An earlier version of this article appeared online before the September/October 2025 issue.
Two studies presented at the IAS 2025 meeting, in Kigali, Rwanda, demonstrated the acceptability and feasibility of using long-acting cabotegravir (CAB-LA; Apretude, ViiV Healthcare) for pre-exposure prophylaxis (PrEP) in different populations, including men who have sex with men (MSM), transgender men and Black women (posters TUPEE116; THPEE096).
PILLAR is a phase 4 implementation trial assessing the integration of CAB-LA for PrEP across 17 U.S. clinics among MSM and transgender men. They enrolled 201 participants between May 2022 and August 2023. Most of the participants were MSM (94%); 23% were Black and 39% were Hispanic. Of those, 142 completed surveys after 12 months in the study, and 44 participated in qualitative interviews.
CAB-LA for PrEP was rated highly acceptable (mean, 4.6/5 at month 12) and feasible (mean, 4.4/5), with 95% of participants (n=131) who switched from oral PrEP reporting satisfaction with the choice, and 98% recommending CAB-LA for PrEP (n=140). Flexible scheduling, reminders and educational tools supported adherence to PrEP.
MSM account for 67% of new U.S. HIV diagnoses, and although fewer become infected, transgender men (<1% of new diagnoses) are also at risk. Problems with taking daily medication and stigma are barriers to taking oral PrEP. CAB-LA, which is given every two months, can address these barriers. “MSM and TGM [transgender men] reported little to no PrEP stigma and anxiety concerns with CAB-LA at Month 6, which remained consistent to Month 12,” the researchers reported.
In a related study, researchers evaluated the feasibility of implementing CAB-LA use among Black cis- and transgender women across U.S. health clinics. In the United States, Black women account for about 50% of new HIV diagnoses. Data from EBONI found CAB-LA for PrEP was highly appropriate (mean, 4.5/5) and feasible (mean, 4.4/5) for Black women.
Between August 2022 and February 2025, 84 healthcare professionals (HCPs) from 15 clinics completed surveys about providing CAB-LA to patients; 52 also completed qualitative interviews. Most of the HCPs were cisgender women; 49% were Black and 12% Hispanic with a mean age of 44 years. They evaluated the appropriateness, acceptability and feasibility of using CAB-LA in the clinic and how it affected their workflow.
Overall, 85% of HCPs found implementing CAB-LA into their workflow was very or somewhat easy, or neither easy nor difficult at month 12.
The sources reported no relevant financial disclosures.
This article is from the October 2025 print issue.