Related Experiment Video
Updated: Jun 28, 2026
07:18
High Throughput In Vitro Assessment of Latency Reversing Agents on HIV Transcription and Splicing
Published on: January 22, 2019
Long-Acting Injectable Cabotegravir Use and Persistence Over 2 Years
Shi Hao Ernest Koh1, Wenting Huang1, Eric W Hall2
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
JAMA Network Open
|June 26, 2026
Summary
Long-acting injectable cabotegravir (LAI-CAB) shows promise for HIV prevention, but its uptake remains low. Persistence with LAI-CAB and overall pre-exposure prophylaxis (PrEP) declines by year two, indicating a need for structural support to improve its use.
Area of Science:
- Pharmacology and Pharmaceutics
- Infectious Disease Epidemiology
- Public Health Interventions
Background:
- Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) offers superior efficacy compared to oral PrEP for HIV prevention.
- Optimizing the impact of LAI-cabotegravir (CAB) hinges on achieving higher drug persistence among users.
Purpose of the Study:
- To characterize users of LAI-CAB in comparison to oral PrEP.
- To describe the trends in national LAI-CAB versus oral PrEP utilization over time.
- To examine the longitudinal persistence rates among individuals using LAI-CAB.
Main Methods:
- A retrospective cohort study utilizing national pharmacy and medical claims data from 2022 to 2024.
- Inclusion criteria: individuals with at least one claim for any PrEP medication (oral or injectable).
- Outcomes assessed: LAI-CAB use, LAI-CAB yearly persistence, and overall PrEP persistence, analyzed using multivariable logistic regression.
Main Results:
- LAI-CAB represented 3% of all PrEP users (24,194/781,040) from 2022-2024, increasing to 4% by late 2024.
- LAI-CAB users were younger, predominantly male, and more likely to have Medicaid coverage compared to oral PrEP users.
- One-year persistence was approximately 50% for LAI-CAB and 57% for overall PrEP among LAI-CAB users, declining to 23% and 30% by year two, respectively. Lower persistence was observed in female users.
Conclusions:
- LAI-CAB use constitutes a small fraction of the overall PrEP landscape in the US.
- Persistence rates for both LAI-CAB and overall PrEP decrease significantly by the second year of use.
- Effective scale-up of highly efficacious PrEP modalities like LAI-CAB requires integrated structural supports and behavioral interventions beyond implementation alone.
Related Concept Videos
01:21Drug Accumulation During Multiple Dosing: Repetitive IV Injections
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:22Antiviral Nucleoside Inhibitors
Antiviral Nucleoside InhibitorsAntiviral nucleoside inhibitors are structural analogs of natural nucleosides that interfere with viral DNA or RNA synthesis. These compounds selectively target viral polymerases due to their resemblance to host nucleosides, thereby disrupting viral genome replication.Mechanism of Acyclovir ActionAcyclovir is a guanosine analog with a three-carbon acyclic side chain. It selectively targets herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2),...
01:29Subviral Agents
Subviral agents are infectious entities that resemble viruses but lack one or more viral components, such as a capsid or essential replication machinery. These agents include viroids, prions, and satellites, each possessing distinct structural and functional characteristics that influence their mode of infection and replication.Viroids are the simplest subviral agents, consisting of circular, single-stranded RNA molecules without a protein coat. They exclusively infect plants, relying entirely...
01:14Pharmacokinetic–Pharmacodynamic Relationship: Duration of Dose-Effect Relationship
For drugs producing a quantal response, onset occurs when plasma concentration reaches a minimum effective level (Cmin). The drug's action duration depends on how long the plasma concentration remains above Cmin.Two primary factors influence this duration: dose size and the rate of drug removal from the action site. Both depend on the drug's redistribution to poorly perfused tissues and elimination processes. A larger dose promotes rapid onset and prolongs the effect's duration.Consider a...
01:10Retrovirus Life Cycles
Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...