Injectable HIV Treatments

There is not yet a cure for HIV. But with treatment, it can be well-controlled. People with HIV should start treatment with antiretroviral therapy (ART) as soon as possible.¹

The Food and Drug Administration (FDA) has approved a few injectable formulas for HIV treatment. This gives people with HIV another option for treatment besides a daily pill. Currently, these injections must be given by a doctor. In the future, shots you can give yourself may become available.^2,3

How do injectable HIV treatments work?

Injectable HIV treatments work in different ways to reduce viral load. The most common types contain long-acting ART. ART works by interfering with the HIV life cycle.^1,2

Different types of ART drugs work at different stages. Types include:^1,2

• Entry inhibitors – block entry of HIV into certain white blood cells
• Non-nucleoside reverse-transcriptase inhibitors (NNRTIs) – block conversion of viral RNA to DNA
• Integrase inhibitors – block enzymes that insert viral DNA into your DNA

Long-acting ART drugs have longer half-lives than the types in pills. This means they stay in the body longer. So, you can take the drug less often while maintaining necessary levels of the drug. Injecting long-acting ART drugs every month keeps viral loads low.^1,2,4

HIV treatment shots work as well as pills do. Most people who get monthly injections achieve viral suppression within a few months. Shots given every 2 months may work as well as shots given every month.^2,5,6

What are examples of injectable HIV treatments?

The FDA has approved these injectable HIV treatments:^2,7-9

• Cabenuva® (cabotegravir and rilpivirine)
• Sunlenca® (lenacapavir)
• Trogarzo® (ibalizumab)

For HIV prevention, Apretude® (cabotegravir) injections may be used. It is an example of pre-exposure prophylaxis (PrEP). People who do not have HIV can use PrEP to avoid transmission. PrEP injections may be more effective than PrEP pills.¹⁰

What are the possible side effects?

Side effects vary depending on the specific drug you are taking. Some people may not have any side effects. Injectable HIV medicines may cause less severe side effects than pills.^1,2,4,5

The most common side effects of injectable ART include:^7-9

• Injection site reactions, such as pain, bumps, and swelling
• Fever
• Fatigue
• Headache
• Muscle or bone pain
• Nausea
• Diarrhea
• Sleeping problems
• Dizziness
• Rash

Side effects tend to last a few days after injection. They may become milder after the first few injections.²

These are not all the possible effects of injectable HIV treatments. Talk to your doctor about what to expect when receiving these injections. You should also call your doctor if you have any changes that concern you when taking injectable HIV treatments.

Other things to know

Injectable treatments are not the first-line therapy for HIV. People starting therapy usually take pills. There are many FDA-approved single-pill and combination pills available. These pills are taken every day.^1,2,4,6

Injectable HIV treatments are meant for people who have had an undetectable viral load for at least 3 months. They are most useful for people who:^1,2,4,6

• Have no history of treatment failure
• Do not have a known allergy to the drugs
• Have issues swallowing pills or absorbing drugs in pills
• Are traveling, lack housing, or have other obstacles to taking daily pills
• Often forget to take daily pills
• Want more confidentiality and privacy

Sunlenca and Trogarzo are meant only for people with resistance to other medicines. They must be given with other HIV medicines (usually daily pills). Before receiving Cabenuva, you may take pill forms of cabotegravir and rilpivirine for a month.^2-4,7-9

Researchers are continuing to develop new injectable HIV drugs. They are looking into new strategies that may increase the convenience of injectable HIV drugs, like:²

• Ways to create a monthly injectable version of TLD (tenofovir/lamivudine/dolutegravir), the most common ART
• How to avoid taking daily pills with Sunlenca or Trogarzo
• Forms that allow you to give yourself shots at home

Injectable HIV treatments give people another option to manage their health that may be more convenient than pills. Take injectable treatments as your doctor prescribes. Before beginning treatment for HIV, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.