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Updated: May 20, 2026
05:46
Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Long-Acting Injectable Cabotegravir HIV PrEP Uptake, Adherence, and Persistence in Two Large US Integrated Healthcare
Michael W Traeger1,2,3, Wendy A Leyden4, Lindsay G Eberhart5
1Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA.
Summary
Long-acting cabotegravir (CAB-LA) for HIV pre-exposure prophylaxis (PrEP) shows high adherence and persistence in real-world use. However, very low uptake limits its population impact, highlighting the need for implementation strategies.
Area of Science:
- Public Health
- Infectious Diseases
- Pharmacology
Background:
- Long-acting cabotegravir (CAB-LA) is approved for HIV pre-exposure prophylaxis (PrEP) in the U.S.
- Limited data exist on CAB-LA's uptake, adherence, and persistence in clinical practice.
Purpose of the Study:
- To evaluate the uptake, adherence, and persistence of CAB-LA in real-world clinical settings.
- To compare characteristics of CAB-LA users with oral PrEP users.
Main Methods:
- Electronic health records of adults receiving oral or injectable PrEP from December 2021 to June 2024 were analyzed.
- Chi-square tests compared user characteristics; Kaplan-Meier methods estimated persistence.
- Adherence to bimonthly CAB-LA injections was assessed post-lead-in doses.
Main Results:
- Only 0.8% of 23,311 PrEP users received CAB-LA; 23.9% had no prior PrEP documented.
- CAB-LA users were more likely to be Black or Hispanic and less likely to have commercial insurance compared to oral PrEP users.
- 90.4% of CAB-LA injections were administered on time; 6- and 12-month persistence was 87.9% and 74.9%, respectively. No HIV infections occurred.
Conclusions:
- CAB-LA engages diverse populations, including those historically underrepresented in PrEP uptake.
- High adherence and persistence were observed in clinical practice.
- Extremely low uptake necessitates expanded implementation strategies for greater population impact.
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