World AIDS Day 2020, Ending the HIV/AIDS Epidemic: Resilience and Impact
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Long-acting HIV prevention tools are new long-lasting forms of HIV prevention being studied by researchers. These are HIV prevention tools that can be inserted, injected, infused, or implanted in a person’s body from once a month to once a year to provide sustained protection from acquiring HIV. These products are not available now, but they might be in the not-too-distant future.
Currently, people who are HIV-negative but at very high risk for HIV can lower their chances of getting HIV by taking a pill that contains two anti-HIV drugs every day. This is called pre-exposure prophylaxis (PrEP). When taken daily, PrEP can stop HIV from taking hold and spreading throughout your body.
PrEP is highly effective when taken daily as prescribed. However, studies have shown that PrEP is much less effective if it is not taken consistently, and that taking a daily pill can be challenging for some people.
That’s why researchers are working to create new HIV prevention tools that do not require taking a daily pill.
Scientists funded by the National Institutes of Health (NIH) are developing and testing several long-acting forms of HIV prevention that can be inserted, injected, infused, or implanted in a person’s body from once a month to once a year. The goal of this research is to provide people with a variety of acceptable, discreet, and convenient choices for highly effective HIV prevention. None of the research on these possible HIV prevention options has been completed, so they are not yet approved by the FDA and are not available for use outside of a clinical trial.
Four types of long-acting HIV prevention are in design and testing in research studies: intravaginal rings, injectable drugs, implants, and antibodies.
Intravaginal rings for women. Long-acting intravaginal rings are polymer-based products that are inserted into the vagina, where they release release one or more anti-HIV (or antiretroviral) drugs over time. The intravaginal ring at the most advanced stage of research is the dapivirine ring, which was tested in two large clinical trials including the NIH-funded ASPIRE study. The dapivirine ring is undergoing further evaluation in the HOPE open-label extension trial.
Injectables. Long-acting injectables are select long-acting antiretroviral drugs that are injected into the body. Injectables are being studied for both HIV prevention and HIV treatment. The first large-scale clinical trial of a long-acting injectable for HIV prevention began in December 2016. Called HPTN 083, the NIH-sponsored study—a partnership with ViiV Healthcare and the Bill & Melinda Gates Foundation—is examining whether a long-acting form of the investigational antiretroviral drug cabotegravir, injected once every 8 weeks, can safely protect men and transgender women from HIV infection at least as well as daily PrEP. Results are expected in 2021. A related study called HPTN 084 is testing whether injectable cabotegravir safely prevents HIV infection in young women.
Implants. Long-acting implants are small devices that are implanted in the body and release an anti-HIV drug at a controlled rate for continuous protection from HIV over time. NIH is funding the development and testing of several of these implants for HIV prevention. These products have not yet entered clinical trials. Studies supported by other funders are exploring an implant for women that protects users from both HIV and unplanned pregnancy.
Antibodies. Scientists have begun to test whether giving people periodic infusions of powerful anti-HIV antibodies can prevent or treat HIV infection. The antibodies involved can stop a wide variety of HIV strains from infecting human cells and thus are described as “broadly neutralizing antibodies” (bNAbs). Two advanced NIH-funded clinical trials are assessing whether giving infusions of bNAbs to healthy men and women at high risk for HIV protects them from acquiring the virus. Several early-stage clinical trials of other bNAbs for HIV prevention also are underway.
No. At this time, some forms of long-acting HIV prevention are being tested in clinical trials. Since their effectiveness has not yet been proven, they have not been considered for approval by the FDA. So, they are not available for your doctor to prescribe yet. However, NIH-supported clinical trials may be seeking volunteers to participate in some studies on long-acting HIV prevention tools. You may be eligible to participate in one of these trials, which are listed in NIAID’s Long-Acting Forms of HIV Prevention infographic. Information about these trials can be found at ClinicalTrials.gov or by calling (800)411-1222.
It will probably be several years before long-acting HIV prevention tools are available to the public. In the meantime, the best forms of prevention against sexual transmission of HIV continue to be:
The more of these actions you take, the safer you will be. To learn more about steps you can take now to prevent getting or transmitting HIV, read other pages in HIV.gov’s HIV Prevention section.
This page was developed in collaboration with NIH’s National Institute of Allergy and Infectious Diseases.