Table 3.

Barriers and Facilitators/Potential Solutions

Domain	CFIR constructs (themes)	Subthemes	Barriers	Facilitators/Potential solutions
Intervention Characteristics	Design	Concerns about cabotegravir/rilpivirine resistance and newness	Potential integrase resistance Discomfort with two-drug regimen Unknown long-term effects	Provider education
		Delivery as a refrigerated injection	Injections are unpopular Need for refrigeration	User-friendly packaging and instructions
	Relative advantage	No more daily pills, but more clinic visits	Requires more trips to clinic Feel that HIV becomes the center of their life	Don’t have to worry about daily adherence to oral ART More contact with patients Proposed autoinjectors
Outer Setting	Local conditions	Limited transportation access and timeliness	No access to transportation (private or public) Miscommunications with provided travel Long travel distances and time Hesitancy to use clinic transportation	Taxi/Rideshares provided through clinics or insurance Bus passes
		Inequity in medication access	Concerns about perpetuating inequalities in access and outcomes	Making LAI CAB/RPV available at places closer to where PWH live
	Local attitudes	Stigma and the risk of inadvertent disclosure	Potential for inadvertent disclosure if seen at clinic Counterproductive for normalizing HIV	Avoid inadvertent disclosure from having oral ART around Increased privacy in waiting rooms
	Financing	Issues with insurance	Inconsistent insurance paperwork Prior authorizations Limited to buy and bill options	Case management helping to access social safety nets Better communication with insurance during rollout
		Utility and accessibility of funding from other payors	Difficulty accessing social safety net systems Limited utility of company support for payment	Support from case management to access safety net systems
	Partnerships	Delivery and communication with pharmacies	Pharmacy requires clinic or patient to contact them	Pharmacy provides reminders and regular communication with clinic
		Communication and coordination with other institutions	Limited jail and prison formularies Lack of communications with hospitals and other clinics
Inner Setting	Compatibility	Protocols for injections	Difficulty creating protocols Delays in creating protocols
		Limited clinic hours and long waiting times	Lack of evening and/or weekend hours Inability to get patients in and out of the clinic in a timely manner	Adding additional hours for injections
	Work Infrastructure	Staffing	Limited staff available or trained to administer Limited staff time for follow-up and tracking	Dedicated staff person to schedule and follow-up with injection appointments
Individual	Need	Effective pills and unmet needs	Lack of perceived need owing to effectiveness of current oral treatments Those with greatest need are not eligible	PWH want an option is current ART stops working
	Motivation	Barriers decrease motivation	Lack of motivation due to other barriers	Want to provide PWH with care that fits their lives