Within one year of starting a program to provide cabotegravir long-lasting injectable (CAB LA) every two months to clinics serving Black women in the US, clinic capacity to provide CAB LA more than tripled, with no increase in staffing, according to EBONI study results.
CAB LA can be integrated into various clinic types to expand PrEP access for Black women by using various implementation resources, such as clinic assessment tools, and strategies such as flexible appointments. Health care professionals in women’s health, primary care, and infectious disease clinics found CAB LA to be highly appropriate for Black women. They also found that additional health benefits of bi-monthly visits included more opportunities to be screened for STIs and comorbidities and to receive psychological care.
Black women make up around 50% of new HIV diagnoses among women in the US, according to the Centers for Disease Control and Prevention. Clinicians administered CAB LA every two months via intramuscular injection, and is the first approved long-acting agent against PrEP.
The 12-month EBONI study evaluated implementation strategies for delivering CAB LA for HIV PrEP to adult Black cis-and transgender women treated at infectious disease, primary care, and women’s health clinics in “Ending the HIV Epidemic” jurisdictions in the US.
From August 2022 to February 2025, 84 health care professionals from 15 clinics completed surveys on implementing CAB LA for Black women, and of these, 52 also completed qualitative surveys. The investigators chose interview topics using the Consolidated Framework for Implementation Research and Proctor implementation outcomes taxonomy, and they analyzed the data using a framework analysis approach.
Overall, 55% of health care professionals were cisgender females, 49% were Black, and 12% were Hispanic, with a mean age of 44 years. At month 12, health care professionals rated CAB-LA as highly appropriate for Black women (mean, 4.5 of 5), acceptable (mean, 4.5 of 5), and feasible (mean, 4.4 of 5). From baseline to month 12, the clinic capacity to accommodate more than 25 patients on CAB-LA more than tripled, from 15% to. 55%, without increasing number of trained staff or weekly staff time.
Over 50% of health care professionals in clinics that had access to resources reported high use of items, including the clinic readiness for CAB-LA checklist, the guide for CAB LA initiation and administration, CAB-LA acquisition tracker, and the CAB-LA injection video. HCPs reported high use of strategies, including flexible scheduling that allowed drop-ins, training on providing PrEP to Black women, and partnerships with specialty pharmacies to acquire CAB-LA. With these strategies in place, 86% of professionals reported that implementing CAB-LA into their workflow was very, somewhat easy, or neither easy nor difficult.
Reference:
Tims Cook Z, et al. IAS 2025. Poster Exhibition THPEE096.
