Yusuf Hassan Wada

This session brings forward discussions on the roadmap (present & future) on “Long Acting” therapies and challenges regarding the implementation offered by health services and special populations. Panel discussions were centred around the need for integrating implementation science in clinical research to advance science on future long-acting technologies.

Moderated by Dr. Laura Water and Dr. Carlos Del Rio (virtual), Dr. Beatriz Grinsztejn kicked off by looking at implementation challenges for injectable long ART (CAB/RPV) and missed opportunities in LMICs. She highlighted major studies with new long-acting ARVS IMPALA and LATA studies in LMIC. Dr. Pedro Cahn presented on long-acting ARVs for key populations (such as transgender, people with psychiatric conditions, and people in nursing homes). He firstly cautioned the audience to remember silicone buttock implants, especially in some trans-women and signposting to research exploring possible thigh injections as an alternative. He added that CAB + RPV LA CU access has been a valuable treatment option for individuals with co-morbidities or other issues preventing enteral administration of antiretroviral drugs. In a survey from Argentina, 91.6% of PLWH preferred LA-ART but only 68% of people without HIV preferred LA-PrEP. Dr. Andrew Owen presented the “Future of long-acting agents” and made it clear that we must turn options into viable choices and understand the difference between “option” and “choices”. For LA-ART and other new technologies to reach everyone, policymakers, donors, governments and implementers need to make affordable access possible.

Long-acting agents are a game-changer option for treatment and PrEP and most in-need populations might benefit from these new options. Research priorities should include special populations and all challenges such as logistics need to be addressed to make it happen. We must ensure biomedical products reach programmes & people and ensure robust civil society engagement in intro/implementation research and planning to understand and balance the clinical, personal, policy and programme factors. Identifying what products can "solve for - and what they can't ensure we do a better, more equitable intro than with oral PrEP and COVID-19 vaccines and therapies.