Q&A: Pharmacist on Medication Developments for People Living with HIV
Jay Holloway, PharmD, AAHIVP, Pharmacist with the AIDS Healthcare Foundation, discussed the ongoing developments impacting patients with HIV and their prescription drugs.
Since the discovery of the HIV virus in the early 1980s, the last 40 years have seen exponential advancements regarding patient care in the HIV space.1 From the peak of AIDS stigmatization to the promotion of pre-exposure prophylaxis (PrEP), patients living with HIV are no longer left in the dark when it comes to receiving care. However, experts within the space still believe more needs to be done to advance what the industry knows about HIV and AIDS.
Jay Holloway, PharmD, AAHIVP, is a staff pharmacist with the AIDS Healthcare Foundation. He sat down with Drug Topics to discuss the current status of HIV care in the state of California and beyond.
“HIV is, nowadays with our developments in medicine, a very manageable health condition. If you're adherent to your medications, then we can get you down to undetectable levels,” said Holloway.
Patients living with HIV are no longer left in the dark when it comes to receiving care. | image credit: Savvapanf Photo © / stock.adobe.com
Find out more about the current developments surrounding HIV care from the perspective of a certified pharmacist with experience in this area. Also, be sure to stay tuned for more content from our interview with Holloway, diving deeper into developments in the HIV space and how pharmacists are viewed amongst other providers working with patients who have AIDS.
READ MORE: Lenacapavir for PrEP Demonstrates Strong Efficacy in Second Phase 3 Trial
Drug Topics: How would you describe the current state of HIV medications within the US drug supply chain? Are these medications thriving, failing, or plateauing in regard to success and improving patient outcomes?
Jay Holloway: I can't speak to the state of other states, but here within California, the situation is good in terms of supply. We're able to have meds accessible. I haven't seen any issues with medication shortages. In regards to antiretrovirals (ARVs), one of the things that has been wonderful has been single-tablet regimens; how that is the go-to medication regimen to start patients on when we do a quick start of ARVs at the clinics. For single-tablet regimens, the fewer pills that a patient has to take, the better the adherence, the better the outcomes.
We're also seeing an increase in the use of injectable ARVs, which is CABENUVA (cabotegravir). Injectable ARVs are really helpful for our patients who may have, due to scheduling issues, due to forgetfulness, or any other reason, difficulty taking a tablet every day. Many patients just don't want to take a tablet every day. We have to meet those patients where they are. For patients who qualify for CABENUVA, that is a good option.
One of the nice things about practicing in California is we also have a very strong ADAP program, which for people living with HIV, enables them to get not just their ARVs, but also other medications at zero cost to them. People can get not just their ARVs through us, but they can get their entire set of maintenance medications as well.
Drug Topics: Are there specific developments in the HIV space that have made a significant impact on patients in recent history?
Jay Holloway: I would definitely say the long-acting injectables has been the biggest development that I'm most excited about because that just gives us another tool for patients. It also especially helps for patients that have major difficulties with adherence. It's really nice that you can just come in every 2 months, get your injection, and be done with it. However, there are some patients who are still falling through the cracks in that regard, and that's why we should still continue to refine our long-acting injectables.
One of the things I'm very excited about is the PURPOSE trial, which utilizes lenacapavir for PrEP. We saw the results of the PURPOSE 1 trial come through and it shows that long-acting injectables for PrEP for cisgender women and girls is a good option. Now, PURPOSE 2, we're hopefully going to get the results of that soon, and that will focus on PrEP for all other populations. One of the things I feel that's important to improve patient outcomes, especially in a condition like HIV, is having a bunch of different tools, having not just your single-tablet regimens, but also having injectables, having things where you can meet the patients at their needs.
Drug Topics: What is one thing about HIV as a whole that you think the general public should understand?
Jay Holloway: One of the things that I want to tell people who maybe just recently had a new diagnosis, or they may not know very much about HIV, is that it is nowadays—with our developments in medicine—a very manageable health condition. If you're adherent to your medications, then we can get you down to undetectable levels. There is also the concept of U equals U, which is undetectable equals untransmissible, which means that if you have an undetectable viral load, you cannot transmit it via sex.
A positive status is not an indicator of one's morality. It's just another thing that patients have, like high blood pressure or asthma. We're here to support you. I think for people who want to be allies in health care and want to end the HIV epidemic, we can't just provide meds, but we also need to address disparities. There's a really good quote from a presentation by Black and Pink, which helps incarcerated and formerly incarcerated people living with HIV: “If you want someone to take meds to save their life, you have to give them a reason to live.” And I hope that inspires people who want to help end the HIV epidemic to not just make sure meds are available, but also to address those health disparities and to do things in their everyday life, no matter how small, that make the world more accessible and equitable.
READ MORE: HIV Resource Center
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