Abstract Introduction Oral HIV pre‐exposure prophylaxis (PrEP) is highly effective, but adherence and persistence are often limited by side effects, pill fatigue and stigma. Long‐acting injectable cabotegravir (CAB‐LA) offers a discreet, convenient alternative with the potential to improve user experience and HIV protection. Data on real‐world use in Europe remain limited. The aim is to describe user‐reported outcomes from individuals initiating CAB‐LA PrEP. Methods This is a prospective cohort study enrolling participants receiving CAB‐LA between November 2024 and July 2025 at a large teaching hospital in Milan, Italy (San Raffaele Institute). At each injection visit, user‐reported outcomes on satisfaction, adherence, perceived protection, quality of life and adverse events, including injection site reactions (ISRs) using a self‐reported survey developed for the study were collected. Results Eighty‐two participants (97.6% cis‐MSM, median age 41.4 years) were included (median injections 4, range 2–5). Most (95.1%) had prior oral PrEP experience; 26.9% reported previous oral PrEP side effects, and 15.4% poor adherence. CAB‐LA satisfaction remained high: at the fourth injection, 90.9% reported a positive overall opinion, and 84.4% felt more protected than on oral PrEP. Convenience and elimination of daily pill‐taking were valued by >94%. Self‐reported adherence improved in 75.3%. Side effects were mostly mild or unchanged compared with oral PrEP; systemic adverse events were uncommon and ISRs were generally minimal. Conclusions In this real‐world cohort, CAB‐LA PrEP was highly acceptable, well tolerated and associated with improved perceived adherence, convenience and HIV protection. These findings support CAB‐LA as a promising, user‐centred HIV prevention strategy, potentially overcoming key limitations of daily oral PrEP.
Lolatto et al. (Mon,) studied this question.