With the release of the WHO Guidelines on Long-Acting Injectable Cabotegravir for HIV Prevention in 2022, HIV prevention programs and implementing partners are working to prepare for rapid expansion of additional methods of HIV pre-exposure prophylaxis (PrEP). Experience from the scale-up of previous HIV prevention programs demonstrates the advantages of ready-made provider capacity building resources that address clinical knowledge as well as key counseling messages and skills, developed specifically to align with WHO guidance and recommendations.
With funding from PEPFAR through USAID, the Reaching Impact, Saturation, and Epidemic Control (RISE) project developed a new provider training resource on use of long-acting cabotegravir (CAB for PrEP) for HIV prevention. The “Provider Training Toolkit on use of CAB for PrEP” (available at www.jhpiego.org/HIVPrEPToolkit) is designed to help clinicians learn about and support provision of CAB for PrEP as an HIV prevention option for their clients.
The toolkit includes a series of eLearning lessons to build provider knowledge of CAB for PrEP covering clinical information and eligibility, administration, ongoing clinical management, and counseling, including an animated demonstration of the injection technique. The eLearning lessons include job aids, algorithms, and other provider support tools that can be downloaded or printed. There are separate complementary resources to guide programs and implementing partners wishing to combine online and in-person practice through a blended learning approach, including a facilitation guide and case-based scenarios. For those limited to classroom-based training approaches, there is also a comprehensive slide deck for in-person only trainings.
CAB for PrEP Clinical and Counseling Content
Clinical Information and Eligibility
- Lesson 1: The Basics of Cabotegravir (CAB) for HIV Prevention
- Lesson 2: Relative Advantages and Disadvantages of Long-acting Injectable Cabotegravir (CAB for PrEP)
- Lesson 3: CAB for PrEP Eligibility Screening
CAB for PrEP Administration
- Lesson 4: CAB for PrEP Injection Technique (with demonstration video)
- Ongoing Clinical Management
- Lesson 5: Follow Up Schedule and Visit Components
- Lesson 6: Assessing and Managing Side Effects and Adverse Reactions of CAB for PrEP
- Lesson 7: Managing Follow-Up Irregularities Including Missed Visits
- Lesson 8: Discontinuation of CAB for PrEP and Tail Phase Monitoring
- Lesson 9: Method Choice: Framing Method Benefits Relative to Client Priorities
- Lesson 10: Cross-Cutting Counseling Techniques
- Lesson 11: Translating Technical Information into Counseling Messages
Pregnancy and Breastfeeding
- Lesson 12: Special Pregnancy and Breastfeeding Considerations for CAB for PrEP
Training Resources and Approaches
- Digital eLearning lessons focused on building knowledge of CAB for PrEP and introducing tools for counseling, clinical assessment, and ongoing clinical management.
- Facilitation resources for in-person blended learning workshops for practice and application of knowledge and tools.
- Classroom-based training resources for use in settings where online access to the digital eLearning lessons is limited, or where classroom-based learning is preferred.
Normative Guidance/Policies, Service Delivery, Vertical Transmission
Elimination of vertical transmission of HIV will require expanded access to HIV prevention strategies, such as PrEP, for pregnant and breastfeeding people. Guidance from the World Health Organization (WHO) supports provision of HIV pre-exposure prophylaxis (PrEP) to pregnant and breastfeeding people (PBFP) who are at continuing substantial risk of HIV infection. Evidence has shown that…
Injectable PrEP Factsheet for MSM Advocates and Community Members in the Asia-Pacific Region
Value Chain Situation Analysis for CAB PrEP – Interview Guide
The interview question bank is designed to help identify questions to ask stakeholders in interviews to inform a situation analysis for CAB PrEP.
Value Chain Situation Analysis for CAB PrEP – Overview Guide
This tool can be used by policymakers or others supporting policy development for CAB PrEP (e.g., nongovernmental organizations, donors) to conduct an analysis to assess the existing situation for the introduction of the new product. The guide facilitates a structured process in three steps to support initial planning for CAB PrEP introduction: data collection, stakeholder…
Feasibility of Long Acting Injectable Cabotegravir PrEP Initiation and Administration by Community Health Workers and Early Aspects of the PrEP Injection Care Continuum in a Primary Care Center in Washington, D.C.
This poster presentation, delivered at IAS 2023 by the Whitman-Walker Institute, describes the integration of long acting injectable cabotegravir for PrEP, administered by community health workers, or non medically licensed staff, in a primary health clinic in Washington, D.C., USA.
Shaping and Coordinating the Implementation Science Agenda for Injectable Cabotegravir for PrEP: The role of the Biomedical Prevention Implementation Collaborative (BioPIC)
This article from JIAS describes the coordinated approach taken by the Biomedical Prevention Implementation Collaborative (BioPIC) to ensure questions regarding delivery of cabotegravir (CAB) for PrEP are addressed so that CAB can be introduced in low- and middle-income countries in timely, acceptable and effective ways.
Counterfactual Estimation of Efficacy against Placebo for Novel PrEP Agents Using External Trial Data: Example of injectable cabotegravir and oral PrEP in women
This article from JIAS uses estimated prevention efficacy against a counterfactual placebo to provide information on the use of cabotegravir for PrEP and oral PrEP compared to no intervention.
Country Planning for Product Introduction Matrix
AVAC’s Country Planning for Product Introduction Matrix tracks the regulatory status of cabotegravir for PrEP and the dapivirine vaginal ring, along with related late stage clinical trials and implementation research, procurement plans, and oral PrEP provision across lower and middle income countries.
Global Acute HIV Infection Algorithm Job Aids for Providers
These job aids can assist providers in ruling out HIV infection by offering guidance through three steps: HIV testing, HIV recent exposure assessment: determining need for PEP instead of PrEP, and acute HIV infection assessment. The job aids cover ruling out HIV acquisition for new or returning adherent or non-adherent clients using oral PrEP, PrEP…
Integrated Study Dashboard
This dashboard, produced under the BioPIC project, reflects all currently known activities relating to implementation research, modelling, clinical research, and landscaping for new late stage biomedical HIV PrEP options, including cabotegravir for PrEP and the dapivirine vaginal ring. To update or add any activities missing from the dashboard, or if you have questions on using…