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October 5, 2025Open Access

Early results from implementation of HIV pre-exposure prophylaxis (PrEP) with long-acting injectable cabotegravir for people with barriers to oral strategies, Italy, December 2024 to August 2025

Key Points

Adherence to cabotegravir injections exceeded 95%, showing strong compliance among participants who typically struggle with oral PrEP.
Only 1.5% of participants discontinued treatment for drug-related reasons, highlighting cabotegravir's favorable tolerability.
The implementation in Italy represents the first real-world application of CAB-LA in Europe aimed at populations facing barriers to oral PrEP.
These findings suggest that CAB-LA could be a viable option for HIV prevention in specific vulnerable populations.

Abstract

Between December 2024 and August 2025, two Italian HIV/STI clinics offered long-acting injectable cabotegravir (CAB-LA) for HIV prevention in 265 individuals, representing the first European real-world implementation. Participants were prioritised based on vulnerabilities compromising oral pre-exposure prophylaxis (PrEP), such as poor adherence, comorbidities and behavioural barriers. Adherence to injections exceeded 95%, tolerability was favourable and only 1.5% discontinued for drug-related reasons. These findings demonstrate the feasibility of CAB-LA in European clinical services and support its use in specific populations.

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