South Africa approves long-acting injectable PrEP

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South Africa has become the second African country to approve the use of an injectable form of PrEP that lasts for two months as a powerful new HIV prevention option.

The South African Health Products Regulatory Authority (SAHPRA) announced on Friday, the day after World Aids Day, that it had registered Cabotegravir, a long-acting HIV pre-exposure prophylactic (PrEP).

Cabotegravir is an antiretroviral drug (ARV) that can be used by people who are HIV-negative to prevent HIV infection. Each cabotegravir injection lasts for two months and will be sold in South Africa under the name of Apretude.

In October, the Medicines Control Authority of Zimbabwe announced its approval of long-acting injectable cabotegravir, the first country in Africa to do so.

PrEP, which is increasingly used by sexually active gay, bi and other men who have sex with men, is an effective method of HIV prevention, but until recently was only available in pill form, taken daily or, in some cases, before and after sex.

Injectable PrEP makes the use of PrEP easier and more effective as it no longer requires users to remember to take a daily pill, which could result in pill fatigue.

“Apretude 600 mg/3ml injection is the first and only long-acting, injectable PrEP for reducing the risk of getting HIV,” said SAHPRA, describing it as “a safe and highly effective prevention option for people at substantial risk of HIV infection.”

The organisation noted that global HIV prevention efforts have stalled, with 1.5 million new HIV infections in 2021, and expressed hope that long-acting injectable PrEP will play an important role in reducing the rate of new infections.

“SAHPRA joins the global fight against this disease. The priority review pathway followed to assess and finally register long-acting Cabotegravir (CAB-LA) marks a bold step in this direction,” commented SAHPRA CEO, Dr Boitumelo Semete-Makokotlela.

The World Health Organisation (WHO) earlier this year backed the use of long-acting injectable PrEP as an HIV prevention method.

It’s not yet known what the cost of the drug will be in South Africa, a factor that will determine how accessible Apretude will be for ordinary South Africans.

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