Apretude (long-acting cabotegravir) injections offer greater protection than daily pre-exposure prophylaxis (PrEP) pills for Black gay and bisexual cisgender men and transgender women, researchers reported at the Conference on Retroviruses and Opportunistic Infections.

Although African Americans make up about 13% of the U.S. population, they account for more than 40% of all new HIV diagnoses, so effective and acceptable prevention tools are urgently needed. While white gay and bisexual men have readily adopted PrEP pills, uptake has been slower among Black men.

Hyman Scott, MD, MPH, of the San Francisco Department of Public Health, and colleagues evaluated PrEP effectiveness among Black men who have sex with men and transgender women in the HPTN 083 trial, which compared Apretude injections given every other month to daily tenofovir disoproxil fumarate/emtricitabine pills (Truvada and generic equivalents).

Black people were more likely than white people to acquire HIV, but Apretude was highly protective for both groups. Among Black participants, HIV incidence was 2.11 cases per 100 person-years in the oral PrEP arm versus 0.58 cases per 100 person-years in the Apretude arm—a 72% reduction. Adherence was better with the injections than with daily pills, suggesting that long-acting PrEP could help close the racial gap in HIV rates.

Apretude “is a powerful HIV prevention tool to increase access to PrEP and address continued racial disparities in HIV incidence in the United States,” the researchers concluded.