will lower the prices for the middle- and low-class income countries but the exact price is not yet known.
The new injectable can be covered by insurance but not everyone has health coverage.
The average annual cost per person for CAB-LA is estimated at $250 which is five times more expensive than oral PrEP.
The United States was the first country to approve CAB-LA in December 2021. The next was Zimbabwe in October 2022. The necessary paperwork is being processed in other countries in sub-Saharan Africa, but regulatory processes are slow, and access is likely to be a challenge for some time.
PrEP needs to be easier for people to take, for instance by making it more convenient and less medical