In 2020 INPUD conducted a Values & Preferences Study that was commissioned by WHO
In 2020 INPUD conducted a Values & Preferences Study that was commissioned by WHO whereby each of the global key population networks conducted community-led research into the values and preferences of our communities in relation to HIV, viral hepatitis and STI services. One of the topics taken up in this research was PrEP and specifically, discussion about some of the recent developments in PrEP modalities including long-acting injectable PrEP or CAB-LA.
While many people who inject drugs interviewed in the study stated that they thought that PrEP, and particularly long-acting PrEP, could be a potentially useful HIV prevention intervention, they were very clear that PrEP should always be provided as part of a suite of HIV interventions and should never been provided instead of access to evidence-based harm reduction such as NSP and OAT. Participants raised concerns about the ongoing lack of access to NSP and OAT and stated that addressing this needed to remain the priority.
Of those participants who were aware of PrEP and of some of the recent developments in modalities including CAB-LA, participants also raised concerns about a lack of information about different modalities and availability among people who inject drugs. Participants stated that even when people who inject drugs hear about PrEP, they are often unsure about what is available and how to access it.
Issues of stigma and discrimination were also raised by many participants with some participants stating that they had been treated by health professionals as ‘undeserving’ of access to such technologies. Other participants raised questions about the gaps in the evidence-base in relation to PrEP and called for greater research into the efficacy and suitability of PrEP for people who inject drugs.
Beyond the study conducted by INPUD, many community advocates are also raising ongoing questions and concerns about the price and availability of CAB-LA particularly for marginalised and criminalised communities. In this context, INPUD believes that community-led advocacy will be critical to keep affordability and access issues in relation to CAB-LA and other new PrEP modalities high on the agenda especially for LMICs.
For communities of people who inject drugs, INPUD also believes that we will need to keep raising our concerns about the gaps in the evidence base to ensure that implementation science is asking and answering the right questions, and to make sure that research and programmes are implemented in ways that are acceptable to community including removing structural barriers such as criminalisation, stigma and discrimination.
If you are interested in more information, there is also a WHO Global PrEP Network (GPN): https://www.who.int/groups/global-prep-network which describes itself as: “a WHO-led forum designed to facilitate global dialogue and collaboration between national, international and regional stakeholders, who share a common commitment to the effective implementation of pre-exposure prophylaxis (PrEP) as part of HIV prevention”. INPUD recently participated in a webinar run by the network and a recording of the webinar will be available on the GPN page in the next few weeks.