In a landmark move for public health, the NHS in England and Wales has approved the use of a long-acting injectable medication to prevent HIV, aligning policy with Scotland and marking a major milestone in HIV prevention efforts across the UK.

The injection – known as cabotegravir (CAB-LA) – represents a breakthrough in HIV prevention therapy, offering protection through just six injections per year. For many, this will provide a more practical and discreet alternative to taking daily tablets.

A New Era for PrEP

Pre-exposure prophylaxis (PrEP) has already transformed HIV prevention, with oral pills offering highly effective protection for people at risk. However, taking medication every day is not always easy or accessible for everyone.

Challenges such as stigma, unstable housing, domestic violence, or privacy concerns can make adherence difficult.

The introduction of CAB-LA provides a convenient, long-acting option, and one that could remove many of these barriers. This would extend protection to individuals who may not have been able to benefit from traditional PrEP.

Supporting the UK’s 2030 Ambition

Experts believe the rollout of CAB-LA could be pivotal in achieving the UK’s ambition of ending new HIV transmissions by 2030. The National Institute for Health and Care Excellence (NICE), which approved the treatment for NHS use, expects injections to become available at NHS-operated sexual health clinics in the coming months.

The treatment, developed by ViiV Healthcare, works alongside safer sex practices and is currently priced at around £7,000 per patient per year (before NHS discounts). It will be offered to adults and adolescents at high risk of sexually acquired HIV, especially those who struggle to take daily tablets.

Equity and Access

While the approval has been widely welcomed, charities and campaigners are calling for the rollout to be implemented swiftly and equitably.

Data from NHS England shows that PrEP uptake is not yet equal across all groups – with the highest use among white and ethnic minority men who have sex with men, and significantly lower rates among Black African heterosexual men and women.

Richard Angell, Chief Executive of the Terrence Higgins Trust, described the new injection as a “transformative therapy” with the potential to reach those not currently accessing prevention through existing services. He also called for the NHS to explore offering the treatment beyond sexual health clinics to make it more widely available.

Innovation in HIV Prevention

This approval also reflects the power of medical innovation in tackling long-standing health challenges. Cabotegravir’s success illustrates how the implementation of long-acting drug delivery systems is reshaping modern medicine – offering new ways to improve treatment adherence, accessibility, and outcomes.

Early research into another long-acting injectable, lenacapavir, even hints at the potential for once-yearly HIV prevention, signalling that the next advancement in HIV care may already be on the horizon.

A Message of Hope

Wes Streeting, Secretary of State for Health and Social Care, described the decision as “game-changing”, saying:

“For vulnerable people who are unable to take other methods of HIV prevention, this represents hope.”

With the arrival of CAB-LA, the UK takes a bold and hopeful step closer to that 2030 goal; a future where new HIV infections become a thing of the past.

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