Health Care Providers’ Experiences With and Perceived Barriers to Implementation of Long-Acting Injectable HIV Preexposure Prophylaxis: A Cross-Sectional Survey

IntroductionLong-acting injectable cabotegravir (CAB-LA) is highly efficacious as PrEP and could increase PrEP coverage, though uptake has been limited.MethodsWe surveyed healthcare professionals regarding experiences with CAB-LA implementation in the United States. We used descriptive statistics to summarize perceived barriers and Fisher's exact tests to assess for factors associated with CAB-LA availability and use.ResultsAmong respondents, 71% (51/72) reported their clinic site offered CAB-LA though only 44% (20/45) reported having prescribed it. The most common perceived barriers were concerns about insurance coverage (38/45, 84%), logistics (35/45, 78%), lack of requests (32/45, 71%), concern for missed injections (17/25, 68%), and cost (16/25, 64%). A majority (30/45, 67%) felt that lack of training was a barrier. Availability and prescribing did not vary by demographic or patient panel characteristics (p-values>0.05).ConclusionsHealthcare professionals' perceived barriers to CAB-LA uptake suggest need for improved implementation strategies, specifically surrounding cost, logistics, and education.