The adoption of injectable pre-exposure prophylaxis (PrEP), an innovative approach to preventing HIV contamination, has shown significantly higher adherence rates among users compared to traditional oral PrEP. This insight stems from the results of the recent ImPrEP CAB research conducted by Brazil's Oswaldo Cruz Foundation (Fiocruz), which highlights the importance of this method in combating the ongoing HIV epidemic.
Presented at the Conference on Retroviruses and Opportunistic Infections in the United States, the study tracked around 1,400 participants across public health units in six major Brazilian cities: Rio de Janeiro, São Paulo, Salvador, Campinas, Florianópolis, and Manaus. The research primarily focused on young adults aged 18 to 30 who had never used PrEP previously, including diverse groups such as men who have sex with men, transgender, and non-binary individuals.
Impressively, 83% of the participants opted for the injectable version of PrEP, which utilizes the drug cabotegravir to be administered every two months. Following the treatment protocol diligently, 94% of these participants adhered to the injection schedule, ensuring they received ongoing protection against HIV throughout the study's duration. According to the results, no individuals using the injectable method tested positive for the virus.
In stark contrast, only 17% chose the oral version, which necessitates daily doses of the antiretroviral medications tenofovir and emtricitabine. This group displayed considerably less adherence, managing to maintain protection for just 58% of the follow-up days, culminating in one confirmed case of HIV among them.
Researcher assessments indicate that the lower adherence in the oral PrEP group may be a significant factor in the rising number of HIV infections, especially among younger populations and marginalized communities. The introduction of injectable PrEP presents a strategic solution to overcoming daily medication challenges, receiving praise for its potential to enhance treatment efficacy among at-risk groups.
This injectable form of PrEP was approved by Brazil's National Health Surveillance Agency (Anvisa) in 2023, yet its incorporation into the Unified Health System (SUS) remains under consideration by the Ministry of Health. Officials regard PrEP as an “essential strategy in HIV prevention,” noting that the total number of users of all PrEP methods in Brazil has doubled over the last three years, reaching an impressive 119,000 users in 2025.
However, the battle against HIV continues, as statistics reveal that Brazil recorded 46,495 new cases in 2023, an increase from 2022. Alarmingly, over 40% of these new cases were among men aged 20 to 29, further emphasizing the urgent need for effective prevention methods.
Despite these daunting figures, there is a silver lining; advances in treatment options have contributed to a significant 32.9% decline in AIDS-related mortality in Brazil from 2013 to 2023, driven by more comprehensive healthcare strategies. The Ministry of Health heralds this as a necessary step towards the elimination of HIV as a public health issue by 2030.
The findings of the ImPrEP CAB study reinforce the potential of injectable PrEP as a crucial tool to improve adherence rates among younger individuals, who are more likely to benefit from treatment that does not require daily vigilance. The endorsement from leading health organizations suggests that, with the right policies and support, injectable PrEP could dramatically curb the number of new HIV infections, especially in communities that have been historically underserved.
This research not only provides insights into the effectiveness of diverse PrEP options but also reflects the shifting paradigms in HIV prevention strategies in Brazil. The outcomes bolster the argument for the rapid evaluation and potential incorporation of injectable PrEP into public health policies, encouraging a broader adoption to safeguard vulnerable populations.
As discussions around HIV prevention continue, the role of innovations like injectable PrEP remains pivotal. Moving forward, it is crucial that stakeholders in the healthcare landscape advocate for swift policy changes to facilitate access and integration of this preventive measure into everyday healthcare options for those at risk. Through these efforts, Brazil can take meaningful strides toward reducing the incidence of HIV and supporting public health as a whole.
