In the last decade, pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention. The World Health Organization first recommended daily oral PrEP containing tenofovir as an additional prevention option for all populations at substantial risk of HIV in 2015 [1], then added a recommendation for event-driven or “on-demand” PrEP for men in 2019 [2], the monthly dapivirine vaginal ring for women in 2021 [3] and long-acting injectable cabotegravir (CAB-LA) in 2022 [4]. More PrEP options are becoming available, such as lenacapavir, which is administered as a sub-cutaneous injection. Recent clinical trial results suggest lenacapavir injections every 6 months are highly efficacious [5, 6], and early safety and pharmacokinetic data show potential for once-yearly dosing [7].
Despite the promise of PrEP and the recent proliferation of products, the programmatic rollout of PrEP has been challenging, as system-level constraints (e.g. cost, policy, operational barriers), social-level factors (e.g. stigma and lack of normalization of HIV prevention) and individual behaviours (e.g. adherence) have all contributed to limiting overall impact [8-10]. However, more countries have recently adopted PrEP into national guidelines, and global use of PrEP has increased substantially over the last several years [11]. Research suggests that expanding the menu of PrEP options to better meet the diverse needs and preferences of end users could improve uptake and use [12]. The advent of PrEP methods with different administration routes, discreet formulations and less frequent dosing will potentially enable easier access, more effective use, reduce stigma and, in some cases, allow for the implementation of more flexible delivery channels.
To collate early evidence related to expanding access to a choice-based HIV prevention market, we invited investigators and research teams across the globe to submit multidisciplinary articles for this supplement, designed to speak to the evaluation and delivery of PrEP choice in diverse settings and for varied populations. After careful consideration, the editorial team selected 15 contributions that illustrate current evidence, implementation learnings and challenges associated with the introduction, uptake and continued use of PrEP within the context of an expanded HIV prevention method-mix.
Choice in PrEP methods and service delivery approaches have the potential to improve prevention coverage. In a commentary by Schmidt et al. [13], the authors highlight that despite the significant strides made in accelerating oral PrEP scale-up, it is unlikely that global PrEP targets will be met. In the era of PrEP choice, the authors remind readers that choice is not only about PrEP methods, but also service delivery approaches that have the potential to transform global HIV prevention efforts and m
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号