A missing perspective: injectable pre-exposure prophylaxis for people who inject drugs

ABSTRACT

The efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention has been established among people who inject drugs (PWID). HIV uninfected, at risk PWID, could likely benefit from long-acting injectable formulations of PrEP (“LAI-PrEP”); however, its acceptability in this population has not been previously documented. Thirty-three HIV-uninfected PWID in the U.S. Northeast completed an in-depth interview regarding perceived acceptability of LAI-PrEP. Coded data were synthesized using deductive thematic analysis. The majority of PWID interviewed believed LAI-PrEP would be acceptable. Participants perceived that receiving injections every two months would reduce barriers to daily oral PrEP adherence, including forgetting while “high” and safeguarding pills when homeless. A few participants expressed concerns regarding LAI-PrEP, including medical mistrust, a concern that injections could alter their “high” or be “triggering” for PWID. LAI-PrEP has the potential to reduce HIV among PWID; however, their perspectives are largely absent from research examining its efficacy, representing a missed opportunity.

KEYWORDS:

• HIV infections
• pre-exposure prophylaxis
• substance abuse
• intravenous
• sexual behavior
• risk factors

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

K. B. Biello http://orcid.org/0000-0002-5017-5699

A. Edeza http://orcid.org/0000-0001-7503-5134

M. J. Mimiaga http://orcid.org/0000-0001-9256-2905

A. R. Bazzi http://orcid.org/0000-0001-6828-1919

Additional information

Funding

This work was supported by the Providence/Boston Center for AIDS Research collaborative developmental grant (NIH grant P30AI042853), NIH/NIDA (National Institute on Drug Abuse) grant K01DA043412, and the BU Peter Paul Career Development Professorship.