MILAN (ITALPRESS) – Modernizing HIV pathways, from prevention to therapy, to intercept unsatisfied needs and approach international goals at 2030. This is the theme at the center of the second table of HIV-LAB Lombardy, held at Palazzo Pirelli in Milan with the involvement of infectious, pharmacists hospitals, institutions, health professionals, academic world and third sector. “Therapies are increasingly effective, but in order to take a further step forward we must also modernize the paths. Prevention and treatment are two components of the same strategy: it means first reach people at risk, customize available options and build organizational models that support adherence over time. Innovation produces value when it is inserted into the right path for the right person,” said Davide Croce, Director of CREMS – Research Centre in Economics and Management in Health and Social. Despite the increasing effectiveness of therapies, new diagnoses remain substantially stable and persist unconscious people of the infection, patients who do not fully reach the therapeutic goals and populations at risk still difficult to intercept. In Lombardy, in 2024, 449 new HIV diagnoses were recorded, equivalent to approximately 19% of national diagnoses. These data show that the availability of effective pharmacological tools alone is not enough: it is necessary to build paths that can help access, appropriateness and continuity over time. The project HIV-LAB Lombardia, created by CREMS and Summeet as part of the Health Sinergy partnership, with the non-conditional contribution of ViiV Healthcare, continues with a second table that, after the first appointment dedicated to the organization of the network, enters the merit of prevention and internal organization of the centers. The table aims to translate the debate into measurable actions: from updating PrEP programming on the basis of real access to adhesion monitoring, to structured pre-screening of therapies and to the definition of organizational models shared for long-acting paths, both in prevention and treatment. These actions will be the basis of the work of the coming months, which will converge in the course of 2027 in a new moment of comparison dedicated to verify its actual implementation. On the prevention front, the PrEP is now a consolidated reality also in Lombardy, with about 9,000 users from the start of the route, but the offer remains concentrated and some populations are even less reached. The availability of different modes of administration allows today to think of more personalized paths, adapting the preventive strategy to the characteristics and needs of the person. Among the options available, PrEP long-acting can help support the continuity of the preventive path in people for whom oral intake may be a limit. The data recalled during the meeting show significant differences in the continuity of the path in relation to the different modes of administration: evidence presented at the International AIDS Conference 2026 indicate, at one year, a 6.3% interruption with the PrEP injectable long-acting compared to 33.8% with the daily oral one. Suboptimal adhesion is also 9.4% and 54.9% respectively. The availability of innovation must be accompanied by a programming that can evolve together with the accesses and needs observed. In the course of the comparison, the importance of monitoring the use in the different centers has been emphasized, periodically updating the forecasts and sharing operational indications between clinicians, hospital pharmacies and institutions, in order to further improve access and taking charge. More flexible programmingbile and based on data can allow the offer to adapt to the actual trend of access in the different territories.The economic data of recent years strengthen the need to focus attention also on the organization. Between 2018 and 2024, due to an increase of 6.3% of treated patients, average patient spending decreased by 11.1%. A trend that shows how a part of efficiency has already been generated on the pharmaceutical side, while additional margins can be sought in the way in which prevention, treatment and takeover are organised. The programming, therefore, also affects the treatment of people with HIV, where long-acting therapies broaden the possibilities of customizing the grip, but require a dedicated organization. Pre-screening before visiting, identifying eligible patients, programmed agendas, recall systems, role of nursing staff and coordination with hospital pharmacy are some of the elements necessary to integrate these options into clinical practice. With long-acting paths, therapeutic continuity no longer depends solely on the patient’s daily behavior, but it becomes more shared with the health structure.
– photo f12/Italpress –(ITALPRESS).
