For the first time, patients in England and Wales will be able to access a long-acting injection to prevent HIV through the NHS, bringing the policy in line with Scotland. The new jab, administered every two months, provides an alternative to daily oral pills, offering convenience and discretion for those who find tablets challenging to take.Experts hope the introduction of cabotegravir (CAB-LA) injections will help the UK meet its goal of eliminating new HIV cases by 2030. Meanwhile, early results from another injection, lenacapavir, suggest that annual HIV prevention injections could become a possibility in the future.A “Game-Changing” OptionWes Streeting, the Secretary of State for Health and Social Care, described the new injection as “game-changing” and told the BBC: “For vulnerable people who are unable to take other methods of HIV prevention, this represents hope”.HIV prevention therapy, known as PrEP (pre-exposure prophylaxis), is used by HIV-negative individuals to reduce the risk of infection. While daily oral PrEP has been effective for years, some people find it difficult to adhere to. Challenges include lack of privacy, homelessness, domestic violence, or the fear of others discovering their medication.A long-acting injection that lasts for months addresses these issues, offering both practicality and discretion. Cabotegravir, produced by ViiV Healthcare, is intended to be used alongside safer sex practices, such as condom use. NHS England has secured a confidential discount from the manufacturer, whose list price is around £7,000 per patient per year, as reported by the BBC.Who Will Be Eligible?The injection will be offered to adults and adolescents at high risk of sexually acquired HIV who are eligible for PrEP but may struggle with daily tablets. Around 1,000 people are expected to be offered the injection initially, with others continuing or starting oral PrEP. Patients can access it through NHS-operated sexual health clinics “in the coming months,” according to the National Institute for Health and Care Excellence (NICE).Dom Baldwin, who currently takes PrEP pills, told the BBC he is “over the moon” about the injections: “When you look at where we are now compared to the epidemic in the 80s… HIV is no longer a death sentence”.Calls for Rapid and Equitable RolloutCharities have emphasized the need for a fast rollout, as some patients face long waits for appointments. Richard Angell, of the Terrence Higgins Trust, said to the BBC that the therapy should be offered in more settings, not just sexual health clinics: “It’s highly effective and acceptable for patients, and a vital tool for tackling inequalities, with the potential to reach those who are not currently accessing other HIV prevention”.Official figures show that PrEP access in England is increasing, but gaps remain. In 2024, 146,098 HIV-negative people attending sexual health services were at substantial risk of HIV, with about 76% starting or continuing PrEP, a 7.7% rise from 2023. However, uptake varies by group, with lower rates among black African heterosexual men and women compared to men who have sex with men.Dr Michael Brady, NHS England’s National Advisor for LGBT+ Health, said to the BBC: “This long-acting injection is a significant addition to our HIV prevention strategies, giving us a powerful new option for people at risk of HIV who cannot have oral PrEP tablets”.
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