Angelique
A real patient on oral PrEP who sometimes forgets to take her daily pill.
Angelique: I felt like utilizing a PrEP option that isn’t a daily oral pill would be more convenient for me.
SUPER: PrEP=pre-exposure prophylaxis.
All participants compensated by ViiV Healthcare.
AVO: APRETUDE is for PrEP to reduce the risk of sexually acquired HIV infection for HIV-negative adults and adolescents who weigh at least 35 kg and are at risk of sexually acquiring HIV.
SUPER: INDICATION
APRETUDE is indicated in at-risk adults and adolescents weighing at least 35 kg for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 infection. Individuals must have a negative HIV-1 test prior to initiating APRETUDE (with or without an oral lead-in with oral cabotegravir) for HIV-1 PrEP.
AVO: There is a Boxed Warning for APRETUDE, shown in full here, which describes a risk of drug resistance if APRETUDE is used in people with HIV. Don’t give APRETUDE or oral cabotegravir until the patient is confirmed to be HIV negative with a test that can diagnose acute or primary HIV. Any individual diagnosed with HIV must begin a complete HIV treatment.
SUPER: BOXED WARNING: RISK OF DRUG RESISTANCE WITH USE OF APRETUDE FOR HIV-1 PRE-EXPOSURE PROPHYLAXIS (PrEP) IN UNDIAGNOSED HIV-1 INFECTION Individuals must be tested for HIV-1 infection prior to initiating APRETUDE or oral cabotegravir, and with each subsequent injection of APRETUDE, using a test approved or cleared by the FDA for the diagnosis of acute or primary HIV-1 infection. Drug-resistant HIV-1 variants have been identified with use of APRETUDE by individuals with undiagnosed HIV-1 infection. Do not initiate APRETUDE for HIV-1 PrEP unless negative infection status is confirmed. Individuals who become infected with HIV-1 while receiving APRETUDE for PrEP must transition to a complete HIV-1 treatment regimen.
AVO:
Keep watching for the remaining select safety information.
SUPER: Keep watching for the remaining select safety information. Please see full Prescribing Information, including Boxed Warning, for APRETUDE on this website.
Angelique: I’m modeling now full-time and I also work in nightlife. I just want to be, like, the representation. Like, I’ve always, like, looked at billboards, and I’ve wanted to see, like, someone like me on them. A beautiful, Black trans woman.
SUPER: Angelique
On daily oral PrEP
Angelique: I have not had a relationship in New York. I’ve had “situationships” in New York. So my PrEP journey began over 6 years ago. I was extremely sexually active, and I had a scare. This is pre-transition. So the optics were a little different. Whenever I went in to get tested, I let the provider know that I unfortunately had been active and I had a scare ’cause I didn’t really discuss status or sexual history with the person. It just, like, was a hookup.
I take the daily PrEP pill and I’m still on it after 6 years. So I’ve missed doses of PrEP a few times. Solely because, like, my life is a little, timing is chaotic for me. My nights are people’s mornings. So a lot of the time it’s really just like trying to figure out when I can take stuff. I just feel kind of, like, irresponsible because it’s, like, it’s one thing, all you have to do is get up and open the bottle and take it. It’s kind of like uh, girl, you know you’re supposed to do this. Like, just take the pill, like, and it’ll be fine.
Angelique: So I have, like, multiple alarms set throughout the day to where I can, like, remind myself, like, hey, it’s time.
If you miss some certain amount of doses on daily PrEP, you basically are unprotected. And that’s the part that’s stressful for me.
I did discuss APRETUDE with my provider, and she never really did ask me until I brought it up to her. And she’d say, are you still taking your PrEP? And I’m like, yes, and then you get tested and you go home.
I felt like utilizing a PrEP option that isn’t a daily oral pill would be more convenient for me. I don’t have to have that constant worry like, oh girl, you missed it, or, oh my gosh, let’s just go get tested real quick. Like, make sure everything is okay and then come, like, get back on schedule.
SUPER:
Individuals should strictly adhere to the recommended dosing schedule for
prescribed PrEP.
Angelique: Every 2 months, every 2 months is like, girl, you can set that time aside. Like, every day is very, like, it’s tedious. At the end of the day, I’m only able to take care of myself. You’re still going to have sex, but have safer sex.
SUPER: APRETUDE is administered as an intramuscular injection by a healthcare professional
every 2 months after 2 initiation injections administered 1 month apart.
Dr Hatfield: I’m Kevin Hatfield, and I’m a family practice doc. I have over 1000 patients that I see who are either transfeminine-identified or transmasculine or nonbinary, gender-fluid.
