Preference for different PrEP formulations: A cross-sectional study in a PrEP cohort in Spain

HIV Med. 2026 May 6. doi: 10.1111/hiv.70252. Online ahead of print.

Abstract

Objectives: To gain a better understanding of PrEP-users' preference for long-acting vs. oral PrEP formulation.

Methods: From April 2023 to January 2024, participants who were prescribed PrEP completed an anonymous, structured, self-administered, cross-sectional survey as part of their routine PrEP care in a hospital setting in Madrid, Spain. Inclusion criteria were attendance at the clinic for PrEP care and the ability to understand the Spanish language. Eligibility was not restricted by age. A convenience sample of 200 participants was used. The ethics committee approved a waiver of written consent. Descriptive statistics and chi-square tests were used to analyse the data.

Results: A sample of 201 participants completed the survey, of which 193 (96.5%) were male and most were 30-39 years old (48.8%). The response rate was estimated to be more than 90%. Among participants, 74.9% preferred LA-PrEP (53.9% preferred a subcutaneous (SC) injection every 6 months and 21.0% preferred an intramuscular (IM) injection every 2 months). Participants reported that LA-PrEP is more practical, indicating fewer visits to the clinic as a primary reason (67.4%). 29.4% of participants were aware of IM LA-PrEP, 10.0% of SC LA-PrEP and 10.4% were familiar with both. Respondents who selected LA-PrEP were more often under 40 years of age (p = 0.016) compared to those who preferred oral PrEP (73.7% vs. 61.2%, respectively). Limitations included the use of a cross-sectional design, a homogeneous sample and the use of one study location, among others.

Conclusion: LA-PrEP is the preferred form of PrEP for the majority of respondents.

Keywords: PrEP; adherence; cabotegravir; lenacapavir; long‐acting.