SUAC0309 | CAB-LA: AN APPEALING ALTERNATIVE TO HIV PREVENTION AND BOOSTED ADHERENCE: THE CASE OF GABORONE TEBELOPELE WELLNESS CENTER, BOTSWANA

Tshwetso Yanzi, Molemane Lefakae Lekoko, Refilwe Motlakaloso | Tebelopele Wellness Centres, Gaborone, Botswana

The UNAIDS 2023 report provides evidence of a surge in global HIV infections, with new cases projected to reach 1.2 million by 2025, assuming all other factors remain constant. Therefore, we must intensify evidence-based interventions for populations at high risk of HIV by expanding prevention options. Gaborone Tebelopele Wellness Centre (GTWC) was approved to offer the long-acting injectable Cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) alongside the existing oral PrEP method since April 2025. We hypothesized an improved acceptance of PrEP among high-risk clients, subsequently increasing retention due to increased options. HIV-negative adults (excluding pregnant women) accessing GTWC services were screened using the national PrEP eligibility tool to determine HIV-negative status, HIV-risk level, acute-HIV infection symptoms, and eGFR (>60 mL/min). Those eligible were offered oral PrEP or CAB-LA, then initiated upon acceptance, with data recorded in the Microsoft Excel database from 23 April to 23 May 2025. Descriptive statistics were obtained via cross-tabulations for CAB-LA against gender, age and population group. Additionally, a logistic regression model was fitted to the data, taking CAB-LA as a binary dependent variable (1= opted, 0= otherwise) with gender, age and population group as predictors. Odd ratios were computed for these variables. Out of 129 clients initiated on PrEP, 117 (91%) chose CAB-LA, while 12 (9%) chose oral PrEP. 82 initiated clients were PrEP-naïve, with 70 (85%) opting for CAB-LA, 42 (60%) being male and 28 (40%) female. Additionally, 47 clients (23 (49%) males and 24 (51%) females) switched from oral to CAB-LA, citing improved adherence due to the elimination of pill burden. 76%, 21%, and 3% of the general, key, and AGYW population groups chose CAB-LA, respectively. Most users were aged 35-39 (26%) and 40-49 (21%), with the lowest uptake in the 20-24 age group (2.1%). Only the population group was significant in the logistic model (p = 0.006); age and gender were not. The odds ratio showed that AGYW is 40 times more likely to choose CAB_LA than KP (p-value=0.005). Expanding access to varied HIV prevention options is one of the building blocks for a successful global HIV response, which contributes to the decline of new HIV infections. Scaling up CAB-LA for PrEP nationally is recommended to increase reach among at-risk populations.