Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 11.
doi: 10.1007/s11606-025-09350-8. Online ahead of print.

Early Implementation of Long-Acting Injectable Cabotegravir for HIV Prevention in a Safety Net Hospital-based Primary Care Center in U.S. South

Dylan Baker  1   2 , Lauren F Collins  3   4 , Valeria D Cantos  3   4 , Emma Hollenberg  5 , Alexander Kaplan  5 , Terri Cowan  3 , Jose Garcia  3 , Meredith Lora  6   7
Affiliations

Early Implementation of Long-Acting Injectable Cabotegravir for HIV Prevention in a Safety Net Hospital-based Primary Care Center in U.S. South

Dylan Baker et al. J Gen Intern Med. .

Abstract

Background: Long-acting injectable cabotegravir (CAB-LA), approved in 2021, is a more effective HIV prevention method than daily oral PrEP. CAB-LA expansion addresses key HIV prevention gaps, especially in the Southern United States (U.S.), to support national Ending the HIV Epidemic (EHE) goals. However, complex implementation requirements hinder CAB-LA expansion, highlighting the need for real-world data to guide effective and equitable scale-up.

Objective: Describe the implementation and early outcomes of implementing CAB-LA in a large safety-net primary care center in the Southern U.S.

Design: We described the integration of CAB-LA into an existing oral PrEP program. We manually abstracted individual sociodemographic and clinical data. We developed a CAB-LA care continuum and reported early outcomes among CAB-LA initiators.

Participants: Individuals referred to the CAB-LA program from 12/1/2022 to 8/1/2023, with outcomes assessed through 12/1/2023.

Main measures: Development of a CAB-LA care continuum from linkage, eligibility assessment, program enrollment, initiation, and persistence. We reported the sociodemographic and clinical characteristics of individuals referred for and initiated on CAB-LA, the total number and timing of injections administered, self-reported adverse events, CAB-LA discontinuations, and HIV seroconversions.

Key results: Integration of CAB-LA into an existing oral PrEP program required multidisciplinary team adaptation, protocol development for drug procurement and care coordination, and adapting an existing population health registry to the CAB-LA workflow to monitor and track individuals. Of 221 referred individuals, 77 (35%) initiated CAB-LA. Initiation barriers included program intake scheduling delays (29%), individuals declining CAB-LA (19%), and delayed medication procurement (16%). Among CAB-LA initiators, 275 injections were administered, 94% were administered on time, six individuals (8%) reported adverse effects, and eight (10%) discontinued CAB-LA. No HIV seroconversions occurred.

Conclusions: We successfully implemented a CAB-LA PrEP program in a safety-net primary care center in the U.S. South, using an approach designed to address structural barriers to PrEP uptake and persistence.

Keywords: HIV prevention; U.S. South; implementation science; long-acting cabotegravir; pre-exposure prophylaxis uptake.

PubMed Disclaimer

Conflict of interest statement

Declarations:. Conflict of Interest:: Dr. Dylan Baker has received research grant funds from Viiv Healthcare and has received compensation from Viiv Healthcare for participation on a medication advisory board, paid to Emory University. Dr. Valeria Cantos has received research grant funds from Gilead Sciences, paid to Emory University. All other authors declare no competing interests.

References

    1. Landovitz RJ, Donnell D, Clement ME, Hanscom B, Cottle L, Coelho L, et al. Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women. N Engl J Med. 2021;385(7):595-608. https://doi.org/10.1056/NEJMoa2101016 . - DOI - PubMed - PMC
    1. Delany-Moretlwe S, Hughes JP, Bock P, Ouma SG, Hunidzarira P, Kalonji D, et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. Lancet. 2022;399(10337):1779-89. https://doi.org/10.1016/S0140-6736(22)00538-4 . - DOI - PubMed - PMC
    1. Chou R, Spencer H, Bougatsos C, Blazina I, Ahmed A, Selph S. Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2023;330(8):746-63. https://doi.org/10.1001/jama.2023.9865 . - DOI - PubMed
    1. Calabrese SK. Understanding, Contextualizing, and Addressing PrEP Stigma to Enhance PrEP Implementation. Curr HIV/AIDS Rep. 2020;17(6):579-88. https://doi.org/10.1007/s11904-020-00533-y . - DOI - PubMed
    1. Serota DP, Rosenberg ES, Lockard AM, Rolle CM, Luisi N, Cutro S, et al. Beyond the Biomedical: Preexposure Prophylaxis Failures in a Cohort of Young Black Men Who Have Sex With Men in Atlanta, Georgia. Clin Infect Dis. 2018;67(6):965-70. https://doi.org/10.1093/cid/ciy297 . - DOI - PubMed - PMC

LinkOut - more resources