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.
Cabotegravir and rilpivirine (brand name Vocabria + Rekambys, or Cabenuva) is the first long-acting injectable HIV treatment available in the UK. Instead of taking a daily tablet, you receive two injections every one or two months at your HIV clinic. It’s a complete HIV regimen — no daily pills needed.
Here’s how it works, who it’s for, and what to expect.
Order a discreet home HIV test
How It Works
| Drug | Class | How It’s Given |
|---|---|---|
| Cabotegravir | Integrase inhibitor | Intramuscular injection (gluteal) |
| Rilpivirine | NNRTI | Intramuscular injection (gluteal) |
Both drugs are given as injections into the buttock muscle at the same clinic visit. The long-acting formulation releases drug slowly from the injection site over weeks.
Dosing Schedule
- Every month or every two months — your HIV team will advise which schedule suits you
- Before starting injections, you take oral cabotegravir + rilpivirine tablets for about a month to check you tolerate them
- After the oral lead-in, injections begin with loading doses followed by maintenance doses
Who Can Have It?
You’re eligible if you:
- Are already on effective ART with an undetectable viral load
- Have no resistance to cabotegravir or rilpivirine
- Tolerate the oral lead-in without problems
- Can attend clinic for regular injection appointments
It’s not currently approved for people starting HIV treatment for the first time.
Advantages
- No daily pills
- No visible medication at home
- Can feel liberating — many people report improved quality of life
- No food requirements
- High patient satisfaction in clinical trials
Side Effects
- Injection site reactions — pain, swelling or hardness at the injection site (very common, usually mild and improves with subsequent doses)
- Headache
- Fever after the first injection (uncommon)
- Mood changes (rare)
Important Considerations
- Missed appointments matter — if you miss an injection, drug levels drop and resistance can develop
- Rilpivirine interactions — proton pump inhibitors are still contraindicated
- Long tail — if you stop injections, the drugs stay in your system for months at declining levels, which can risk resistance if you don’t switch to oral ART promptly
Read more: Biktarvy | Dovato | Can I stop medication?
Frequently Asked Questions
Do the injections hurt?
Most people experience some discomfort at the injection site, especially in the first few months. It usually settles within a day or two and tends to get better over time.
Can I switch back to pills if I don’t like it?
Yes. You can switch back to an oral regimen. Your HIV team will help plan the transition to ensure continuous viral suppression.
Is this a cure?
No. Long-acting injections are treatment, not a cure. They must be continued on schedule to keep HIV suppressed.
Related reading
- Choosing the Right PrEP Drug: Truvada vs Descovy
- Dovato for HIV: A Two-Drug Regimen
- Triumeq for HIV: A Straightforward Guide
- Efavirenz for HIV: An Older NNRTI Still in Use
- Eviplera: How This Anti-HIV Drug Works
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.
