Assignment Prompt & Instructions
– ## MyCapstonebuildup.pdf
**## MyCapstonebuildup.pdf**
This is my PICOT
PICOT Statement (APA format, Times New Roman, 12 pt, 1" margins):
PICOT Question:
In adults living with HIV who are virally suppressed (P), how does monthly long-acting
injectable Cabenuva (I) compared to daily oral antiretroviral therapy (C) affect medication
adherence and viral suppression rates (O) over a 6-month period (T)?
Assignment 1: PICOT Breakdown
Population and Setting
The target population includes adults diagnosed with HIV who have achieved viral suppression
on oral antiretroviral therapy (ART). The setting is an urban outpatient infectious disease clinic
(AHF) that provides continuity of care and medication management for people living with HIV.
This population often struggles with adherence to daily oral medications due to stigma, pill
fatigue, or unstable living situations.
Intervention Overview
The proposed intervention is the administration of long-acting injectable Cabenuva, which
combines cabotegravir and rilpivirine, given as an intramuscular injection once every month or
every two months. This therapy removes the need for daily pill intake, potentially improving
long-term adherence and quality of life. Nursing roles would include medication education,
administering injections, and monitoring for side effects.
Comparison of Approaches
The comparison group will continue with standard daily oral ART. While effective, oral ART can
be associated with adherence challenges that impact viral suppression. Alternative or
complementary interventions could include nurse-led adherence counseling, mobile health
reminders, or pharmacy-based support programs. These strategies may help improve outcomes
in both treatment modalities.
Outcome
The outcome is to measure the differences in adherence and sustained viral suppression
between patients receiving injectable therapy versus those on daily oral ART. Improved
outcomes would support the clinical value of expanding access to injectable treatment,
especially for patients struggling with daily adherence.
Time Estimate
A proposed timeline for the intervention and evaluation is six months. Month 1 would involve
participant selection, education, and initial assessment. Months 2 through 5 would include
ongoing treatment and data tracking. Month 6 would be dedicated to outcome evaluation,
comparing adherence rates and viral load measurements.
This my References
During this Capstone project we find sources that highly and thoroughly explain the point with
valid sources, sources that have been acquired within the last 5 years. My PICOT Question:
In adults living with HIV who are virally suppressed (P), how does monthly long-acting
injectable Cabenuva (I) compared to daily oral antiretroviral therapy (C) affect medication
adherence and viral suppression rates (O) over a 6-month period (T)?
Analysis of Current Evidence
Recent studies have demonstrated that long-acting injectable antiretroviral therapy (LAI-ART),
such as Cabenuva, is effective in maintaining viral suppression among individuals with HIV who
have previously achieved viral suppression on oral ART. A study published in 2024 reviewed
clinical trial and real-world data, highlighting that LAI-ART is associated with excellent virologic
outcomes, even among individuals with adherence challenges . This evidence supports the
potential of LAI-ART to improve medication adherence and viral suppression rates in the target
population.
However, the implementation of LAI-ART faces several barriers. Clinics have reported
challenges related to the high cost of the medication, complexity in procurement, and the need
for refrigerated storage . Additionally, state-level variations in access to LAI-ART have been
observed, with some Medicaid programs and AIDS Drug Assistance Programs (ADAPs) not
covering the medication or requiring prior authorization . These policy-related barriers could
impact the feasibility and scalability of implementing LAI-ART in the proposed setting.
Evaluation of Existing Health Policy
Health policies play a crucial role in determining the accessibility and implementation of
LAI-ART. The Ryan White HIV/AIDS Program (RWHAP) provides funding for medication
assistance, but the coverage of LAI-ART varies across states. A report from the ACE TA Center
indicates that procurement and distribution requirements for LAI-ART often differ by payer, and
providers must navigate various billing and payment processes . These disparities in policy
could affect the consistent availability of LAI-ART for individuals in need.
Furthermore, the Centers for Medicare & Medicaid Services (CMS) and the Health Resources
and Services Administration (HRSA) have roles in overseeing and providing guidance to
improve access to LAI-ART. Policies that increase access are needed to ensure the equitable
distribution of LAI-ART . Advocacy for policy changes at both the state and federal levels is
essential to address these barriers and facilitate the broader implementation of LAI-ART.
Now I will write the five references in which I will extract my Data to support my PICOT thesis.
