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Background and Importance Long-acting injectable antiretroviral therapy (ART) offers an innovative approach to HIV management, reducing treatment burden and improving adherence. Cabotegravir plus rilpivirine (CAB/RPV LA) is the first complete long-acting regimen approved for maintenance therapy in virologically suppressed adults. Clinical trials confirmed its non-inferiority to oral ART and high patient satisfaction, but real-world evidence remains limited.Aim and Objectives To evaluate the effectiveness, safety, adherence, and treatment satisfaction of patients treated with CAB/RPV LA after 1 year.Material and Methods A retrospective observational study included all patients receiving CAB/RPV LA at our hospital between July 2023 and December 2024. Variables included demographics, HIV duration, prior ART lines, last oral regimen, viral load (VL <50 copies/mL; blip 50–200), and CD4+ count (baseline, weeks 8, 32, 48). Adverse events (AEs) and satisfaction (ESTAR questionnaire, score 0–6) were recorded.Results Thirty-seven patients were included, 30 men, median age 51 years (24–65) and HIV duration 15 years (4–37). Before switching, 14 had ≥4 prior ART lines, 9 three, 11 two, and 3 one. The last regimen was dual in 31 (83.8%) and triple in 6 (16.2%). All had undetectable VL at baseline; 36 (97.3%) maintained undetectable VL at week 8, all at week 32, and 34 (94.5%) at week 52, with 3 blips, none requiring modification. Median CD4+ counts were 856, 755, 778, and 810 cells/µL at baseline, weeks 8, 32, and 52. Injection site pain occurred in 11 patients (29.7%), mainly moderate. Lipid levels remained stable. All attended visits, showing full adherence. Median ESTAR score was 6, with slightly lower ratings for side effects and flexibility.Conclusion and Relevance Long-acting CAB/RPV maintained virological suppression, good safety, and excellent adherence after 1 year. High satisfaction supports this regimen as an effective and well-accepted maintenance option for virologically suppressed individuals. Continued monitoring is warranted to confirm long-term outcomes.References and/or Acknowledgements 1. Orkin C, et al. Long-acting cabotegravir and rilpivirine for HIV-1 treatment. New England Journal of Medicine 2021;385(7):640–649. doi:10.1056/NEJMoa21016022.Conflict of Interest No conflict of interest