PURPOSE OF REVIEW: Cabotegravir (CAB) and rilpivirine (RPV) is the first 
long-acting injectable antiretroviral therapy (ART) option approved for 
virologically suppressed adults with HIV-1. In addition, long-acting CAB is a 
promising agent for HIV preexposure prophylaxis (PrEP). This review focuses on 
phase 3 clinical trial results and implementation considerations for these 
long-acting ART and PrEP strategies.
RECENT FINDINGS: Long-acting CAB and RPV administered every 4 weeks demonstrated 
noninferiority to oral ART through week 96 in both the ATLAS and FLAIR studies, 
whereas ATLAS-2M found similar efficacy through 96 weeks when the long-acting 
injectable ART was administered every 8 weeks instead of every 4 weeks. For 
prevention, two phase 3 trials were stopped early due to fewer incident HIV 
infections in participants receiving long-acting CAB every 8 weeks compared with 
daily oral tenofovir disoproxil fumarate-emtricitabine for PrEP. The long-acting 
therapies were well tolerated across all clinical trials.
SUMMARY: Clinical trial results support the use of long-acting CAB for HIV PrEP 
and long-acting CAB and RPV as a switch strategy for adults with HIV-1 who are 
first virologically suppressed with oral ART. Implementation challenges persist, 
and data are urgently needed in populations who may benefit most from 
long-acting therapy, including adolescents, pregnant individuals, and those with 
barriers to medication adherence.