References
● Centers for Disease Control and Prevention. (2022). HIV prevention: Pre-exposure
prophylaxis (PrEP). https://www.cdc.gov/hiv/risk/prep/index.html
● National Institutes of Health. (2023). Long-acting injectable antiretroviral therapy for HIV.
https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretrovir
al-therapy-hiv
● U.S. Department of Health and Human Services. (2024). Ryan White HIV/AIDS Program
services report. https://hab.hrsa.gov/data/data-reports
● U.S. Department of Health and Human Services. (2025). State Medicaid and AIDS Drug
Assistance Program formularies.
https://www.medicaid.gov/medicaid/prescription-drugs/formularies/index.html
● U.S. Department of Health and Human Services. (2025). Health Resources and Services
Administration: HIV/AIDS Bureau. https://hab.hrsa.gov/
Below is what they are asking for:
APA FORMAT REQUIRED FOR ALL ASSIGNMENTS
● Written communication is free of errors that detract from the overall message.
● Font and font size: Times New Roman, 12 point.
● Use 1” margins and in text citations
(minimum of 3 to 4 pages)
Intervention Plan Components
● Define the major components of an intervention plan for a health promotion,
quality improvement, prevention, education, or management need
● Explain the impact of cultural needs and characteristics of a target population
and setting on the development of intervention plan components
Theoretical Foundations
● Evaluate theoretical nursing models, strategies from other disciplines, and
health care technologies relevant to an intervention plan
● Justify the major components of an intervention by referencing relevant and
contemporary evidence from the literature and best practices
Stakeholders, Policy, and Regulations
[https://www.cdc.gov/hiv/risk/prep/index.html](https://www.cdc.gov/hiv/risk/prep/index.html)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
● Analyze the impact of stakeholder needs, health care policy, regulations, and
governing bodies relevant to health care practice and specific components of
an intervention plan
Ethical and Legal Implications
● Analyze relevant ethical and legal issues related to health care practice,
organizational change, and specific components of an intervention plan
Management and Leadership
● Propose strategies for leading, managing, and implementing professional
nursing practices to ensure interprofessional collaboration during the
implementation of an intervention plan
● Analyze the implications of change associated with proposed strategies for
improving the quality and experience of care while controlling costs
Delivery and Technology
● Propose appropriate delivery methods to implement an intervention which will
improve the quality of the project
● Evaluate the current and emerging technological options related to the
proposed delivery methods
Stakeholders, Policy, and Regulations
● Analyze stakeholders, regulatory implications, and potential support that
could impact the implementation of an intervention plan
● Propose existing or new policy considerations that would support the
implementation of an intervention plan
Timeline
● Propose a timeline to implement an intervention plan with reference to
specific factors that influence the timing of implementation
– This is my PICOT
– PICOT Statement (APA format, Times New Roman, 12 pt, 1" margins):
**## MyCapstonebuildup.pdf**
This is my PICOT
PICOT Statement (APA format, Times New Roman, 12 pt, 1" margins):
PICOT Question:
In adults living with HIV who are virally suppressed (P), how does monthly long-acting
injectable Cabenuva (I) compared to daily oral antiretroviral therapy (C) affect medication
adherence and viral suppression rates (O) over a 6-month period (T)?
Assignment 1: PICOT Breakdown
Population and Setting
The target population includes adults diagnosed with HIV who have achieved viral suppression
on oral antiretroviral therapy (ART). The setting is an urban outpatient infectious disease clinic
(AHF) that provides continuity of care and medication management for people living with HIV.
This population often struggles with adherence to daily oral medications due to stigma, pill
fatigue, or unstable living situations.
Intervention Overview
The proposed intervention is the administration of long-acting injectable Cabenuva, which
combines cabotegravir and rilpivirine, given as an intramuscular injection once every month or
every two months. This therapy removes the need for daily pill intake, potentially improving
long-term adherence and quality of life. Nursing roles would include medication education,
administering injections, and monitoring for side effects.
Comparison of Approaches
The comparison group will continue with standard daily oral ART. While effective, oral ART can
be associated with adherence challenges that impact viral suppression. Alternative or
complementary interventions could include nurse-led adherence counseling, mobile health
reminders, or pharmacy-based support programs. These strategies may help improve outcomes
in both treatment modalities.
Outcome
The outcome is to measure the differences in adherence and sustained viral suppression
between patients receiving injectable therapy versus those on daily oral ART. Improved
outcomes would support the clinical value of expanding access to injectable treatment,
especially for patients struggling with daily adherence.
Time Estimate
A proposed timeline for the intervention and evaluation is six months. Month 1 would involve
participant selection, education, and initial assessment. Months 2 through 5 would include
ongoing treatment and data tracking. Month 6 would be dedicated to outcome evaluation,
comparing adherence rates and viral load measurements.
This my References
During this Capstone project we find sources that highly and thoroughly explain the point with
valid sources, sources that have been acquired within the last 5 years. My PICOT Question:
In adults living with HIV who are virally suppressed (P), how does monthly long-acting
injectable Cabenuva (I) compared to daily oral antiretroviral therapy (C) affect medication
adherence and viral suppression rates (O) over a 6-month period (T)?
