The Joint United Nations Programme on HIV/AIDS (UNAIDS) has announced that it is strongly encouraged by new study results showing that the antiretroviral medicine cabotegravir, which is administered by injection every two months, prevents HIV among women. The study shows that the long-acting injections among women in sub-Saharan Africa were 89% more efficient in preventing HIV compared to daily tablets of pre-exposure prophylaxis (PrEP).
“These results are hugely significant. UNAIDS has long been calling for additional, acceptable and effective HIV prevention options for women, and this could be a real game-changer,” said Winnie Byanyima, Executive Director of UNAIDS. “If donors and countries invest in rolling out access of injectable PrEP to women at higher risk of HIV, new infections could be dramatically reduced.”
The trial enrolled over 3200 women aged between 18 and 45 years who were at higher risk of acquiring HIV in Botswana, Kenya, Malawi, South Africa, Eswatini, Uganda and Zimbabwe. The trial was halted early on the recommendation of the Data and Safety Monitoring Board due to clear statistical evidence showing that the injectable medicine is more effective than a daily pill.
Four HIV infections occurred among women randomly assigned to the cabotegravir injectable arm of the study, compared to 34 infections in the arm that was randomly assigned to daily oral PrEP. The risk of HIV was ninefold lower with cabotegravir injections than with daily oral PrEP.
The study results are important and timely as more methods to prevent HIV among women at higher risk of HIV are urgently needed, including methods that do not depend on daily or near-daily pill-taking, condom use or abstention from sex. The development of alternative methods to prevent HIV, and more adherence-friendly schedules than are currently available, will increase the HIV prevention choices and acceptability for women and reduce new HIV infections.
“UNAIDS congratulates everyone involved in this landmark study,” said Ms Byanyima. “Like with a COVID-19 vaccine, we now must work to ensure that these life-changing injections are accessible, affordable and equitably distributed to people who choose to use them.”
