Long-acting cabotegravir PrEP users report no HIV infections, high satisfaction | AIDS 2026

In a real-world study of 241 individuals using long-acting cabotegravir (CAB LA) for HIV pre-exposure prophylaxis (PrEP), no HIV acquisitions were reported and participants expressed high satisfaction and a strong preference for the injectable over daily oral PrEP, according to a poster presentation presented at the 26th International AIDS Conference (AIDS 2026) being held July 26 through July 31, 2026, in Rio de Janeiro, Brazil.

CAB LA, marketed as Apretude, is an injectable integrase strand transfer inhibitor the FDA approved in December 2021 as the first long-acting injectable PrEP option, indicated for at-risk adults and adolescents weighing at least 35 kg. After two monthly starter doses, it is administered as few as six times a year, an alternative to the daily pills that have long defined oral PrEP. Understanding how the injectable performs once it moves into everyday practice and how patients experience it is central to expanding its use, according to the study authors.

Study design and population

CAPTIVATE was a multisite observational study conducted across 18 U.S. clinics between November 2024 and April 2025, combining retrospective chart reviews with cross-sectional experience surveys of individuals using PrEP, led by Marisa Brizzi, Pharm.D., from UC Health in Cincinati, Ohio. Participants were at least 18, had received their most recent CAB LA injection within the prior six months, and had at least six months of follow-up after initiation. The 241 individuals in the analysis had a median age of 36 (range 19 to 72); 76% were male, 54% were White and 29% were Black or African American. Seventy percent had switched from oral PrEP when they started CAB LA, after a mean 23 months on oral regimens, while 17% were new to PrEP altogether.

No new HIV diagnoses, high continuation

No incident HIV diagnoses were reported during the study period. Nearly all participants, 98% (235 of 241), remained on CAB LA at study enrollment, and participants received a mean of 10 injections, counting initiation and continuation doses. Dosing adherence was strong: 92% of second initiation injections and 82% of continuation injections were administered within the target dosing window. Only six participants discontinued CAB LA, most commonly citing side effects other than injection-site reactions or reluctance to continue receiving injections; three switched to a once-daily oral regimen and remained on it through data collection, and all discontinuers who were surveyed said they would consider CAB LA again for future PrEP needs.

Satisfaction, preference and reasons for choosing CAB LA

Participants reported broadly positive experiences with the injectable regimen: 99% said they were satisfied receiving PrEP by injection every two months rather than taking a daily pill, 95% said it was easy to fit injection visits into their schedule, and 95% said they were able to return to their daily activities right after an appointment. Among the 190 participants with prior oral PrEP experience, 97% said they preferred CAB LA. Ease of adherence was the most commonly cited primary reason for both starting CAB LA (43%) and staying on it (45%), followed by its demonstrated superiority over once-daily tenofovir disoproxil fumarate/emtricitabine in reducing HIV risk.

Participants also described benefits that extended past HIV prevention itself. Ninety-nine percent said they felt protected from HIV and 99% said they worried less about acquiring it; 91% said CAB LA gave them more of a sense of control over their lives, and 91% said it let them focus more on their sexual health. The every-two-month visit cadence also opened the door to additional care: 95% of participants received STI screening, 76% had blood pressure checks, and smaller shares received vaccinations, hepatitis C testing, mental health screening or blood sugar testing during their injection appointments.

The authors noted that discrepancies between clinician-reported and patient-reported reasons for initiating or continuing CAB LA in the study may reflect differences in perspective and recall between the two types of respondents, alongside the inherent gap between subjective self-report and clinically documented assessment.