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Background and Importance Long-acting injectable antiretroviral therapy (ART) with cabotegravir/rilpivirine (CAB/RPV) offers an alternative to daily oral treatment for people living with HIV (PLWHIV). It may improve adherence and patient satisfaction, supporting a person-centred approach. Real-world evidence outside clinical trials remains limited.Aim and Objectives To describe the effectiveness of long-acting injectable CAB/RPV in PLWHIV in real-world clinical practice.Material and Methods Single-centre, retrospective observational study at a secondary-level hospital including PLWHIV who initiated injectable CAB/RPV between January 2023-March 2025.Collected variables: sex, age, years since diagnosis, weight/body mass index (BMI), baseline viral load (VL), CD4 count, CD4/CD8 ratio, previous ART regimen and medication possession ratio (MPR). Effectiveness was defined as achieving or maintaining undetectable VL (VL<50 copies/mL). Only patients with ≥12 weeks of therapy were included. Reasons for discontinuation were recorded.Results 167 patients were included (92.4% male). Age 45±12 years. Time since diagnosis 11±6 years. Weight 77.9±13.7 kg (n=161), BMI 25.8±3.9 kg/m 2 (n=63).At baseline, 94% (157/167) had undetectable VL, 6% detectable VL (mean 188±251 copies/mL). Mean CD4 count 872±385 cells/µL; CD4/CD8 ratio 0.97±0.48 (n=148).Previous ART regimens: nucleotide/nucleoside reverse transcriptase inhibitor (NRTI) + non-nucleoside reverse transcriptase inhibitor (NNRTI): 32.9% (55/167), dual therapy: 32.3% (54/167), NRTI + integrase inhibitor: 28.2% (47/167), NRTI + protease inhibitor: 3.8% (6/167), others: 2.8% (5/167). No patient received prior oral CAB/RPV before starting the injectable regimen. Mean MPR was 94% (20–100%).Effectiveness CAB/RPV:– Week 12±8 (n=148), 89.2% undetectable VL; CD4 925±478 (n=63). 10.8% VL >50 copies/mL, mean VL 638 ±257 (median 77 copies/mL).– Week 28±8 (n=76), 86.8% undetectable VL; CD4 880±429 (n=42). 13.2% VL >50 copies/mL, mean VL 100±46 (median 102 copies/mL).– Week 44±8 (n=23), 95.7% undetectable VL; CD4 785±254 (n=14). 1 patient VL >50 copies/mL, mean VL 116.5.4% (9/167) discontinued treatment: 1.8% (3/167) due to adverse events (injection site reaction, local pain, dry skin) and 3.6% (6/167) by patient preference. No discontinuations related to virological failure.Conclusion and Relevance Long-acting injectable CAB/RPV was effective and well-tolerated. Virological suppression at week 44 was similar to pivotal trials, despite including patients with VL >50 copies/mL at baseline. Detectable viremia was rare and low-level. No treatment interruptions for lack of efficacy were observed, and discontinuations due to adverse events were minimal.Conflict of Interest No conflict of interest