ArticleLancet regional health. Americas2026
PrEP uptake, persistence, and patterns of choice dynamics between oral and long-acting injectable with cabotegravir among sexually and gender-diverse adolescents in Brazil: a multisite cohort implementation study.
Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) is a newly approved HIV prevention method, and scarce data exist on its real-world implementation among sexually and gender-diverse adolescents (SGDA). This study investigated PrEP uptake, persistence, and patterns of choice dynamics between oral and LAI-PrEP in SGDA in Brazil. Methods: PrEP15-19 Choices is an implementation study offering both oral and LAI-PrEP with cabotegravir to SGDA aged 15-19, across three Brazilian cities. Data were collected through structured forms and PrEP prescription records (between April 1, 2024, and September 2, 2025). Choice dynamics were defined as the willingness to use each modality of PrEP as well as initiation and switching between injectable and oral options. Descriptive, bivariate, and multiple logistic regression analyses were conducted. Findings: Of 2150 adolescents reached, 30.0% (n = 644) initiated a PrEP modality: mean age of 18 years old (standard deviation = 1.0), 78.3% were cisgender men who had sex with men and 73.4% self-identified as Black or Interpretation: Adolescent-centered HIV prevention should prioritize choice and psychosocial support. The preference for long-acting formulations among adolescents experiencing discrimination and among Black and Funding: UNITAID and Brazilian Ministry of Health.
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