Injectable PrEP and HIV Treatments

In January 2021, Health Canada approved the use of Cabenuva as a stand-alone injectable treatment for HIV.  Its two medications, cabotegravir and rilpivirine, are administered as a once-a-month injection in a clinic.  (The injection should be a deep intramuscular injection requiring a medical professional to administer it.)

Cabenuva can give people living with HIV more treatment options if they especially do not like taking pills or find they miss taking their meds on time; however, recent US studies have shown the biggest obstacles to taking Cabenuva is a history of missing clinic/lab appointments and the clinic not being able to contact the person who is supposed to get their injection. [1]  Be aware that in Canada most people living with HIV who have already achieved an undetectable viral load are considered eligible for this option. [2] Some people with HIV may have a strain of the virus that is resistant to Cabenua, and your doctor can determine if the injection can work for you. If you do qualify for Cabenuva you do not start injections right away; you are switched to an oral regiment of the pills that contain the same medications as the injected version and then eventually switched over to the injections.

With the recent introduction of injectable HIV treatment drugs in Canada it was only a matter of time before this method presented itself for HIV prevention.

Research is currently ongoing, but in the future, additional antiviral medications may be approved to be used as PrEP.  Since 2021, injectable PrEP has been available in the US under the name Apretude. This medication contains cabotegravir and is injected into the muscle tissue.  Apretude is a breakthrough in HIV prevention as it is only required to be taken once every two months.

Although we may not see injectable PrEP in Canada until 2024, it’s still an exciting development, and PrEP providers with clinics have already been telling us that they are prepared to administer it when it is available.

Community members can participate in a current research project looking at gaps in PrEP access. “The Future of PrEP is Now” is one such project that is focused on ensuring that the needs of men who are not currently taking PrEP are prioritized for injectable PrEP.  See here for more information. The Future of PrEP is Now – Community-Based Research Centre (cbrc.net)

Foot notes:

[1] CATIE. (March 30, 2023). Clinic finds almost half of people who want long-acting HIV treatment don’t initiate it. Retrieved Sept 5, 2023 from:  https://www.catie.ca/catie-news/clinic-finds-almost-half-of-people-who-want-long-acting-hiv-treatment-dont-initiate-it .

[2] CATIE. (2021).  Cabenuva (injectable cabotegravir + rilpivirine). Retrieved Sept 5, 2023 from: https://www.catie.ca/cabenuva-injectable-cabotegravir-rilpivirine .