Spanish cohort reports high injection-schedule adherence with long-acting CAB+RPV

A nationwide observational cohort study in Spain assessed injection timing among adults receiving long-acting cabotegravir plus rilpivirine (CAB+RPV LA). Among 3,280 participants with evaluable injection data, 70.4% had every injection within the study’s ±7-day target window, while 0.7% had suboptimal adherence.

70.4% had all evaluable injections within the target window.
Suboptimal schedule adherence occurred in 0.7%.
At least one late injection occurred in 38.2%.
Baseline variables poorly predicted schedule adherence.

The RELATIVITY substudy combined retrospective data on existing users with prospective follow-up of new initiators receiving CAB+RPV LA in routine care in Spain. The analysis included 3,349 virologically suppressed adults; 3,280 had evaluable injection-schedule data. Injections were assessed against each participant’s scheduled date, with a ±7-day window defining on-time administration. The cohort included 53 centers, and data were collected through March 1, 2026.

Complete schedule adherence was recorded in 2,309 participants (70.4%); another 948 (28.9%) had 90–99.9% of evaluable injections within the target window. Twenty-three participants (0.7%) had suboptimal adherence. At least one late injection occurred in 38.2%, and two or more late injections in 13.3%. Virological failure remained infrequent across adherence categories. Baseline characteristics had limited associations with schedule deviations; an exploratory prediction model had a cross-validated AUC of 0.53.

The findings suggest high schedule adherence in this large real-world cohort, but do not establish that injection delivery is equally reliable in other settings. The observational design and limited predictive performance mean baseline characteristics alone did not identify patients likely to deviate. The results underscore the operational role of clinic delivery systems, rather than supporting a change in treatment selection or practice.

In practice

For clinicians and services providing long-acting cabotegravir plus rilpivirine to virologically suppressed adults, the cohort indicates that high injection-schedule adherence is achievable in routine Spanish care, although late injections were not uncommon. The findings support attention to reliable appointment and injection-delivery processes; baseline patient characteristics alone did not meaningfully identify who would have schedule deviations. This observational cohort does not compare adherence strategies or establish that the results generalize to other health systems, and it does not support changing treatment selection on its own.

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Source

AIDS: Controlled adherence with long-acting injectable cabotegravir plus rilpivirine: determinants and clinical impact of injection-schedule adherence in the Spanish RELATIVITY cohort ↗

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