Daily Dose: Real-World Use of Cabotegravir for HIV PrEP

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings presented at IDWeek 2023, held October 11-15 in Boston, MA.

The study

Researchers conducted the study to assess real-world utilization and adherence to cabotegravir for PrEP in an outpatient community-based clinic network in the US. They retrospectively reviewed electronic medical records from the CAN Community Health Network encompassing 26 outpatient clinics in 6 US states. Their objective was to identify HIV-negative individuals who received a prescription or injection for cabotegravir for PrEP between December 2021 and April 2023. Demographic data collected included age, race, ethnicity, sex assigned at birth, gender identity, and sexual orientation.

Researchers focused on 2 distinct groups: Those who received ≥1 cabotegravir injections following a prescription, and those who were prescribed but did not receive any cabotegravir injections.

Findings

The study cohort consisted of 293 HIV-negative individuals (median age, 36 years) prescribed cabotegravir for PrEP.

Among the cohort, 155 (52.9%) participants received ≥1 cabotegravir injections. Among those who initiated cabotegravir for PrEP, 126 (81.3%) demonstrated PrEP persistence, and there were no reported cases of HIV seroconversion. Moreover, the discontinuation rate was 29 (18.7%) in this group.

The primary reasons for discontinuation and switching back to oral PrEP were insurance coverage gaps or cost of copay (7 cases), side effects (6 cases), and conflicts with work schedules (2 cases). In 1 case, the reason for discontinuation was not documented.

Authors' comment

"Individuals prescribed cabotegravir for PrEP reflected a diverse population. However, only 52.9% of prescriptions for cabotegravir for PrEP resulted in at least one injection administered indicating limitations in use and access to injectable [cabotegravir] for PrEP.”

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