– Dr Moti Ramgopal
Long-acting injectable (LAI) therapies are transforming HIV prevention and treatment by improving adherence and reducing stigma associated with daily oral regimens. However, successful implementation requires a coordinated, multidisciplinary approach to overcome logistical, educational and structural barriers in clinical practice.
In this Q&A, Dr Moti Ramgopal (Medical Director, Midway Immunology and Research Center, Florida, USA) discusses lessons learned from high-performing clinics, practical implementation strategies, and the future balance between oral and injectable HIV therapies – highlighted from IDWeek 2025 in the session: Proven LAI Implementation Strategies in HIV Prevention and Treatment.
Lessons from successful clinics highlight the importance of patient choice. Initially, we expected only around 5% of patients to be open to injectable therapy; however, recent data suggest that 10–15% of patients are receptive. Understanding patient preferences and offering multiple treatment options are central to successful implementation.
Provider barriers often stem from underutilizing the wider interdisciplinary team. A collaborative, team-based approach, one that empowers patients to select the treatment option best suited to their lifestyle and preferences, is essential to overcoming operational and adherence challenges.
The future balance between oral and LAI therapies will depend on expanding access and maintaining choice. LAIs could be particularly valuable for people who struggle with adherence, have experienced treatment fatigue, or wish to reduce stigma associated with daily medication. As newer, longer-acting formulations become available, this balance will continue to evolve.
Key advances include the development of next-generation LAI medications capable of sustaining viral suppression for longer intervals between injections. Additionally, strategies to address injection-site side effects and support at-home administration in collaboration with pharmacy teams will be critical areas of focus in the coming year.
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This content has been developed independently by Touch Medical Media for touchINFECTIOUS DISEASES. Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Session: Proven LAI Implementation Strategies in HIV Prevention and Treatment, IDWeek 2025, San Diego, CA, USA.
Editor: Katey Gabrysch, Editorial Director.
Disclosures: This short article was prepared by touchINFECTIOUS DISEASES in collaboration with Moti Ramgopal. The content was developed and edited by human editors. No fees or funding were associated with its publication. touchINFECTIOUS DISEASES utilize AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat).
Moti Ramgopal discloses that he is a consultant for Gilead, Merck, and ViiV Healthcare; has received honoraria/honorarium from AbbVie, Gilead, Merck, and ViiV Healthcare; and is a speaker’s bureau participant for AbbVie, Gilead, and ViiV Healthcare.
Cite: Moti Ramgopal. First proof-of-concept trial of pirmitegravir: A novel allosteric integrase inhibitor for HIV-1. touchINFECTIOUS DISEASES. 10 November 2025.
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