{
  "abstract": "LA-ART integration into routine HIV care remains constrained by organizational barriers. Italian data have shown heterogeneous uptake across centers, driven by structural limitations. In March 2025, our clinic implemented PROGRESS, a structured clinical care pathway designed to optimize delivery of LA-ART through organizational redesign. We evaluated early implementation outcomes during the first 48w.Methods We conducted a single-center pre–post observational implementation study. The pre-implementation period spanned from October 2022 to February 2025. PROGRESS included: a dedicated nurse care manager coordinating injection scheduling; a centralized triage desk serving as access point; protected agendas and dedicated clinical spaces; and a reminder system to ensure adherence to schedule.Guided by the Proctor implementation outcomes framework, we evaluated predefined implementation outcomes. Adoption was defined as the rate of new PWH initiating CAB/RPV over time. Penetration was defined as the proportion of eligible patients receiving LA-ART. Timeliness referred to the interval between treatment proposal and first injection. Fidelity was defined as adherence to the recommended 56 ± 7-day dosing window. Treatment discontinuation was assessed as incidence rate per 100 PYFU. Service throughput was defined as the number of injections/month.Penetration was calculated relative to two previously estimated eligible populations at our center: 1,205/1,752 (68.8%) based on clinical criteria, and 923/1,752 (52.7%) when restricting to patients with available GRT and no RAMs.Results The n of patients receiving CAB/RPV increased from 80 to 218, corresponding to an increase in the monthly initiation rate from 2.76 to 19.82 PWH/month.Penetration increased from 5.0–6.5% to 18.3–23.8%, representing a 3- to 4-fold relative increase in access among eligible PWH.Service throughput improved: administered injections increased from a mean of 18/month (510 injections over 29 months) to approximately 80/month (874 injections).Timeliness improved, with median time from treatment proposal to first injection decreasing from 7 days (IQR 3–14) to 3 days (IQR 2–6).Treatment discontinuation decreased from 23/80 patients (28.8%; 11.9 per 100 PYFU) to 6/218 patients (2.8%; 3.0 per 100 PYFU). All 874 injections administered post-implementation were delivered within the recommended 56 ± 7-day dosing window, whereas two delayed administrations occurred during the pre-implementation period.Conclusions Implementation of the PROGRESS multicomponent care pathway was associated with substantial improvements in adoption, penetration, timeliness, fidelity, treatment retention, and service capacity for CAB/RPV LA delivery. Organizational redesign incorporating centralized access, dedicated care coordination, and protected injection capacity significantly enhanced scalability of long-acting ART within a publicly funded healthcare system without compromising virological effectiveness.Abstract OC71 Table 1Implementaion outcomes before and after PROGRESS pathway implementationAbstract OC71 Figure 1Cumulative number of patients initiating long-acting CAB/RPV over time",
  "authors": [
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "S Di Giambenedetto"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "PF Salvo"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "A Carbone"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy"
      ],
      "name": "G Cucinotta"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "F Lombardi"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "E Visconti"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "E Tamburrini"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "G Baldin"
    },
    {
      "affiliations": [
        "Dipartimento Scienze della Vita e Sanità Pubblica, Igiene e Medicina Preventiva, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "F Pellegrini"
    },
    {
      "affiliations": [
        "UOC Percorsi Clinici e Valutazione degli Outcome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy"
      ],
      "name": "A De Belvis"
    },
    {
      "affiliations": [
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy",
        "Dipartimento di Sicurezza e Bioetica, Sezione Malattie Infettive, Università Cattolica del Sacro Cuore, Roma, Italy"
      ],
      "name": "C Torti"
    }
  ],
  "title": "OC71 Scaling long-acting cabotegravir/rilpivirine in routine HIV care: 48-week implementation outcomes from the PROGRESS model",
  "uid": "fdba4861-36f1-525c-aa07-17c1fabd1428"
}