{
  "abstract": "Background The impact of oral PrEP with tenofovir disoproxil fumarate/emtricitabine (F/TDF) can be limited by poor adherence. Long-acting cabotegravir (CAB-LA) may overcome adherence challenges and enhance prevention coverage, yet real-world evidence from Europe is lacking. We described Italian CAB-LA use in the Italian PrIDE cohort, compared proportion of days covered (PDC) between CAB-LA and F/TDF, and explored predictors of low PDC.Methods All PrEP users enrolled in the PrIDE cohort from December 2024 (CAB availability) to December 2025 (database cut-off) were included.PrEP coverage was measured as the proportion of days covered (PDC) from the first injection or refill through the follow-up period and was compared between the CAB-LA and F/TDF groups using the Wilcoxon rank-sum test. Predictors of poor coverage (defined as >4 weeks delay from target CAB injection and <4 pills/week for F/TDF) were assessed by a multivariable logistic regression. For CAB-LA, injections were classified as on time (within ±7 days from the target date), delayed (>7 days), or interrupted; discontinuations were categorised by reason.Results Among 4,105 users, 487 (12%) received CAB-LA and 3,618 (88%) oral PrEP. Overall, participants were mostly Italian (87.3%) and male (98.5%), with a median age of 37 years (IQR 31–45) ( table 1).Median PDC was 100.0 (IQR 100.0–100.0) with CAB-LA and 87.6 (71.4–100.0) with oral PrEP (p<0.001) (figure 1A).Poor coverage occurred in 37/487 (7.6%) CAB-LA and 338/3,618 (9.3%) oral users (p=0.21).In oral PrEP, poor coverage was less likely in community-based vs hospital settings (aOR 0.69, 95%CI 0.51–0.94; p=0.021) and more likely in Centre/South/Islands vs North (aOR 1.33, 1.05–1.70; p=0.020). No predictors of low PDC were identified in the CAB-LA group.Overall, 94.1% of injections were on time, with on-time proportions remaining ~92–93% from the 4th to the 8th injection (figure 1B). CAB-LA discontinuations occurred in 35 users (7.2%): 20 switched to oral PrEP and 15 discontinued definitively. The most frequent reasons for discontinuation were perceived reduction of sexual exposure risk (23%), injection-site reactions (23%) and logistical barriers (17%) (table 2).Conclusions In the Italian experience of the PrIDE cohort, CAB-LA was feasible and achieved higher prevention coverage than oral F/TDF, with high injection timeliness, supporting its role to mitigate adherence barriers in real-world settings. Oral PrEP coverage gaps clustered by care setting and geography, suggesting targets for tailored adherence support.Abstract OC26 Table 1–2Abstract OC26 Figure 1",
  "authors": [
    {
      "affiliations": [
        "INMI L Spallanzani IRCCS- Roma, Italy"
      ],
      "name": "V Mazzotta"
    },
    {
      "affiliations": [
        "Ospedale San Raffaele, Università Vita-Salute - Clinica Malattie Infettive - Milano, Italy"
      ],
      "name": "S Nozza"
    },
    {
      "affiliations": [
        "INMI L Spallanzani IRCCS- Roma, Italy"
      ],
      "name": "S Leone"
    },
    {
      "affiliations": [
        "Fondazione ICONA, Italy"
      ],
      "name": "G Frate"
    },
    {
      "affiliations": [
        "INMI L Spallanzani IRCCS- Roma, Italy"
      ],
      "name": "D Farinacci"
    },
    {
      "affiliations": [
        "Milano Checkpoint, Milan, Italy"
      ],
      "name": "E Caruso"
    },
    {
      "affiliations": [
        "Ospedale San Raffaele, Università Vita-Salute - Clinica Malattie Infettive - Milano, Italy"
      ],
      "name": "AR Raccagni"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Locale Città di Torino, Torino, Italy"
      ],
      "name": "A Lucchini"
    },
    {
      "affiliations": [
        "ASST Santi Paolo e Carlo, Milan, Italy"
      ],
      "name": "GC Marchetti"
    },
    {
      "affiliations": [
        "University Hospital of Padova, Padua, Italy"
      ],
      "name": "AM Cattelan"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Locale Città di Torino, Torino, Italy"
      ],
      "name": "M Tutone"
    },
    {
      "affiliations": [
        "PLUS Roma, Italy"
      ],
      "name": "VL del Negro"
    },
    {
      "affiliations": [
        "ASST Santi Paolo e Carlo, Milan, Italy"
      ],
      "name": "R Rossotti"
    },
    {
      "affiliations": [
        "ASST Santi Paolo e Carlo, Milan, Italy"
      ],
      "name": "C Tincati"
    },
    {
      "affiliations": [
        "Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy"
      ],
      "name": "C Mussini"
    },
    {
      "affiliations": [
        "Milano Checkpoint, Milan, Italy"
      ],
      "name": "M Cernuschi"
    },
    {
      "affiliations": [
        "Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "A Gori"
    },
    {
      "affiliations": [
        "Ospedale San Raffaele, Università Vita-Salute - Clinica Malattie Infettive - Milano, Italy"
      ],
      "name": "A Castagna"
    },
    {
      "affiliations": [
        "INMI L Spallanzani IRCCS- Roma, Italy"
      ],
      "name": "A Antinori"
    },
    {
      "affiliations": [
        "Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "D Moschese"
    }
  ],
  "title": "OC26 Proportion of days covered by long-acting cabotegravir versus oral PrEP in the Italian PrIDE cohort",
  "uid": "347a8613-fb78-5c3f-9000-fcd5071f0ffc"
}