Cabotegravir: Revolutionizing HIV Prevention and Treatment with Long-Acting Shots

18 Apr 2025

Cabotegravir: The Game-Changer in HIV Prevention and Treatment

In the ever-evolving world of medicine, a few breakthrough drugs manage to shift the landscape—and cabotegravir is definitely one of them. Whether you're someone interested in HIV prevention, newly diagnosed, working in healthcare, or just a curious mind, cabotegravir has become a headline-making name for good reason.

So what is it, how does it work, and why is it generating so much buzz?

Meet Cabotegravir: What Is It?

Cabotegravir is an antiretroviral drug developed by ViiV Healthcare, designed to prevent and treat HIV-1, the most common form of the virus. It belongs to a class of medications called integrase strand transfer inhibitors (INSTIs)—a bit of a mouthful, but stay with us.

Here’s the cool part: unlike traditional HIV meds that are taken daily in pill form, cabotegravir can be given as a long-acting injection. That’s right—just one shot every one or two months instead of remembering to pop a pill every day.

How Does It Work?

To understand how cabotegravir works, you need a quick crash course in HIV 101.

HIV replicates by inserting its genetic material into human immune cells. The enzyme responsible for this sneaky move is called integrase. Cabotegravir steps in and blocks this enzyme, preventing the virus from establishing a stronghold in the body. No integration, no replication. It’s like locking the door before the intruder gets in.

Prevention Power: PrEP with Cabotegravir

One of cabotegravir’s biggest breakthroughs is its use in PrEP (pre-exposure prophylaxis). Traditionally, PrEP has been offered as a daily pill (like Truvada or Descovy), which works well—if you take it consistently.

That’s where cabotegravir shines.

Apretude: The PrEP Brand Name

Under the name Apretude, cabotegravir was approved by the FDA in December 2021 as the first and only injectable PrEP option. It's given once every 2 months, and studies have shown it to be more effective than daily pills, especially in populations where daily adherence is a challenge.

In clinical trials (like HPTN 083 and HPTN 084), Apretude reduced the risk of HIV acquisition by 66%–89% compared to oral PrEP. That’s a massive leap in public health.

Cabotegravir for Treatment: Long-Acting Combo with Rilpivirine

Cabotegravir isn’t just for prevention. For people living with HIV, it’s available in a long-acting treatment combo with another drug called rilpivirine (a non-nucleoside reverse transcriptase inhibitor). This combo is marketed as Cabenuva.

Here’s the routine:

First, patients start with a short period of daily pills to make sure the combo works well for their body.
Then, they switch to monthly or bi-monthly injections of Cabenuva.
It’s a major lifestyle improvement—less medicalization, less pill fatigue, and more freedom.

Who Is It For?

Cabotegravir is recommended for:

People at high risk for HIV who want a discreet, long-acting preventive method.
People living with HIV who are already virally suppressed and looking for a more manageable treatment option.
Individuals who struggle with daily pill adherence due to lifestyle, stigma, or forgetfulness.

It’s also particularly helpful in communities where healthcare access is uneven—getting to a clinic every 2 months is often easier than managing a daily routine.

Side Effects & Considerations

Of course, no drug is without side effects. The most common ones for cabotegravir include:

Injection site reactions (pain, swelling)
Headache
Fever
Fatigue
Nausea

These are generally mild and temporary. Still, cabotegravir isn’t for everyone. People with a history of certain resistance mutations or liver issues may not be ideal candidates.

Also important: once injected, you can’t “un-inject” it. If side effects occur, the drug stays in your system for a while—so it requires a bit more commitment than a daily pill.

The Bigger Picture: Why It Matters

Cabotegravir isn’t just a scientific novelty—it’s a paradigm shift. It has the potential to dramatically reduce new HIV infections and help people living with HIV maintain viral suppression with fewer disruptions to daily life.

This is especially significant in regions with high HIV prevalence and limited healthcare infrastructure. Long-acting injectables can help close the gap in access, reduce stigma, and simplify treatment.

Final Thoughts

Whether you’re preventing HIV or managing it, cabotegravir represents a new era of flexibility, empowerment, and medical innovation. It’s not magic—but it’s a mighty step toward an HIV-free generation.