The HIV Clinic at Ward 86 is located on the Zuckerberg San Francisco General Hospital (ZSFG) campus. Since FDA approval of iCAB/RPV, Ward 86 has been leading the way in the implementation of long-acting injectables, including iCAB/RPV and lenacapavir.

This example protocol provides practical guidance for care teams implementing iCAB/RPV and iCAB/RPV plus lenacapavir in routine HIV care, including for patients with adherence challenges and viremia.

It outlines key clinical considerations, eligibility and resistance review, patient education points, and recommended dosing and monitoring strategies. In addition, it offers a step-by-step workflow for referral, initiation, follow-up, and care coordination to support safe and effective program implementation. Finally, it summarizes preliminary data on the first 50 patients initiated on lenacapavir-based regimens.

We share this resource as an example of one clinic’s approach to implementing LAI ART in routine practice. We hope it serves as a useful reference for programs exploring similar models of care.