Analysis of Current Evidence
Recent studies have demonstrated that long-acting injectable antiretroviral therapy (LAI-ART),
such as Cabenuva, is effective in maintaining viral suppression among individuals with HIV who
have previously achieved viral suppression on oral ART. A study published in 2024 reviewed
clinical trial and real-world data, highlighting that LAI-ART is associated with excellent virologic
outcomes, even among individuals with adherence challenges . This evidence supports the
potential of LAI-ART to improve medication adherence and viral suppression rates in the target
population.
However, the implementation of LAI-ART faces several barriers. Clinics have reported
challenges related to the high cost of the medication, complexity in procurement, and the need
for refrigerated storage . Additionally, state-level variations in access to LAI-ART have been
observed, with some Medicaid programs and AIDS Drug Assistance Programs (ADAPs) not
covering the medication or requiring prior authorization . These policy-related barriers could
impact the feasibility and scalability of implementing LAI-ART in the proposed setting.
Evaluation of Existing Health Policy
Health policies play a crucial role in determining the accessibility and implementation of
LAI-ART. The Ryan White HIV/AIDS Program (RWHAP) provides funding for medication
assistance, but the coverage of LAI-ART varies across states. A report from the ACE TA Center
indicates that procurement and distribution requirements for LAI-ART often differ by payer, and
providers must navigate various billing and payment processes . These disparities in policy
could affect the consistent availability of LAI-ART for individuals in need.
Furthermore, the Centers for Medicare & Medicaid Services (CMS) and the Health Resources
and Services Administration (HRSA) have roles in overseeing and providing guidance to
improve access to LAI-ART. Policies that increase access are needed to ensure the equitable
distribution of LAI-ART . Advocacy for policy changes at both the state and federal levels is
essential to address these barriers and facilitate the broader implementation of LAI-ART.
Now I will write the five references in which I will extract my Data to support my PICOT thesis.
References
● Centers for Disease Control and Prevention. (2022). HIV prevention: Pre-exposure
prophylaxis (PrEP). https://www.cdc.gov/hiv/risk/prep/index.html
● National Institutes of Health. (2023). Long-acting injectable antiretroviral therapy for HIV.
https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretrovir
al-therapy-hiv
● U.S. Department of Health and Human Services. (2024). Ryan White HIV/AIDS Program
services report. https://hab.hrsa.gov/data/data-reports
● U.S. Department of Health and Human Services. (2025). State Medicaid and AIDS Drug
Assistance Program formularies.
https://www.medicaid.gov/medicaid/prescription-drugs/formularies/index.html
● U.S. Department of Health and Human Services. (2025). Health Resources and Services
Administration: HIV/AIDS Bureau. https://hab.hrsa.gov/
Below is what they are asking for:
APA FORMAT REQUIRED FOR ALL ASSIGNMENTS
● Written communication is free of errors that detract from the overall message.
● Font and font size: Times New Roman, 12 point.
● Use 1” margins and in text citations
(minimum of 3 to 4 pages)
Intervention Plan Components
● Define the major components of an intervention plan for a health promotion,
quality improvement, prevention, education, or management need
● Explain the impact of cultural needs and characteristics of a target population
and setting on the development of intervention plan components
Theoretical Foundations
● Evaluate theoretical nursing models, strategies from other disciplines, and
health care technologies relevant to an intervention plan
● Justify the major components of an intervention by referencing relevant and
contemporary evidence from the literature and best practices
Stakeholders, Policy, and Regulations
[https://www.cdc.gov/hiv/risk/prep/index.html](https://www.cdc.gov/hiv/risk/prep/index.html)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
[https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv](https://www.nih.gov/news-events/nih-research-matters/long-acting-injectable-antiretroviral-therapy-hiv)
● Analyze the impact of stakeholder needs, health care policy, regulations, and
governing bodies relevant to health care practice and specific components of
an intervention plan
Ethical and Legal Implications
● Analyze relevant ethical and legal issues related to health care practice,
organizational change, and specific components of an intervention plan
Management and Leadership
● Propose strategies for leading, managing, and implementing professional
nursing practices to ensure interprofessional collaboration during the
implementation of an intervention plan
● Analyze the implications of change associated with proposed strategies for
improving the quality and experience of care while controlling costs
Delivery and Technology
● Propose appropriate delivery methods to implement an intervention which will
improve the quality of the project
● Evaluate the current and emerging technological options related to the
proposed delivery methods
Stakeholders, Policy, and Regulations
● Analyze stakeholders, regulatory implications, and potential support that
could impact the implementation of an intervention plan
● Propose existing or new policy considerations that would support the
implementation of an intervention plan
Timeline
● Propose a timeline to implement an intervention plan with reference to
specific factors that influence the timing of implementation
– This is my PICOT
– PICOT Statement (APA format, Times New Roman, 12 pt, 1" margins):