Health Worker Experiences and Perspectives on the Integration of Long-Acting Injectable Antiretroviral Therapy into a Safety-Net HIV Clinic in the Southeastern United States.

Abstract

BackgroundFollowing its approval by the US Food and Drug Administration in January 2021, clinics have moved to implement the first long-acting antiretroviral regimen (cabotegravir [CAB] and rilpivirine [RPV]) into routine care.MethodsIn this qualitative implementation study, we characterize health worker experiences with the introduction of CAB/RPV into a safety net HIV clinic in the Southeastern US during the first 10 months of service integration. Interviews were analyzed using directed content analysis and results were synthesized using the updated Consolidated Framework for Implementation Research.ResultsHealth workers described both successes and challenges. Successes included strong awareness of and enthusiasm for CAB/RPV and the integration of supportive resources over time. Challenges included inconsistent communication about logistics, perceived pressures on human resources, and concerns about structural barriers affecting patient access to care.ConclusionsFindings highlight the resource demands of implementing CAB/RPV, and the complex array of factors that shape successful implementation.