The Journal of the International AIDS Society (JIAS) has launched a special issue, titled “Advancing use of long-acting and extended delivery (LAED) HIV prevention and treatment regimens”, at IAS 2023, the 12th IAS Conference on HIV Science.

The content of the special issue was guided by Guest Editors Sinéad Delany-Moretlwe (University of the Witwatersrand, Johannesburg, South Africa), Charles Flexner (Johns Hopkins University, Baltimore, USA) and José A Bauermeister (University of Pennsylvania, Philadelphia, USA). It is funded by the United States National Institutes of Health (NIH) through the National Institute of Allergy and Infectious Diseases Therapeutics Research Program and the National Institute of Mental Health, Division of AIDS Research.

The introduction of LAED products has the potential to reshape the HIV prevention and treatment landscape through dosing schedules that are measured in months rather than days. However, they could face various implementation challenges similar to those encountered by oral pre-exposure prophylaxis (PrEP), including issues related to cost, delivery, uptake and persistent use, particularly in resource-constrained settings and among key populations. Although long-acting regimens could overcome many of the challenges associated with daily oral regimens, uncertainties persist regarding optimal methods for promoting uptake, managing product switching, and determining the best service delivery models when using long-acting products.

The articles in this special issue highlight three take-home messages: 

  1. Understanding end-user needs, desires and contexts can improve LAED development and delivery. 
  2. Multilevel initiatives must address existing and potential barriers to LAED access, including disparities in health access within countries or regions where health resources are limited.
  3. A multidisciplinary research agenda is needed to produce further long-acting options, in addition to strategies that support their effective and equitable use.

While more data are needed, the articles in this special issue touch upon a myriad of opportunities and challenges that must be considered to advance the field as LAED regimens are developed and implemented. They highlight how structural, policy, community and healthcare contexts might facilitate or hinder the delivery of LAED regimens.

Access the special issue here: bit.ly/3CgfXe0