Early experiences with usage of long-acting injectable cabotegravir among adults in rural Ugandan and Kenyan communities: qualitative research from the SEARCH “Dynamic Choice HIV Prevention” intervention trials

We conducted in‐depth semi‐structured interviews in July−October 2023 with a purposively selected sample of 47 DCP trial participants who initiated CAB‐LA and had at least two injections. Interviews explored participants’ reasons for choosing CAB‐LA and their experiences with the method. The 47 participants ranged from 20 to 59 years of age; 13 were men and 34 were women. Participants were enthusiastic about CAB‐LA. They perceived it as novel, efficacious and advantageous relative to oral daily PrEP, which had been hindered by stigma, interruptions due to work, family visits and travel, side effects, and pill attributes (size and smell). Two major advantages of CAB‐LA over PrEP were improved protection from HIV stigma and from HIV acquisition due to easier adherence. Participants felt CAB‐LA was clearly distinguishable from antiretroviral therapy and would not mark them (mistakenly) as living with HIV; among women, clandestine use to guard against stigma from family members was more achievable compared to oral PrEP. Appointments for injections were rare enough (monthly, then bimonthly) that they could be kept, especially with reminders from providers, although for some, unpredictable work and travel schedules hindered their uptake of CAB‐LA. Participants cited injection‐site pain as the main drawback.