What PrEP products can I get now?
Two types of oral pills have been approved by a regulatory body for prevention. TDF/FTC was the first oral PrEP method available (brand name Truvada), although in select countries generic options such as TDF/3TC and TDF are also available. TDF/FTC has been approved for all populations. F/TAF (brand name Descovy) is a newer addition to the prevention portfolio, approved by the US FDA for daily use by cisgender men and transwomen in 2019. A trial is planned to investigate efficacy in cisgender women.
Someday soon other kinds of PrEP may be available.
The Dapivirine Ring is currently under review by several African countries. Studies show that the ring, inserted monthly, reduces the risk of HIV acquisition through a slow release of an ARV called dapivirine, with no safety concerns. After receiving a positive opinion from the European Medicines Agency (EMA) in July 2020 and WHO pre-qualification in November 2020, the WHO released new clinical recommendations on HIV prevention in March 2021 with detailed guidance for the ring as an additional prevention choice for women at substantial risk of HIV infection as part of a combination prevention package. IPM has applied for the ring to be reviewed by countries in sub-Saharan Africa, where women face persistently high HIV risk. Initial regulatory submissions have been filed for Eswatini, Kenya, Lesotho, Malawi, Rwanda, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. For the latest information, visit IPM's website.
Cabotegravir is an ARV approved for use as prevention by the US FDA, as of December 2021. It was found to be safe and efficacious in two studies administering the drug, every two months, as a long acting injection. HPTN 083 enrolled cisgender men who have sex with men and transwomen and HPTN 084 enrolled cisgender women. Both trials will continue as open label extension studies, and further regulatory review in other countries is underway.
A dual-prevention pill (DPP), an option which combines active ingredients from oral contraceptives and oral PrEP into one daily pill is also being studied. Results are expected in 2022. This kind of combination prevention is referred to as multipurpose prevention technology (MPT).
Other PrEP strategies are in development. These include a monthly oral pill (islatrivir), a quick-dissolving vaginal film containing ARVs that can be inserted right before sex, a long-acting injection of a drug called lenacapavir, and a long-acting implant that could offer protection for up to a year.
PrEP doesn’t protect against other STIs or pregnancy.
Oral PrEP, the Dapivirine Ring, or cabotegravir offer protection against HIV. None of these products reduce the risk of chlamydia, gonorrhea, syphilis or herpes, or prevent pregnancy. Male and female condoms do all this. Comprehensive access to PrEP, condoms, voluntary medical male circumcision (VMMC), communication and counseling must be integrated to empower people around their sexual and reproductive health.