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. 2023 Aug 28;23(1):1643.
doi: 10.1186/s12889-023-16382-4.

Perspectives on long-acting formulations of pre-exposure prophylaxis (PrEP) among men who have sex with men who are non-adherent to daily oral PrEP in the United States

Brooke G Rogers  1   2 , P A Chan  3   4 , C Sutten-Coats  4 , A Zanowick-Marr  3 , R R Patel  5 , L Mena  6   7 , W C Goedel  8 , C Chu  3 , E Silva  3 , D Galipeau  3 , T Arnold  9 , C Gomillia  7 , K Curoe  5 , J Villalobos  5 , A Underwood  5 , C Sosnowy  3 , Amy S Nunn  10   11
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Perspectives on long-acting formulations of pre-exposure prophylaxis (PrEP) among men who have sex with men who are non-adherent to daily oral PrEP in the United States

Brooke G Rogers et al. BMC Public Health. .

Abstract

Introduction: Pre-exposure prophylaxis (PrEP) persistence among men who have sex with men (MSM) in real world clinical settings for HIV prevention is suboptimal. New longer-acting formulations of PrEP are becoming available, including injectables, subdermal implants, and other oral medications. These longer-acting formulations have the potential to improve retention among those who have challenges remaining adherent to daily oral PrEP.

Methods: We interviewed 49 MSM who had initiated but discontinued oral PrEP at three diverse clinics across the United States. We examined participants' perspectives about long-acting PrEP formulations and how long-acting options could affect PrEP use using thematic analysis.

Results: Participants were not very knowledgeable about long-acting formulations of PrEP but were open to learning about them and considering use. Participants were concerned about safety and efficacy of products given that they were still newer and/or in development. Finally, participants had clear preferences for oral pills, injectables, and then subdermal implants and were most interested in options that reduced the number of visits to the clinic.

Conclusion: Long-acting formulations of PrEP are acceptable to MSM with suboptimal PrEP persistence and have the potential to improve PrEP persistence. However, many felt they needed more information on safety, efficacy, and use to consider these options. As these long-acting formulations are implemented, public health campaigns and clinical interventions to encourage may maximize uptake particularly among those who are not currently adherent to daily oral PrEP.

Keywords: HIV prevention; Medication adherence; Men who have sex with men (MSM); PrEP continuum; Pre-exposure prophylaxis (PrEP).

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Conflict of interest statement

B.G.R. co-leads a Gilead Sciences grant to provide PrEP within the Rhode Island Department of Corrections: #IN-US-276-5463. Dr. Philip Chan is staff at Rhode Island Public Health Institute and consults for Rhode Island Department of Health. Dr. Leandro A. Mena reports the following consultant and research grants from Gilead Sciences, ViiV Healthcare/Glaxo-Smith Kline, Merck, Roche and research grants from TaiMed and Janssen. All other authors declare no competing interests.

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