IDWeek 2023: New Data Provide Closer Look at Real-World Utilization of Cabotegravir for HIV PrEP

This article is part of our IDWeek 2023 coverage. You can find all of our newshere.

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Results from a new study showed that just slightly more than half of prescriptions for cabotegravir for HIV pre-exposure prophylaxis (PrEP) resulted in at least 1 injection, suggesting limitations in use and access to injectable cabotegravir for PrEP.

The findings are being presented during a poster session at IDWeek 2023, being held from October 11-15 in Boston, MA.

In December 2021, the US Food and Drug Administration approved cabotegravir as the first long-acting injectable form of HIV PrEP. A team of researchers conducted the current study to assess real-world utilization and adherence to cabotegravir for PrEP in an outpatient community-based clinic network in the US.

Investigators 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, according to the study abstract.

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. They also examined the rate of switching from oral PrEP to cabotegravir injections, persistence, and discontinuation of cabotegravir injections, and HIV seroconversion. Discontinuation was defined as either a return to oral PrEP or being more than 67 days from the last cabotegravir injection.

FINDINGS

The study cohort consisted of 293 HIV-negative individuals (median age, 36 years) prescribed cabotegravir for PrEP, of whom 239 were assigned male at birth and 54 were assigned female at birth. The population represented diverse sexual orientations, with 167 identifying as same-sex, 53 as heterosexual, and 48 as bisexual. In terms of ethnicity, 97 participants were non-Hispanic White, 86 were non-Hispanic Black, and 60 were White Hispanics, according to investigators.

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.

“Individuals prescribed cabotegravir for PrEP reflected a diverse population,” concluded researchers. “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.”

Source: Early real-world experience of long-acting cabotegravir (CAB) for HIV pre-exposure prophylaxis (PrEP) in a large community-based clinic network (CAN Community Health): Utilization and PrEP persistence. Abstract presented at IDWeek; October 11-15, 2023; Boston, MA.

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