…ImPrEP CAB Brasil study presented at CROI 2025 highlights 95% protection coverage with long-acting injectable PrEP, offering a game-changing strategy for HIV prevention in vulnerable populations.
By Bunmi Yekini
A groundbreaking Brazilian study has revealed that long-acting injectable PrEP (Pre-Exposure Prophylaxis) offers significantly better protection against HIV compared to daily oral PrEP—especially among young people from the most vulnerable populations. The results were presented at the 32nd Conference on Retroviruses and Opportunistic Infections (CROI), held in San Francisco, USA.
The study, known as ImPrEP CAB Brasil, is a collaboration between Fiocruz, Brazil’s Ministry of Health, and international research partners. It enrolled 1,447 participants aged 18 to 30—including gay, bisexual, transgender, and non-binary individuals—across six major Brazilian cities.
According to the study’s findings, participants who chose the long-acting injectable regimen with Cabotegravir achieved a PrEP coverage rate of 95%, compared to 58% among those on daily oral PrEP. A matched comparison group using oral PrEP through Brazil’s Unified Health System (SUS) had an even lower coverage rate of 48%.
“The importance of the study is to show that the implementation of injectable Cabotegravir for people of sexual and gender minorities, including the most vulnerable, is feasible and very effective,” said Dr. Beatriz Grinsztejn, lead researcher and infectologist at Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz). “Coverage was very high compared to oral PrEP, which is corroborated by the fact that we have not recorded HIV infections among people who used injectable PrEP.”
A striking 83% of participants in the ImPrEP CAB Brasil study opted for the injectable method, and 94% adhered to the injection schedule. Only 0.8% dropped out after the first dose. In contrast, all nine HIV infections recorded during the study occurred among participants using daily oral PrEP in the comparison groups—none occurred among injectable PrEP users.
Dr. Grinsztejn explained the advantage: “Medications for daily use usually present greater difficulty in adherence, while Cabotegravir, applied every two months, provides much better coverage. The drug remains in the muscle, ensuring protection for about two months.”
The researchers believe the findings support the incorporation of injectable PrEP into Brazil’s public health system.
“Eventually, it is expected that the drug will be incorporated into the SUS, benefiting those who have more difficulty adhering to oral PrEP,” said Dr. Grinsztejn. “This study provides important subsidies for the Ministry of Health to evaluate the feasibility of implementation.”
ImPrEP CAB Brasil is the largest study of its kind in Latin America and is expected to influence HIV prevention strategies not only in Brazil but also in other countries with similar public health challenges. The research team is already preparing for a follow-up study evaluating Lenacapavir, another injectable PrEP option, to be applied every six months and covering individuals aged 15 to 30.
The study’s strong reception at CROI 2025, including an invitation to the event’s official press conference, underscores its international relevance in the ongoing fight against HIV.