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MINI REVIEW article

Front. Reprod. Health
Sec. HIV and STIs
Volume 6 - 2024 | doi: 10.3389/frph.2024.1438005
This article is part of the Research Topic Accelerating to 2030 – Doubling Down on HIV Prevention to End HIV/AIDS as a Public Health Threat View all 3 articles

Achieving HIV epidemic control through accelerating efforts to expand access to pre-exposure prophylaxis for people who inject drugs

Provisionally accepted
Lirica Nishimoto Lirica Nishimoto 1*Adaobi L. Olisa Adaobi L. Olisa 2*Philip Imohi Philip Imohi 2Judy Chang Judy Chang 3Christopher Obermeyer Christopher Obermeyer 4Dama Kabwali Dama Kabwali 5Christopher Akolo Christopher Akolo 6
  • 1 FHI 360, New York, United States
  • 2 FHI 360, Abuja, Nigeria
  • 3 International Network of People who Use Drugs (INPUD), London, United Kingdom
  • 4 The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
  • 5 Tanzania Network for People who Use Drugs, Dar es Salaam, Tanzania
  • 6 FHI 360, Washington, California, United States

The final, formatted version of the article will be published soon.

    The world is not on track to reach the majority of the UNAIDS 2025 targets, and people who inject drugs (PWID) continue to be left behind, hindered by counterproductive law enforcement practices, punitive laws, economic distress, and social stigma and discrimination. Poor access to HIV preexposure prophylaxis (PrEP) among PWID is nested within the limited access to broader harm reduction services, including needle and syringe programs, opioid overdose management, opioid agonist therapy (also known as medication-assisted treatment), and condoms. Among PWID, women who inject drugs are disproportionately affected and face additional gender-based barriers. Intersections between PWID and other key and priority population groups also exist. Although the prioritization of PWID for new PrEP products like the dapivirine vaginal ring and injectable cabotegravir has lagged in research, studies have shown that PWID find injectable and long-acting options acceptable and preferrable, including among women who inject drugs. While new PrEP products introduce new opportunities, equity in access must be assured for optimized impact toward achieving epidemic control. Programming for services must engage and empower PWID community leadership to address the structural barriers to services, implement community-led, differentiated, and integrated service modalities, and offer the choice of all harm reduction options to close the equity gaps in health outcomes. While waiting for necessary evidence and approvals, programs should work together with the PWID community to prioritize, expand, and facilitate efforts and investments toward increased access to and integration of PrEP and all recommended harm reduction services for PWID.

    Keywords: PWID1, HIV2, PrEP3, prevention4, integration5, community-led6, access7, new and emerging products8

    Received: 24 May 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Nishimoto, Olisa, Imohi, Chang, Obermeyer, Kabwali and Akolo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lirica Nishimoto, FHI 360, New York, United States
    Adaobi L. Olisa, FHI 360, Abuja, Nigeria

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.