Investigating the feasibility of providing injectable PrEP for HIV Prevention in Flanders

BACKGROUND

In countries such as Belgium, the yearly number of HIV diagnoses is decreasing. The decrease can be partially attributed to oral PrEP, which is being rolled out in Belgium. Long-acting injectable PrEP (LAI-PrEP) is not yet available and is recently demonstrated to have a 66% higher efficacy than oral PrEP. With LAI-PrEP, HIV negative individuals are injected with Cabotegravir every 8 weeks to protect them against HIV infection. It has the potential to further accelerate the decreasing number of HIV diagnoses, if targeted to those who currently have at highest risk for HIV (e.g. male sex workers). However, more scientific evidence is needed to translate this novel tool into an effective realworld application.

AIM

To investigate the feasibility, safety and acceptability of LAI-PrEP for HIV prevention in Flanders.

PROJECT APPROACH

FORMATIVE phase: In work packages (WPs) 1 and 2, we will investigate which populations can benefit most from LAI-PrEP, how they can be reached and how LAI-PrEP provision can be tailored to their needs.

WP1: Triangulation of available datasets from various studies to determine who could benefit most from LAI-PrEP.

WP2: Systematic literature review and Discrete Choice Experiment (n=350) to study potential uptake of LAI-PrEP.

PILOT STUDY phase: insights from formative phase will be used to set up a clinical study to investigate the effectiveness, safety, acceptability and feasibility of LAI-PrEP.

WP3: Demonstration study with LAI-PrEP among +/-100 male and transgender women who will be followed up for at least 2 years, including one-year phase after the injections. They will be followed up in the PrEP clinic of ITM and/or via community-based organisations.

WP4: Interview study among providers (n=25) and multiple case study design to investigate barriers and facilitators for LAI-PrEP provision.