Patterns and correlates of initiation of long-acting injectable cabotegravir for pre-exposure prophylaxis: a case-control analysis

Abstract

We conducted a case-control analysis to evaluate the determinants for initiating long-acting injectable cabotegravir (LACAB) as PrEP in a real-world setting with limited drug access. Individuals selected for LACAB experienced more side effects from oral PrEP, riskier sexual behavior, longer prior PrEP use, and a significantly higher incidence of STIs during follow-up. Despite this, LACAB was well tolerated, and discontinuation rates were low. Our findings support prioritizing LACAB for individuals most exposed to HIV and with low adherence to oral regimens, especially in contexts where logistical or economic constraints limit universal access to PrEP.

Keywords: HIV prevention; PrEP selection; long-acting cabotegravir; pre-exposure prophylaxis; sexually transmitted infections.