Policy Recommendations to Support Equitable Access to Long-Acting Injectables for HIV Prevention and Treatment: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association
Julia L. Marcus, Andrea Weddle, Colleen F. Kelley, Allison L. Agwu, Sheila Montalvo, Elizabeth M Sherman, Tara Vijayan, José I. Gutierrez, Matthew D. Hickey, Samantha E. Dilworth, Douglas Krakower, Teaniese L. Davis, Lauren F. Collins, Moira McNulty, Jonathan Colasanti, Katerina Christopoulos
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.