Acceptability, Facilitators, and Barriers of Long-Acting Injectable Cabotegravir/Rilpivirine Among Youth With HIV in the United States

Authors

Justin Unternaher, Division of Infectious Diseases, Children's National Hospital, Washington, D.C.. Electronic address: junternahe@childrensnational.org.
Christine Craddock, Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, D.C.
Wei Li Koay, Department of Pediatrics, Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina.
Andrew P. Barnett, Division of Infectious Diseases, Children's National Hospital, Washington, D.C.; Division of Psychology and Behavioral Health, Children's National Hospital, Washington, D.C.
Tierra Williams, Division of Infectious Diseases, Children's National Hospital, Washington, D.C.
Natella Rakhmanina, Division of Infectious Diseases, Children's National Hospital, Washington, D.C.; Department of Pediatrics, The George Washington University School of Medicine, Washington, D.C.; Technical Strategies and Innovation, Elizabeth Glaser Pediatric AIDS Foundation, Washington, D.C.

Document Type

Journal Article

Publication Date

9-18-2025

Journal

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

DOI

10.1016/j.jadohealth.2025.07.025

Keywords

Cabotegravir/rilpivirine; HIV; Long-acting injectable; Youth with HIV; implementation

Abstract

PURPOSE: Implementation data on long-acting injectable cabotegravir/rilpivirine (LAI-CAB/RPV) among adolescents and youth with HIV (AYWH) remain sparse. We aimed to evaluate the acceptability, facilitators, and barriers of LAI-CAB/RPV among AYWH in care at a specialized HIV clinic in the United States. METHODS: A prospective single-center, cross-sectional survey study among AYWH aged 12-23 years. Adapting the Theoretical Framework of Acceptability and using the Consolidated Framework for Implementation Research, two separate surveys were administered to participants receiving (RCP) and not receiving (NRCP) LAI-CAB/RPV. RESULTS: Sixty-five participants (RCP, n = 18; NRCP, n = 47; median age = 20 years (interquartile range:18-21); 87.7% African American/Black; 55.4% males) were enrolled. Most RCP (44.4%) received LAI-CAB/RPV for 6-12 months. Most NRCP received one pill (83.0%) daily (97.9%). NRCP who have not switched were happy with oral treatment (n = 11; 31.4%) or had transportation concerns for attending appointments (n = 10; 28.6%). Sixteen (45.7%) NRCP were thinking about switching to LAI-CAB/RPV. NRCP interested in switching to LAI-CAB/RPV and RCP were motivated by removal of pill burden and fatigue and the opportunity to think less about their HIV diagnosis. Most RCP (n = 17; 94.4%) found LAI-CAB/RPV to be generally acceptable with 88.9% (n = 16) endorsing wanting to be on it long-term. Eighteen (38.3%) NRCP were at least likely to switch to LAI-CAB/RPV. DISCUSSION: LAI-CAB/RPV barriers among AYWH included side effects and more frequent visits. Removal of pill burden and fatigue and thinking less about their HIV diagnosis were the main facilitators. Further studies are needed for the implementation of LAI-CAB/RPV for AYWH in the United States.

APA Citation

Unternaher, Justin; Craddock, Christine; Koay, Wei Li; Barnett, Andrew P.; Williams, Tierra; and Rakhmanina, Natella, "Acceptability, Facilitators, and Barriers of Long-Acting Injectable Cabotegravir/Rilpivirine Among Youth With HIV in the United States" (2025). GW Authored Works. Paper 7937.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7937

Department

Pediatrics