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Related Experiment Video

Updated: May 17, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
05:46

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Published on: April 9, 2014

Multi-Center Real-World Implementation Outcomes of Lenacapavir for HIV Pre-Exposure Prophylaxis.

Aniruddha Hazra1,2, Philip A Chan3, Meredith Clement4,5

  • 1Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 15, 2026
PubMed
Summary

Lenacapavir for PrEP initiation faced payer delays. Early non-persistence was linked to injection site reactions, highlighting barriers to lenacapavir PrEP access and adherence.

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Pharmacology

Background:

  • Lenacapavir is a novel long-acting injectable medication for HIV pre-exposure prophylaxis (PrEP).
  • Real-world implementation data are crucial for understanding PrEP effectiveness beyond clinical trials.

Purpose of the Study:

  • To characterize the implementation of lenacapavir PrEP across multiple U.S. sites.
  • To identify factors associated with early non-persistence with lenacapavir.

Main Methods:

  • Retrospective analysis of 501 individuals initiating lenacapavir PrEP across 17 U.S. sites.
  • Evaluation of initiation delays and early non-persistence rates.
  • Association analysis between injection-site reactions and non-persistence.

Main Results:

  • Implementation was marked by significant delays in initiation, primarily due to payer processes.
  • Early non-persistence occurred in 3.6% of participants, surpassing clinical trial discontinuation rates.
  • Abdominal injections and injection-site reactions requiring clinical contact were strongly associated with early non-persistence.

Conclusions:

  • Payer processes represent a significant structural barrier to timely lenacapavir PrEP initiation.
  • Injection site reactions are a modifiable clinical barrier impacting early adherence to lenacapavir.
  • Strategies addressing payer issues and managing injection site reactions are needed to improve lenacapavir PrEP persistence.