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

Background Following 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. Methods In 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. Results Health 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. Conclusions Findings highlight the resource demands of implementing CAB/RPV, and the complex array of factors that shape successful implementation.