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Long Acting Cabotegravir, a preventative ARV for HIV

Many of you have heard about this strange sounding medication, Cabotegravir (Cah-bot-er-grah-ver), floating around news broadcasts and print outlets. Well, this medication is a Human Immunodeficiency Virus (HIV) anti-retroviral (ARV) that has been recently approved by the South African Health Products Regulatory Authority (SAHPRA).

What is CAB-LA?
Cabotegravir, also referred to as CAB-LA/CAB, is a long-acting HIV pre-exposure prophylactic. Let’s simplify this. Long-acting is self-explanatory in that this drug will remain active in your body for a long period of time. HIV, as you know, continues to be a major public issue across the globe including South Africa. When we say this medication is an HIV pre-exposure prophylactic (PrEP), it is medication taken before exposure to HIV. This treatment is used to reduce the risk of being infected with HIV.

Who can take this ARV?
This anti-retroviral (ARV) medication is prescribed to people who are HIV negative and at high risk of exposure to HIV, for example, sex workers, people with multiple sex partners, or even people in perhaps disempowered relationships to name a few. Also, it is approved for use in adults who weigh at least 35kg.

According to the World Health Organisation, “CAB-LA was shown to be safe and highly effective among cisgender women, cisgender men who have sex with men, and transgender women who have sex with men in 2 randomised controlled trials, HPTN 083 and HPTN 084”. So, it is important to:

•	Know your HIV status
•	Assess your sexual health and risk exposure
•	Chat to a healthcare professional (doctor, nurse, etc.)

If you are already HIV+, you need to continue taking your ARV medication to treat HIV. Please remember that this medication can only help reduce your risk of getting HIV infection before you are infected.

How is it administered (dosing)?
CAB-LA is a schedule 4 (S4) medicine and needs to be administered by a healthcare professional. S4 medications need a professional diagnosis and management. CAB-LA will need to be administered with these factors in mind:

•	Individuals must have had a documented negative HIV test.
•	Individuals should be counselled about the importance of adherence to scheduled dosing visits to help reduce the risk of acquiring an HIV infection and potential development of resistance.    

CAB-LA is administered as an in intramuscular (IM) injection once each month for the first two months to assess tolerability. Thereafter, you will receive an IM injection of CAB-LA one time every two months. This medication can stay in your body for 12 months or longer after your last injection.

SAHPRA has registered Apretude 600 mg/3ml injection which is the first and only long-acting, injectable PrEP (oral PrEP and the vaginal ring are also available) for reducing the risk of getting HIV.

Are there any side effects?
Understanding the side effects of a medication are critical before you decide to take any medication. The side effects of CAB-LA may include:

•	severe skin rash and allergic reactions (hypersensitivity reactions)
•	headaches
•	diarrhoea
•	tiredness
•	loss of appetite
•	depression
•	mood changes

It must be noted that these side effects do not affect everyone. If individuals do find themselves experiencing any side effects, they are encouraged to please report these to SAHPRA using the MedSafety App that allows the regulator to address and monitor safety issues to better manage medication usage across the country.

SAHPRA is tasked with regulating (monitoring, evaluating, investigating, inspecting, and registering) all health products. The regulator does not control or manage the availability and access to health products so this information will need to be provided when engaging with hospitals, clinics, or healthcare professionals.

Key things to remember about CAB-LA:

•	It is a medication that can prevent HIV infection in people at risk for HIV exposure.
•	It is administered by a healthcare professional.
•	It does have side effects.
•	It is not a cure for HIV, it is a preventative medication.


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Get the facts about CAB-LA