Knowledge Gaps and Educational Needs Among Patients Receiving Long-Acting Injectable Cabotegravir/Rilpivirine: A Multisite Cross-Sectional Survey

Long-acting injectable antiretroviral therapy (LAI ART) offers an alternative to daily ART by mitigating adherence barriers such as pill fatigue and stigma. However, it introduces new challenges, including the need for continued engagement, clear communication, and understanding of the consequences of missed or delayed doses. Patient knowledge of these issues remains poorly characterized. Between June 1 and October 2, 2025, we administered a structured survey to individuals receiving LAI ART at two academic medical centers to assess sociodemographic characteristics, knowledge of key treatment concepts (injection schedules, dosing windows, oral bridging indications, and consequences of delayed or missed doses), and treatment perceptions. Eight questions were used to assess LAI ART-related knowledge among participants. Associations were evaluated using Fisher’s exact tests ( p < 0.05). A total of 119 participants completed the survey (70.6% University of Nebraska Medical Center and 29.4% University of Chicago). Mean age was 45.8 years, and most identified as male (74.8%) and White (54.6%) or Black (41.2%). Nearly all (95.0%) reported receiving pre-LAI ART education, and 89.1% were satisfied or very satisfied with their treatment. Despite this, the mean knowledge score was only 3.4/8 (42.5%; SD = 1.66). In exploratory analyses, higher education was associated with better understanding of on-time injections, treatment windows, and oral bridging thresholds, while both education and income were associated with knowledge of drug interactions. Although satisfaction with LAI ART was high, we found substantial knowledge gaps among patients receiving LAI ART despite education before treatment initiation. These findings highlight opportunities to strengthen patient education and reinforce key aspects of LAI ART management, particularly for patients with lower educational attainment and income.