Title

Paving the road for new PrEP products: The promise of differentiated, simplified, and decentralized delivery to maximize the potential of new PrEP products

Code

SA20

Session Type

Satellite

Track

Not applicable

Channel

Channel 2

Date Time

19 July 08:30- 09:30

Local Date Time

08:30 - 09:30 W. Europe Daylight Time

Co-Chairs:

Jessica RODRIGUES, AVAC, United States
Anna GRIMSRUD, International AIDS Society, South Africa
Davina CANAGASABEY, PATH, United States
Kim GREEN, PATH, United States

Organizer:

PATH, AVAC, International AIDS Society

The world missed the 2020 UNAIDS target of 3 million people accessing pre-exposure prophylaxis (PrEP). Despite missing this target, PrEP uptake has increased 113% since 2019, largely due to efforts to differentiate, simplify, and demedicalize PrEP delivery. PrEP delivery has shifted from clinic-only models to mobile, pharmacy, and virtual ones that have led to increased uptake and effective use of PrEP. As new PrEP products come to market, including long-acting injectables, antiretroviral-containing vaginal rings, and the dual prevention pill, the world is poised for continued PrEP scale-up. However, there is a critical need to simplify delivery of these products in order to optimize their availability and acceptability to benefit all populations. This session will convene implementers, advocates, and researchers to share viewpoints on what can be done to differentiate access points and models to define a pathway for inclusive, client-responsive delivery of these new PrEP tools.

4 min	Welcome and framing the session: People at the center of prevention Davina CANAGASABEY, PATH, United States

5 min	What’s on the horizon? The PrEP pipeline Jessica RODRIGUES, AVAC, United States

8 min	Video perspectives: What people want? - Introduction to pre-records Davina CANAGASABEY, PATH, United States Dvora Joseph DAVEY, University of California - Los Angeles, United States Oleksandr MAKHNO, Alliance Global, Ukraine Sithembiso MNQUBE NDLOVU, University of the Free State, South Africa Hellen OTIENO, PrEP Ambassador, Kenya

39 min	Roundtable: Where does PrEP need to go? Considerations to ensure new PrEP products meet the needs and reach those who need it. Kim GREEN, PATH, United States Rachel BAGGALEY, Switzerland Kenneth NGURE, Jomo Kenyatta University of Agriculture and Technology, Kenya Zeda ROSENBERG, International Partnership for Microbicides, United States Leonashia Leigh Ann VAN DER MERWE, SHE, Social, Health and Empowerment Feminist Collective of Transgender Women of Africa, South Africa Midnight POONKASETWATTANA, APCOM, Thailand Dustin Phuc NGUYEN, Vietnam

4 min	Key takeaways and closing Anna GRIMSRUD, International AIDS Society, South Africa Lilian Benjamin MWAKYOSI, Tanzania Youth Alliance, Tanzania, United Republic of

AUTHOR

Rayner Tan

SUMMARY

This session included a summary of the latest PrEP products and situated them in four principles of improving PrEP uptake and adherence; to simplify, differentiate, integrate, and demedicalize PrEP services. Contributions from end-users and panelists provided insight into the aspirations and realities of differentiated service delivery for new PrEP products.

HIGHLIGHTS

The session chair opened the session with a review of the new PrEP products and the four key principles to scaling up PrEP: (i) Demedicalization of PrEP through task-shifting to other healthcare workers, (ii) Simplifying PrEP care for end-users, (iii) Integration of PrEP with other services, (iv) and Differentiation of PrEP services based on client needs. Video presentations by end-users of PrEP and community members highlighted how pill burden, stigma, accessibility of healthcare facilities may serve as barriers to uptake and adherence, and shared about how new long-acting products have the potential to help make PrEP more accessible to diverse groups. We were reminded by the panelists that "choice is empowering", but the availability of choice may differ for end-users depending on the implementation contexts in which such users are embedded, which include the "societal, personal and structural barriers". Panelists reflected on exciting innovations like the monthly Dapivirine Ring and oral Islatravir, and discussed the potential for PrEP delivery and adherence through their alignment with the earlier principles. We are reminded that a variety of options are required to not only just address the varying needs of different groups, but also the changing needs of individuals over the life course.

CRITICAL ASSESSMENT

The development of innovative PrEP formulations, methods, and differentiated service delivery models hold promise for the scale up of PrEP, which is sorely needed given how far we are from reaching the 2020 and 2025 UNAIDS targets for people accessing PrEP. In spite of such innovations, we need a better understanding of the needs of end-users, in terms of the immediate needs to initiate PrEP, as well as how such needs may change over time as they remain on PrEP. Such data are especially lacking for individuals and key populations, such as transgender women, who are especially vulnerable to HIV.