Over 3 years, adoption of long-acting cabotegravir increased, with the highest uptake observed among pre-exposure prophylaxis (PrEP)-naïve individuals who began treatment with samples. The findings of the observational study were presented by Jessica A. Altamirano, MD, of CAN Community Health in Miami Gardens, Florida, at IDWeek 2025.
Altamirano and colleagues evaluated the adoption of long-acting cabotegravir and outcomes, such as rates of initiation, discontinuation, persistence, and seroconversion, because prior to the study period, just over 50% of long-acting cabotegravir prescriptions resulted in at least one injection administered at CAN Community Health Network. Samples for the medication became available in December 2024 through the buy-and-bill program.
The researchers used medical data of HIV-negative individuals (n=1003) from 24 CAN clinics across six states, which they assessed from December 20, 2021, to March 22, 2025.
Results showed that 75% (n=747) of those prescribed long-acting cabotegravir initiated treatment (received at least one injection). Most of them were men (83%) and ranged in age from 21 to 44 years (76%). Furthermore, initiation was highest among White people (78%), followed by Black/African American (68%), and Asian (62%). Compared with non-Hispanic people, Hispanic people had a higher rate of initiation (72% vs 81%, respectively).
Initiation also varied by sexual orientation and gender identity. Same-sex (78%) and bisexual (73%) individuals were more likely to initiate PrEP compared with those who identified as heterosexual (68%). Researchers observed an initiation rate of 77% in transgender men versus 67% in cisgender females.
Samples, via the buy-and-bill program, helped 78 people initiate cabotegravir. The median age of this group was 36.5 years, and 65% were cisgender men. More than half (56%) had never received PrEP, and most identified as same-sex (49%) and Black (33%).
In addition, 289 (39%) of participants discontinued cabotegravir (more than 67 days since their last injection). More than 100 people switched to oral PrEP following a median of 4 injections.
“Despite the discontinuation rate, many switched to oral PrEP with continued engagement in prevention,” the researchers wrote.
Among the study population, two people either tested positive for HIV via an Ag/Ab test or had detectable HIV RNA PCR.
Reference
Altamirano JA, Prerak Shukla, Blankenship B, et al. Scaling long-acting injectable cabotegravir for PrEP: adoption, implementation and outcomes from a three-year observational study in a large community-based clinic network. P-304. Presented at: IDWeek 2025, Oct. 19-22, 2025, Atlanta, GA.
