Why a Subdermal Implant Could Revolutionize HIV Prevention and Care

It can be difficult for HIV sufferers to keep up with their daily drug treatments, but a new subdermal implant may be about to change that.

Created by scientists at Oak Crest Institute of Science in California, the implant, which is a small flexible tube just a little larger than a matchstick, is designed to work in a similar way to contraceptive subdermal implants. Sitting under the skin, the implant would steadily deliver a daily dose of potent antiretroviral drugs that can keep HIV under control.

While for some people HIV medication isn’t that cumbersome, for others required to take multiple drugs every day, it can be more problematic. In fact, some people living with HIV report that they find it hard to take their medication consistently, especially if they are dealing with other health problems or mental health issues. The drugs can serve as an unwelcome reminder of a chronic condition that, together with their side-effects can make them hard to take.

A subdermal implant could therefore provide users with a means to not have to worry about their HIV medication as much as they might have, allowing them more freedom to travel and generally enjoy life. While this probably won’t reduce the side-effects of these drugs, it could help people stay more positive which we know is a powerful tool in keeping people in generally good overall health.

Another reason that HIV awareness and health care advocates are excited about the possibility of this implant is that it could represent a critical step in driving down HIV infections in places like sub-Saharan Africa. While significant strides have been made in the region, poor infrastructure means that sometimes people who require HIV medication cannot always access it easily, reducing the medication’s effectiveness and potentially causing other health problems. This can be particularly true if the patient needs to travel great distances to get to a clinic where they can get a new batch of medication. The implant, providing it can be installed and left for long enough, could therefore be a great way around that problem. It may also help to reduce the stigma surrounding HIV treatment, particularly problematic for women in developing countries.

Early tests have shown that the subdermal implant is safe and effective over a 40-day period, and future tests will attempt to gauge precisely how long will be optimal in terms of balancing cost effectiveness with safety and uptake.

Study author Dr Marc Baum says, “To our knowledge, this is the first implant to be used for this purpose. ‘This novel device will revolutionise how we treat or prevent HIV and Aids as it delivers powerful HIV-stopping drugs and eliminates one of the key obstacles in HIV/Aids prevention – adherence to proper dosing regimens.”

The researchers are keen to stress though that the implant needn’t just be used for treating HIV—it could also be used as a method of preventing HIV transmission. We’ve previously discussed PrEP drugs like Truvada, which can cut HIV transmission by over 70 to 90 percent according to several trials. This method has been largely praised as an important tool but it still has one flaw: users must take the drug everyday (or as instructed) in order to get the full preventative benefit. Unfortunately, and for many different reasons, some people still struggle to do that.

On the other hand, a subdermal implant that could lower the viral load in someone’s body so that it becomes low enough that transmission is no longer possible could be a significant help in the fight against HIV, particularly if it was targeted at at-risk populations.

AIDS Healthcare Foundation President Michael Weinstein (AHF), who has opposed widescale reliance on PrEP, has indicated that the subdermal implant could tackle some of the foundation’s key concerns over HIV care:

“Numerous medical studies and our years of treating people living with HIV all over the world have proven to us that one of the most significant challenges in suppressing the virus is getting patients to take their medications every single day,” the AHF spokesperson said. “From the beginning of the debate on pre-exposure prophylaxis as a public health strategy, AHF has said that we would support a vaccine or implant that reduces the human tendency to skip doses. While patient studies, federal approval and information on pricing and availability is still needed at this early stage, the news that scientists have created the first implant to deliver HIV medications for prevention or treatment is a potential medical breakthrough that AHF wholeheartedly welcomes. We’ll be closely monitoring the next steps following these promising preliminary studies.”

All that said, the studies so far have only been done on animal models and as a result the implant’s effectiveness on humans is unknown. There are other hurdles to overcome, too. As mentioned above, researchers will have to find the so-called sweet spot for how long the implant can safely remain in use before it is replaced. If the time frame is too short, for instance, only a couple of months, this might put some people off from having the procedure.

While ultimately the implant may still be a long way off, it does represent an enticing glimpse of how it might be possible to offer people living with HIV a new way in which they can get the care they need while not feeling chained to their medication, and that in itself could help to save lives.

Photo credit: Thinkstock.

26 comments

Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing

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Nikki Davey
Nikki Davey2 years ago

Good idea

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Elizabeth F.
Elizabeth F2 years ago

noted

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Paulinha Russell
Paulinha Russell2 years ago

Thanks

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Hussein Khalil
Hussein Khalil2 years ago

thanks

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Cara Livingston
Cara Livingston2 years ago

This is such an interesting idea. I personally hadn't thought about the possibility of sub dermal implants for HIV. I hope that this is a real possibility that becomes widely available as soon as possible, as long as it is safe and actually works.

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Winn Adams
Winn A2 years ago

Thanks

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Winn Adams
Winn A2 years ago

Thanks

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Mark Vaughan
Mark Vaughan2 years ago

Subdural medication, and long lasting shots are especially important for people with mental illness, as their condition can interfere with taking meds. Since people with bipolar and schizophrenia are at greater risk of engaging in risky sex, the Truvada prevention could be especially helpful. It's no substitute for proper condom use, but like abstinence only, accidents and incidents ARE going to happen. This can help prevent them from being disasters.

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Mark Vaughan
Mark Vaughan2 years ago

Subdural medication, and long lasting shots are especially important for people with mental illness, as their condition can interfere with taking meds. Since people with bipolar and schizophrenia are at greater risk of engaging in risky sex, the Truvada prevention could be especially helpful. It's no substitute for proper condom use, but like abstinence only, accidents and incidents ARE going to happen. This can help prevent them from being disasters.

SEND