Men Experience Less Stigma when Using Long-Acting PrEP | ID Week 2024

Men reported little to no stigma or anxiety concerns about using pre-exposure prophylaxis (PrEP) to prevent HIV when using Apretude (cabotegravir), according to a poster at ID Week 2024, which is being held this week in Los Angeles.

Developed by ViiV Healthcare, Apretude is a long-acting medication used to reduce the risk of getting HIV-1 in adults and adolescents. It is given by injection by a healthcare professional every two months, after two initial injections in the first month.

As part of the phase 4 PILLAR study, 201 men who have sex with men and transgender men from 17 clinics were surveyed between May 2022 and August 2023 about the stigma of taking PrEP, as well as about pain after injection. Researchers also interviewed 52 of these participants.

Stigma and anxiety were both assessed through questions that explored perceptions around concerns and experience with both oral medication and long-acting injections. Stigma was also assessed using the validated HIV PrEP Stigma Scale.

Hadrian Holder, M.D.

Researchers, led by Hadrian Holder, M.D., with Southwest Community Health Center in Bridgeport, Conn., found that at baseline, 15% and 29% of participants reported experiencing stigma and anxiety with oral PrEP vs. 0% and 2% with Apretude at month 6 of the study. Additionally, at baseline, 53% to 54% of participants reported concerns around forgetting to take and running out of oral PrEP medication.

Most interviewed participants (78%) discussed the benefit or value of more frequent clinic visits to receive the injections for the long-acting medication. They specifically mentioned having more interaction with healthcare providers, which facilitated discussion of other health issues, more frequent sexually transmitted infection testing, which provided reassurance, and the building of rapport and a relationship with staff at the clinic.

In the surveys, participants reported that the level of pain for the first injection was generally higher than that reported for their most recent injection. During the interviews, 39% mentioned injection site soreness. But most participants reported returning to their usual daily activities immediately following the injections.

A previous review of PILLAR found that most of the participants (71%) had taken oral PrEP in the last six months. Most (63%) had heard of a long-acting cabotegravir before the study from providers (48%), friends (12%) and commercials (13%). Interviewed participants discussed providers as the key influencer in deciding to use a long-acting cabotegravir (85%), followed by themselves (31%), partners (29%) and commercials (25%).

The PILLAR study was sponsored by ViiV Healthcare.