Marcus Julia L, Weddle Andrea, Kelley Colleen F, Agwu Allison, Montalvo Sheila, Sherman Elizabeth, Vijayan Tara, Gutierrez Jose, Hickey Matthew D, Dilworth Samantha E, Krakower Douglas, Davis Teaniese L, Collins Lauren F, McNulty Moira C, Colasanti Jonathan A, Christopoulos Katerina A
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
HIV Medicine Association, Infectious Diseases Society of America, Arlington, Virginia, USA.
Clin Infect Dis. 2025 Jan 28. doi: 10.1093/cid/ciae648.
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.
用于艾滋病毒预防和治疗的长效注射剂（LAIs）可以显著改善艾滋病毒感染者以及那些可从暴露前预防中受益人群的健康状况和健康公平性。尽管长效注射剂在提供者和潜在使用者中具有广泛的可接受性和需求，但自2021年1月推出首个用于艾滋病毒治疗的长效注射剂卡博特韦/利匹韦林，以及2021年12月推出首个用于艾滋病毒预防的长效注射剂长效卡博特韦以来，其实施情况极为有限。我们报告了由艾滋病毒医学协会开展的一项提供者调查结果，该调查确定了与健康保险流程、人员配备和行政支持、药品成本和采购以及未参保者获取途径相关的长效注射剂实施障碍。我们提供了政策建议，以解决这些障碍并促进广泛、公平地获取用于艾滋病毒预防和治疗的长效注射剂，这对于实现美国“终结艾滋病毒流行”倡议的目标至关重要。
