References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Long-acting injectable HIV treatment is one of the most significant advances in HIV care. Instead of taking a daily tablet, you receive two injections every one or two months at your HIV clinic. The regimen — cabotegravir plus rilpivirine — is a complete HIV treatment that maintains viral suppression without daily pills.
Here’s everything you need to know.
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How It Works
Two drugs are injected into the gluteal muscles (buttocks) at each clinic visit:
| Drug | Class | Brand Name |
|---|---|---|
| Cabotegravir | Integrase inhibitor | Vocabria |
| Rilpivirine | NNRTI | Rekambys |
The drugs are formulated as long-acting suspensions that release slowly from the injection site over weeks.
Getting Started
- Eligibility check — you must be virally suppressed on current ART with no resistance to either drug
- Oral lead-in — take oral cabotegravir + rilpivirine tablets for about 4 weeks to confirm tolerability
- First injections — loading doses given at the clinic
- Maintenance — injections every month or every 2 months
Every Month vs Every Two Months
- Both schedules are effective
- Every-2-month dosing means fewer clinic visits
- Your HIV team will recommend the best schedule based on your circumstances
Who Can Have Injectable Treatment?
- Adults already virally suppressed on oral ART
- No resistance to cabotegravir or rilpivirine
- Able to attend clinic for regular injection appointments
- Tolerated the oral lead-in without problems
Not currently available for people starting HIV treatment for the first time.
Advantages
- No daily pills
- No medication at home to store or explain
- High patient satisfaction — many people report feeling liberated
- Good for people who struggle with daily adherence
- No food requirements
Things to Know
- Injection site reactions are very common — pain, swelling, hardness. Usually mild and improve over time
- Missed appointments are serious — falling behind schedule risks resistance
- Long pharmacological tail — if stopping, drugs linger at declining levels for months, so you must switch to oral ART promptly to avoid resistance
- PPI restriction — proton pump inhibitors remain contraindicated with rilpivirine
Read more: Cabotegravir and rilpivirine detail | Single-tablet options | What is HIV?
Frequently Asked Questions
Is injectable treatment a cure?
No. It’s treatment, not a cure. The injections must continue on schedule to keep HIV suppressed.
Can I switch back to pills?
Yes. If injectable treatment doesn’t suit you, switching back to oral ART is straightforward with your HIV team’s guidance.
Are the injections painful?
Most people experience some discomfort, particularly at first. It usually improves with subsequent injections and settles within a day or two.
Related reading
- Are HIV Tests Accurate If You're on PrEP, PEP or ART?
- CD4/CD8 Ratio: What It Means and Why It Matters
- CD4 Counts Explained: What Your Numbers Mean
- Changing HIV Treatment: When, Why and How
- Efavirenz for HIV: An Older NNRTI Still in Use
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
