Western Cape Department of Health reacts to long lasting PrEP

CAB-LA, the first long-acting injection for use as HIV pre-exposure prophylaxis (PrEP). Image: Supplied

CAB-LA, the first long-acting injection for use as HIV pre-exposure prophylaxis (PrEP). Image: Supplied

Published Dec 30, 2021

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Cape Tow - The Western Cape Department of Health (WCDH) reacts to the approval of the long-acting injectable cabotegravir (CAB-LA) as the first long-acting injection for use as a pre-exposure prophylaxis (PrEP).

The cabotegravir injectable drug will be given to individuals as a PrEP every two months.

According to a Human Sciences Research Council (HSRC) survey, in Western Cape, an estimated 12.6% of people were living with HIV in 2017. The WCDH is positive that CAB-LA will be another medication that will be added to the arsenal of HIV prevention packages of tools and may appeal to a wider target population.

WCDH spokesperson Byron La Hoe said although CAB-LA is not registered in South Africa by the South African Health Products Regulatory Authority (SAHPRA) and is not yet available in South Africa, they are aware of it and are excited about this development.

‘’We are very excited about this development. We welcome the long-acting injectable medication that will make it easier for patients to adhere to treatment. We cannot wait for the day it gets approved for usage in our country, and we will only follow the National Department of Health guidelines and procurement through the transversal tenders for distribution,’’ said La Hoe.

This comes after the U.S. Food and Drug Administration (FDA) announced their approval of CAB-LA as the first long-acting injection for use as PrEP. PrEP involves taking an antiretroviral to prevent HIV infection.

Currently, In South Africa, PrEP is only available for intake as a daily pill.

A research professor at the University of the Witwatersrand and Director of Research at Wits RHI, Professor Sinead Delany-Moretlwe, said the approval of the injectable cabotegravir for HIV prevention is a tremendous milestone for the HIV prevention field and adds another option for HIV prevention.

CAB-LA is a much-needed addition to a proven HIV prevention option that now also includes male and female condoms, daily oral PrEP, voluntary medical male circumcision (VMMC) and the Dapivirine Vaginal Ring.

‘’The recommendation is important because it is inclusive of all populations, including adolescents who are at high risk for HIV infection. We believe that the injectable PrEP will offer people a discreet and convenient alternative to daily oral pills for HIV prevention. We are really looking forward to approvals from the regulatory authorities in the African region. We believe that injectable PrEP could significantly impact the trajectory of HIV in our region,’’ said Moretlwe.

A report published by the World Health Organization (WHO) in November last year that is based on a study conducted in south and eastern Africa, on women at risk of acquiring HIV showed bias on the injectable.

Based on the WHO report, while oral PrEP is highly effective in preventing HIV in women when taken as prescribed, some women find it difficult to take a daily tablet, and inconsistent use of oral PrEP reduces the prevention effect. A long-acting injectable formulation has the potential to improve the prevention effect without relying on adherence to a daily oral PrEP regimen, and to increase prevention choices and acceptability.

CAB-LA will only be available in the USA for now but will pave the way for approval in other countries, including South Africa.

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