Grant: Operating Grant - HIV/AIDS CBR Program - General

HIV incidence is not declining in most of Canada, and Two-Spirit, gay, bisexual, queer and other men who have sex with men, including transgender men and non-binary individuals (2SGBQM) are disproportionately affected. Oral pre-exposure prophylaxis (PrEP) is a powerful tool to prevent HIV, but key subpopulations of 2SGBQM are under-reached by oral PrEP including 1) Indigenous and/or Two-Spirit, 2) Black, 3) Other people of colour, 4) remote/rurally located, 5) substance users as well as 6) transgender and non-binary individuals. Meanwhile, new long-acting PrEP agents are in development, including injections, intravenous infusions and implants under the skin, in addition to pills. These products have been designed to overcome the challenges of oral PrEP, which require people to take pills over long periods of time. The new ways in which these drugs are given (eg. an injection every two months) provide valuable opportunities to re-imagine how health care is delivered. In particular, long-acting cabotegravir (CAB-LA) was recently been shown to be better than oral PrEP in preventing HIV. It is time for communities and key stakeholders within the health care system to start planning for long-acting PrEP in Canada, to ensure that the needs and preferences of those not reached by oral PrEP are met. Led by the Community-Based Research Centre (CBRC), national leaders in the field of HIV prevention, and national partner organizations representing Indigenous, Black and other key perspectives, we will use mixed-methods approaches to: 1.characterize the needs and preferences of 2SGBQM regarding long-acting PrEP options and delivery models, 2.assess the feasibility of new models of delivering long-acting PrEP, and 3.design a national demonstration project (real-life implementation study) of CAB-LA PrEP that directly responds to the access needs and priorities of individuals experiencing barriers to oral PrEP.