To characterize individuals using LAI-CAB compared with oral PrEP in the US from 2022 to 2024, describe changes in national LAI-CAB vs oral PrEP use over time, and examine longitudinal persistence among LAI-CAB users.
Approach:
Study Design: Retrospective cohort study using deidentified, deduplicated commercial medical and pharmacy claims data in the US from January 1, 2022, to December 31, 2024.
Data Collection: Claims for approved PrEP medications were identified and abstracted, excluding HIV treatment and postexposure prophylaxis.
Persistence Assessment: Defined as having at least 2 LAI-CAB doses in each biannual period for LAI-CAB users and at least 2 claims for any PrEP medications for PrEP persistence.
Key Findings:
By the end of 2023, LAI-CAB accounted for only 2.5% of US PrEP users despite high interest.
Uptake of LAI-CAB varied by sociodemographic and behavioral characteristics.
Structural challenges, including medication acquisition and insurance processes, impeded LAI-CAB scale-up.
Interpretation:
Limitations:
Study data excludes closed health care systems like Kaiser Permanente and Veterans Affairs.
Persistence definitions may not capture all nuances of modality switching.
by Shi Hao Ernest Koh, Wenting Huang, Eric W. Hall, Jeb Jones, Xiao Zang, Courtney R. Yarbrough, Edwin E. Corbin-Gutierrez, Patrick S. Sullivan, Aaron J. Siegler
