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. 2025 Jan 28:ciae648.
doi: 10.1093/cid/ciae648. Online ahead of print.

Policy Recommendations to Support Equitable Access to Long-Acting Injectables for Human Immunodeficiency Virus Prevention and Treatment: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association

Julia L Marcus  1 , Andrea Weddle  2 , Colleen F Kelley  2   3 , Allison Agwu  2   4 , Sheila Montalvo  5 , Elizabeth Sherman  2   5 , Tara Vijayan  2   6 , Jose Gutierrez  7 , Matthew D Hickey  8 , Samantha E Dilworth  9 , Douglas Krakower  1 , Teaniese L Davis  10 , Lauren F Collins  3 , Moira C McNulty  11 , Jonathan A Colasanti  3 , Katerina A Christopoulos  8
Affiliations

Policy Recommendations to Support Equitable Access to Long-Acting Injectables for Human Immunodeficiency Virus Prevention and Treatment: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association

Julia L Marcus et al. Clin Infect Dis. .

Abstract

Long-acting injectables (LAIs) for HIV prevention and treatment could dramatically improve health outcomes and health equity for people with HIV and those who could benefit from pre-exposure prophylaxis. Despite widespread acceptability and demand by providers and potential users of LAIs, implementation has been extremely limited since the introduction of cabotegravir/rilpivirine, the first LAI for HIV treatment, in January 2021, and long-acting cabotegravir, the first LAI for HIV prevention, in December 2021. We report results of a provider survey, conducted by the HIV Medicine Association, which identified LAI implementation barriers related to health insurance processes, staffing and administrative support, drug costs and acquisition, and access for individuals who are uninsured. We provide policy recommendations to address those barriers and facilitate broad and equitable access to LAIs for HIV prevention and treatment, which will be necessary to achieve the goals of the US Ending the HIV Epidemic initiative.

Keywords: antiretroviral agents; cabotegravir; health policy; lenacapavir; pre-exposure prophylaxis.

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Conflict of interest statement

Potential conflicts of interest . J. L. M., T. L. D., and S. E. D. have received research funding from the National Institutes of Health (NIH) paid to their institutions. A. W. serves on the Women's Research Initiative on HIV/AIDS (WRI) Advisory Group, and lodging and food for annual meetings is paid for by the WRI. C. F. K. has received research funding to her institution from Gilead Sciences, ViiV Healthcare, Moderna, Novavax, and Humanigen. A. A. has received research funding from the National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development paid to her institution, conducted research on HIV prevention in a multicenter study and an investigator-initiated study with grants from Gilead Sciences paid to her institution, and has received consulting fees from Gilead Sciences and ViiV Healthcare. S. M. has received research funding from ViiV Healthcare paid to her institution. D. K. has conducted research on HIV prevention with grants from Gilead Sciences and Merck to his institution, has received consulting fees from the University of Alabama at Birmingham and the University of North Texas Health Science Center, personal funds from Medscape and UpToDate to develop medical education content, and has had travel funded by PrEP4All to their meeting on a national PrEP program. M. C. M. has received research funding from NIH paid to her institution and has served on an advisory board for Gilead Sciences. J. A. C. has received research funding from NIH paid to his institution and consulting fees from Prime Education and Integritas Communications. K. A. C. has received research funding paid to her institution from NIH and has been a workshop participant for Janssen and an advisory board participant for Gilead Sciences. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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