TY - JOUR T1 - Long-Acting HIV Treatment and Prevention: Closer to the Threshold JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 182 LP - 187 DO - 10.9745/GHSP-D-17-00206 VL - 5 IS - 2 AU - Matthew Barnhart Y1 - 2017/06/27 UR - http://www.ghspjournal.org/content/5/2/182.abstract N2 - Substantial progress has been made toward viable, practical long-acting approaches to deliver HIV treatment and prevention through: (1) continued improvements in long-acting antiretrovirals (ARVs); (2) better innovative delivery systems; and (3) collaboration of willing partners to advance new ARVs. More progress on those 3 fronts is still needed to arrive at the goal of optimized HIV treatment and prevention for all who would benefit—and of finally controlling the HIV epidemic.With 18.2 million people currently receiving HIV treatment, 2.1 million new HIV infections per year, and guidelines recommending that treatment be offered to all 36.7 million people living with HIV,1 the need to improve HIV treatment and prevention is clear. Long-acting antiretrovirals (ARVs) are one approach that holds great promise to enable major gains in efficiency and effectiveness.The crucial advantage of long-acting ARVs stems from their potential to improve patients' adherence, which is critical for good outcomes both for treatment and prevention. For treatment, being able to directly administer a long-acting regimen on a monthly or less frequent basis to a patient might minimize risk of treatment failure and resistance due to inconsistent adherence while also potentially reducing the need for costly laboratory tests to monitor treatment efficacy. For prevention, the benefits of long-acting agents compared with daily oral agents may be even more compelling, as oral pre-exposure prophylaxis (PrEP) has been demonstrated to be very effective when used,2,3 but poor adherence has been reported in several studies,4,5 limiting impact. In addition to the greater efficacy that long-acting ARVs might bring, they may also have potential to reduce drug costs, since long-acting formulations typically contain agents that are effective at a very low dosage, which, other things equal, can translate into lower manufacturing costs.Long-acting ARVs have the potential to improve patients' … ER -