Long-Acting Injectable Cabotegravir for HIV Prevention

Publication Date: July 28, 2022
Last Updated: August 2, 2022

New Recommendation

Long-acting injectable cabotegravir may be offered as an additional prevention choice for people at substantial risk of HIV infection, as part of combination prevention approaches. (C, M)
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Key messages on HIV testing for CAB-LA

  • It is important for programmes to select a testing strategy and algorithm that promotes access to CAB-LA among those who would benefit most.
  • Programmes can employ the current national HIV testing strategy and algorithm, using a combination of RDTs and enzyme immunoassays according to WHO recommendations.
  • Some countries and programmes may include NAT where feasible, in addition to the national algorithm, particularly at initiation, prior to the presence of ARVs. Where NAT is implemented, it is important to have the necessary assays, resources, regulatory approvals and a clear testing strategy for resolving discrepant results and establishing HIV infection before initiating life-long ART.
  • Countries need to consider the feasibility of using NAT before CAB-LA initiation, and while taking CAB-LA. While NAT before CAB-LA initiation, and while taking CAB-LA, might prevent a small number of cases of drug resistance, countries need to consider the feasibility of NAT. There are also uncertainties as to what impact these mutations will have on subsequent ART.
  • Ongoing monitoring of implementation is needed to further optimize HIV testing approaches for CAB-LA.

Recommendation Grading

Overview

Title

Long-Acting Injectable Cabotegravir for HIV Prevention

Authoring Organization

Publication Month/Year

July 28, 2022

Last Updated Month/Year

February 13, 2024

Document Type

Guideline

Country of Publication

US

Document Objectives

In this guideline, WHO recommends that long-acting injectable cabotegravir (CAB-LA) may be offered as an additional HIV prevention option for people at substantial risk of HIV infection. CAB-LA is an injectable form of pre-exposure prophylaxis (PrEP) that has been shown to be highly effective at reducing the risk of HIV acquisition. This guideline provides implementation considerations to support Member States, programme managers, policy makers, researchers, health workers, communities, and other stakeholders in the implementation of projects and programmes for CAB-LA. It also outlines critical research gaps for CAB-LA.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management, Prevention

Diseases/Conditions (MeSH)

D006678 - HIV, D065129 - Pre-Exposure Prophylaxis

Keywords

human immunodeficiency virus (HIV), HIV, cabotegravir, pre-exposure prophylaxis, PrEP

Source Citation

Guidelines on long-acting injectable cabotegravir for HIV prevention. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.