SUPER: Dr Kevin Hatfield
Family Practice Physician
Dr Hatfield: Angelique was an amazing story to listen to just because I think she has really been empowered to kind of take care of her health in ways that I feel like all patients should be able to advocate for themselves and have providers actually meet them where they are and give good care.
For a patient like Angelique, part of the questions that I will go through would be just trying to learn more about them and their schedule and kind of the things that make it challenging to be adherent to a medical regimen.
Dr Hatfield: Things that make any life busy for any individual is different. So I have a lot of patients that travel. I have a lot of patients who are in school.
The wheels are turning in my mind to try to decide whether or not this is a patient that really I should be talking a little bit more about something that’s going to be easier as a 2-month regimen.
Those patients who have switched over to APRETUDE in my practice have actually said, this is great. You know, I didn’t realize that it was taking so much of my mental effort to make sure I didn’t forget my pill. And to me as a provider, it makes me think, wow, this is an amazing success that we can actually help patients like her live her life and not have to worry about one more thing because APRETUDE is in the background helping to prevent HIV.
SUPER: What could APRETUDE mean for your patients like Angelique?
AVO: APRETUDE is contraindicated in individuals with unknown or positive HIV status; with previous hypersensitivity reaction to cabotegravir; or with drugs where significant decreases in cabotegravir plasma concentrations may occur.
Use APRETUDE as part of a comprehensive HIV prevention strategy.
There is a potential risk of resistance if an individual acquires HIV either before, while taking, or following discontinuation of APRETUDE. Test before each injection to confirm HIV-negative status. Reassess risk of HIV acquisition and test before each injection to confirm HIV-negative status.
SUPER:
CONTRAINDICATIONS
APRETUDE is contraindicated in individuals with unknown or positive HIV status; with previous hypersensitivity reaction to cabotegravir; or with drugs where significant decreases in cabotegravir plasma concentrations may occur.
WARNINGS AND PRECAUTIONS
- Use APRETUDE as part of a comprehensive HIV prevention strategy.
- There is a potential risk of resistance if an individual acquires HIV either before, while taking, or following discontinuation of APRETUDE. Test before each injection to confirm HIV-negative status. Reassess risk of HIV acquisition and test before each injection to confirm HIV-negative status.
AVO: Because APRETUDE is long-acting, residual concentrations of cabotegravir may remain in the systemic circulation up to 12 months or longer.
Hypersensitivity has been reported with other integrase inhibitors, and hepatotoxicity has been reported with cabotegravir. Discontinue immediately if signs or symptoms of either develop. Depressive disorders have been reported. Prompt evaluation is recommended.
The most common adverse reactions, all grades, observed in at least 1 percent of patients, were injection site reactions, diarrhea, headache, pyrexia, fatigue, sleep disorders, nausea, dizziness, flatulence, abdominal pain, vomiting, myalgia, rash, decreased appetite, somnolence, back pain, and upper respiratory tract infection.
SUPER:
- Because APRETUDE is long-acting, residual concentrations of cabotegravir may remain in the systemic circulation up to 12 months or longer.
- Hypersensitivity has been reported with other integrase inhibitors, and hepatotoxicity has been reported with cabotegravir. Discontinue immediately if signs or symptoms of either develop.
- Depressive disorders have been reported. Prompt evaluation is recommended.
ADVERSE REACTIONS
The most common adverse reactions, all grades, observed in at least 1 percent of patients, were injection site reactions, diarrhea, headache, pyrexia, fatigue, sleep disorders, nausea, dizziness, flatulence, abdominal pain, vomiting, myalgia, rash, decreased appetite, somnolence, back pain, and upper respiratory tract infection.
AVO:
Refer to the full PI for important drug interactions with APRETUDE. Drugs that induce UGT1A1 may significantly decrease plasma concentration.
If patient is breastfeeding an infant, assess the benefit-risk of using APRETUDE. APRETUDE is not recommended for use in pediatric individuals weighing less than 35 kilograms.
Please see the full Important Safety Information and Prescribing Information, including Boxed Warning, on this website.
SUPER:
DRUG INTERACTIONS
Refer to the full PI for important drug interactions with APRETUDE. Drugs that induce UGT1A1* may significantly decrease plasma concentration.
*uridine diphosphate glucuronosyltransferase
USE IN SPECIFIC POPULATIONS
If patient is breastfeeding an infant, assess the benefit-risk of using APRETUDE. APRETUDE is not recommended for use in pediatric individuals weighing less than 35 kilograms.
Please see the full Important Safety Information and Prescribing Information, including Boxed
Warning, on this website.
SUPER: APRETUDE logo
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CBTVID220030 March 2023
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