Provider Factors Likely to Impact Access and Uptake of Long-Acting Injectable Cabotegravir for Transgender Women in the United States: Results of a Qualitative Study

J Assoc Nurses AIDS Care. 2024 Sep-Oct;35(5):437-449. doi: 10.1097/JNC.0000000000000488. Epub 2024 Aug 13.

Abstract

Long-acting injectable cabotegravir (CAB-LA) was US Food and Drug Administration-approved in 2021. However, little is known about providers' CAB-LA knowledge, attitudes, challenges, and prescribing preferences for transgender women patients. Understanding this is critical to developing new pre-exposure prophylaxis (PrEP) interventions tailored to transgender women. We conducted 45-min, in-depth Zoom interviews (IDIs) with United States-based health care providers who prescribe PrEP to transgender women. IDIs focused on providers' CAB-LA knowledge/acceptability, willingness to prescribe CAB-LA to transgender women, potential challenges, and solutions to mitigate challenges. Providers ( N = 17) had a mean age of 43 years, and 35.4% ( n = 6) identified as people of color. Most ( n = 12) had basic knowledge of CAB-LA but wanted additional training. All participants found CAB-LA acceptable and were willing to prescribe. Most ( n = 11) anticipated minimal challenges to implementation. Others ( n = 4) reported potential issues, including logistical/scheduling concerns that impede CAB-LA integration and staffing concerns. Many providers expressed support for self-injection ( n = 13) and injections at "drop-in" clinics ( n = 8) to overcome challenges.

MeSH terms

  • Adult
  • Anti-HIV Agents* / administration & dosage
  • Anti-HIV Agents* / therapeutic use
  • Attitude of Health Personnel
  • Delayed-Action Preparations
  • Diketopiperazines
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Health Knowledge, Attitudes, Practice
  • Health Personnel* / psychology
  • Health Services Accessibility
  • Humans
  • Injections
  • Interviews as Topic
  • Male
  • Middle Aged
  • Pre-Exposure Prophylaxis* / methods
  • Pyridones* / administration & dosage
  • Pyridones* / therapeutic use
  • Qualitative Research*
  • Transgender Persons* / psychology
  • Transgender Persons* / statistics & numerical data
  • United States

Substances

  • cabotegravir
  • Anti-HIV Agents
  • Pyridones
  • Delayed-Action Preparations
  • Diketopiperazines