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Knowledge, awareness, feasibility, and acceptability of long-acting Cabotegravir for HIV prevention: results from the SEARCH Dynamic Choice HIV prevention trial
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AIDS 2024 July 20-26 Munich
Abstract
BACKGROUND: Injectable Cabotegravir (CAB-LA) is highly effective for HIV prevention, but real-world implementation studies among men and women in Africa are lacking. We assessed knowledge, awareness, feasibility, and acceptability among participants who used CAB-LA for prevention in the ongoing SEARCH Dynamic Choice HIV prevention (DCP) randomized implementation study in rural Uganda and Kenya.
METHODS: The SEARCH DCP study enrolled women and men aged =15 years with self-assessed risk for HIV acquisition. The intervention arm included structured product choice (oral PrEP, PEP, or injectable CAB-LA), with flexibility to switch between products based on changes in participant risk or preferences over 48 weeks of follow-up. CAB-LA injections were provided at Ministry of Health clinics. Quantitative surveys were completed by participants who chose and initiated CAB-LA at time of initiation and after 24-weeks of CAB-LA use.
RESULTS: Of 487 intervention arm participants, 274 (56%) started CAB-LA during follow-up (183 women, 91 men; 79 youth aged 15-24 years); of these, 198 (72%) used CAB-LA for =24 weeks. At initiation, 64% chose CAB-LA because it was easier to take an injection and 49% because of difficulty remembering to take oral pills. Among youth initiators, 42% chose CAB-LA because they did not want someone to see them taking pills and 22% because partners/friends would not let them take pills. At CAB-LA initiation, 99% of participants had basic to no knowledge of CAB-LA, consistent across gender and age groups. Awareness, acceptability, and feasibility were high at 24 weeks (Table).
CONCLUSIONS: In rural Uganda and Kenya, over half of participants in the SEARCH DCP trial who were offered choice of oral PrEP/PEP or CAB-LA chose and started CAB-LA during the first 48 weeks. CAB-LA was a popular choice for men and women and was feasible to deliver with a high level of satisfaction.
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