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HIV, PrEP & PEP

Injectable PrEP: What Are Cabotegravir and Lenacapavir, and Who Are They For?

Long-acting injectable PrEP reduces daily pill-taking but still needs HIV testing, on-time injections and a plan for missed visits. A physician explains both medicines, injection schedules, key cautions and access in Thailand.

Dr. Krida Uakridathikarn By Dr. Krida Uakridathikarn · MD, Board-certified Family Physician 3-min read
Illustration: Injectable PrEP: What Are Cabotegravir and Lenacapavir, and Who Are They For?
AI-generated illustrative image; people and places are fictional.

What is injectable PrEP?

Injectable PrEP is a long-acting antiretroviral given at intervals instead of a daily tablet. It eases the burden for people who find daily pills hard, but still requires HIV testing, scheduled visits and a plan for missed injections.[1]

Two medicines are currently supported in CDC guidance, cabotegravir and lenacapavir, with different schedules and requirements.[1],[2]

A new option for some people

Long-acting prevention reduces problems with forgotten pills, worry about others seeing medication and day-to-day inconvenience.[1] For many people, that is the difference between prevention that works in practice and prevention that keeps slipping.

However, injections depend on reliable attendance. People who travel often or cannot keep appointments may not be suited to them.

Risk depends on the type of exposure

The risk of infection depends on the type of exposure, other prevention and the partner's viral load.[4] Every form of PrEP has the same goal: preventing HIV during periods of ongoing risk.

Two medicines, two mechanisms

Cabotegravir blocks integrase, the enzyme HIV uses to insert its genetic material into cells.[1]

Lenacapavir blocks the virus's capsid, its protein shell, a newer mechanism that allows very long intervals between doses.[2]

Both decline slowly in the body for a long time after the last injection. During this “tail”, without other prevention, levels may be too low to protect but high enough to cause drug resistance if infection occurs.[1],[2]

What is assessed before starting

HIV must be excluded before injections start, including considering very recent infection that some tests may miss. Your doctor reviews other medicines for interactions and assesses whether you can attend reliably.[1],[2]

Urgent: possible HIV exposure in the last 72 hours?Message us now. If the clinic is closed, go to a hospital that provides PEP; do not wait.
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Schedules and follow-up

Cabotegravir starts with two injections one month apart, then every two months.[1]

Lenacapavir, after its initiation regimen, is given every six months.[2]

Both require HIV testing at intervals set out in guidance, and a plan for missed injections or stopping, to cover the tail period.[1],[2]

Access in Thailand. Availability of injectable PrEP varies between countries. In Thailand, the Department of Disease Control announced preparations for a pilot lenacapavir PrEP service in 2026.[3] Check actual local availability with your provider before planning; meanwhile, oral PrEP remains highly effective.

How we care for you at Dr. Kris Clinic

We give straightforward information about every form of PrEP, help you decide which suits your life, and provide oral PrEP with follow-up testing, in English or Thai. If you are interested in injections, we help check which access routes actually exist and plan any switch from tablets without a gap in protection.

Frequently asked questions

Is injectable PrEP more effective than tablets?

Both are highly effective when used correctly. The main advantage of injections is not having to take a pill every day, which helps people who often forget.

What if I miss an injection?

Contact your doctor quickly. You may need to restart or use tablets temporarily so there is no gap in protection.

Is it available in Thailand yet?

The Department of Disease Control announced preparations for a lenacapavir pilot in 2026. Ask your provider about local availability.

Can I stop the injections?

Yes, but plan it with your doctor, because the medicine stays in the body for a long time. Use other prevention while you are still at risk.

Summary

Injectable PrEP reduces daily pill-taking but still requires HIV testing and regular follow-up.[1] Check local availability before planning, and never leave a gap in protection when switching.

Safety: When switching from oral to injectable PrEP, or stopping injections, plan with your doctor so there is no gap in protection.[1],[2]

Talk to a doctor about this

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Dr. Krida Uakridathikarn

Dr. Krida Uakridathikarn (Dr. Kris)

Board-certified family physician with certificate training in clinical sexology and sexual medicine. He works at Suratthani Hospital and provides sexual health, hormone and LGBTQ+ inclusive care at Dr. Kris Clinic. Profile and CV

References

  1. CDC HIV Nexus: Clinical Guidance for PrEP (current page)
  2. CDC: Injectable Lenacapavir PrEP Recommendations (2025)
  3. กรมควบคุมโรค: เตรียมบริการนำร่อง Lenacapavir PrEP (1 ก.ย. 2569)
  4. CDC nPEP Recommendations 2025. MMWR 74(RR-1)

Keep reading

Main guide: HIV & STI prevention

PrEP vs PEP: HIV Prevention Before and After ExposureWhat to Do After a Possible HIV Exposure: The First 72 HoursAfter Starting PEP: The 28-Day Course and Follow-Up Testing

This article is general education, not personal medical advice or a promise of results. Diagnosis and treatment require assessment by a doctor. Content reflects the cited sources as of the update date.

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