March 8, 2024
The Sustainable East Africa Research in Community Health (SEARCH) collaboration, including Berkeley Public Health's Maya Petersen (co-PI with Moses Kamya and Diane Havlir) and Laura Balzer (Primary Statistician) recently demonstrated major improvements in HIV prevention coverage and reductions in HIV incidence when a person-centered flexible choice-based prevention delivery model was combined with access to a new injectable prevention product (long acting cabotegravir). Dr. Moses Kamya (BPH Alumn, 2023 recipient of Haas International Award) presented these findings at this year's Conference on Retroviruses and Opportunistic Infections (CROI) conference in Denver, Colorado on March 5.
The SEARCH team compared their Dynamic Choice HIV Prevention intervention, including person-centered delivery and flexible choice between oral Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), or long-acting injectable PrEP, with the option to switch over time, to the standard-of-care in a randomized trial extension in rural Kenya and Uganda.
The SEARCH intervention increased time using biomedical HIV prevention by 5-fold as compared to standard practice. The SEARCH intervention also reduced new HIV infections- over 48 weeks, no persons receiving the intervention were infected with HIV, while HIV incidence under standard practice was 1.8%. Among intervention participants, over half used injectable PrEP and nearly 1/3 switched products during the 48-week follow-up; over 40% of persons who used injectable PrEP were not previously using an oral option. This real-world study, enrolling both men and women in rural Sub-Saharan Africa, serves as a catalyst for advocacy and policy that both expands person-centered flexible HIV prevention delivery models and ensures access to long acting injectable PreP.