real-World Data Supports Long-Acting injectable PrEP for HIV Prevention in Europe
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despite significant advancements in HIV prevention, over 100,000 new HIV diagnoses still occur annually in the World Health Organization European Region. Recent data from Italy demonstrate the feasibility and positive early outcomes of using long-acting injectable cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) in a real-world setting. This offers a promising alternative for individuals who may face challenges with daily oral PrEP.
Background on PrEP and CAB-LA
Pre-exposure prophylaxis (PrEP) involves taking medication before potential exposure to HIV to prevent infection. Traditionally, PrEP has been administered as a daily oral pill. Though, adherence to a daily regimen can be difficult for some individuals, reducing its effectiveness.
Cabotegravir long-acting (CAB-LA), administered as an intramuscular injection, provides sustained drug levels with less frequent dosing – currently recommended every two months after an initial series of injections. https://www.cdc.gov/hiv/risk/prep/cabotegravir.html CAB-LA was recommended in European guidelines in 2024, but real-world data outside of clinical trials were limited until recently.
Italian Study Findings
Between December 2024 and August 2025, two Italian centers specializing in HIV/STI care enrolled 265 individuals in a program offering CAB-LA for PrEP. The program specifically targeted individuals with factors that could hinder the effectiveness of daily oral PrEP, including:
* Suboptimal adherence: Difficulty remembering or consistently taking daily medication.
* Comorbidities: Co-existing health conditions that might complicate oral PrEP use.
* Structural/Behavioral Barriers: Factors like stigma,lack of access,or lifestyle challenges.
A rapid dialog published in Eurosurveillance details the characteristics of the participants,their motivations for choosing CAB-LA,and initial results regarding adherence,tolerability,safety,and discontinuation rates. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2025.30.39.2500739 While the full details are available in the publication, early findings suggest CAB-LA is a viable and well-tolerated option for PrEP in this population.
Implications for HIV Prevention
The italian study provides valuable real-world evidence supporting the use of CAB-LA for PrEP in Europe. This is notably important for individuals who may struggle with daily oral PrEP, offering a new tool to reduce HIV transmission. Further research and broader implementation are needed to fully assess the long-term impact of CAB-LA on HIV incidence in the region. the availability of diverse PrEP options is crucial for tailoring prevention strategies to individual needs and maximizing effectiveness.
Primary topic: HIV Prevention, specifically focusing on Pre-Exposure prophylaxis (PrEP)
Primary Keyword: CAB-LA (Cabotegravir long-acting)
Secondary Keywords: PrEP, HIV, HIV prevention, long-acting injectable, Europe, Eurosurveillance, adherence, sexual health, STI, public health.