Injectable PrEP: Cabotegravir and Lenacapavir, Available in Thailand?

Tablet PrEP has prevented an enormous number of HIV infections, but the biggest problems I see are people who forget to take their tablets, or who do not want a bottle of pills at home. Injectable PrEP was developed to solve exactly this, and it is something patients have asked me about a lot over the past year. This article summarizes the medicines, the research and the real situation in Thailand as of October 2026, so you can make an informed decision.

What types of injectable PrEP are there?

Cabotegravir (CAB-LA)

Apretude

• Injected into the buttock muscle
• First 2 shots 1 month apart, then every 2 months
• HPTN 083 / 084
• Registered in Thailand in 2024

Lenacapavir (LEN)

Yeztugo (US)

• Injected under the skin of the abdomen
• Every 6 months
• PURPOSE 1 / 2
• Registration under review in Thailand

vs

Both need an HIV test before every injection and do not protect against other STIs.

Cabotegravir every 2 months

Cabotegravir is a long-acting antiretroviral from the integrase inhibitor class. The HPTN 083 trial in men who have sex with men and transgender women, which included sites in Thailand, found that the injection group had about 66% fewer infections than the tablet group. HPTN 084 in women found about 89% fewer. Most of this difference was because there was no problem with missed doses.

Things to know:

• You need to come for injections on schedule, within about 7 days either side.
• The most common side effects are pain, swelling or a lump at the injection site, which usually lessen after several injections. Some people get a mild fever or headache.
• If someone becomes infected with HIV while on the injections, or during the period when the drug is slowly wearing off, the virus may become resistant to the same drug class used in main HIV treatments. That is why an HIV test is needed before every injection.

Lenacapavir twice a year

Lenacapavir belongs to a new class of drugs that block the virus's protective shell (capsid inhibitors). The PURPOSE 1 trial in young women in South Africa and Uganda, published in the New England Journal of Medicine in 2024, found no infections at all in the lenacapavir group. PURPOSE 2, in men who have sex with men, transgender women and gender-diverse people in several countries including Thailand, found only 2 infections among more than 2,000 participants.

The US Food and Drug Administration approved it in June 2025, and the World Health Organization recommended lenacapavir as an additional PrEP option on 14 July 2025. The WHO also recommended using rapid HIV tests with long-acting injectables, so the service can be offered in communities, pharmacies, clinics and through telemedicine.

Status in Thailand (as of October 2026)

• Cabotegravir was registered in Thailand in 2024. Some services in Bangkok, such as the Anonymous Clinic at the Thai Red Cross AIDS Research Centre, opened registration from early 2025, but the number of users is still small and it is not yet available in every province.
• Lenacapavir is under review for registration. The Division of AIDS and STIs at the Ministry of Public Health trained teams from 9 services in Bangkok in late September 2026 to prepare a pilot project, and Thailand is on the list of countries for which the Global Fund plans to procure the drug by 2027.
• Generic lenacapavir for middle-income countries is expected to start reaching the market around early 2027, which should improve access.

This situation is changing quickly, and I will update this page when there are official announcements. In the meantime, if you are at risk now, do not wait for the injection. The oral PrEP already available is highly effective when taken consistently. Read PrEP: HIV prevention before exposure and On-demand PrEP (2-1-1).

1. 2022
   WHO recommends cabotegravir

   The first injectable PrEP option

2. 2024
   Cabotegravir registered in Thailand

   Some Bangkok services opened sign-up in early 2025

3. Jun 2025
   FDA approves lenacapavir

   Given twice a year

4. 14 Jul 2025
   WHO recommends lenacapavir

   Also advises rapid tests for long-acting injectables

5. Sep 2026
   Thai pilot being prepared

   Training teams from 9 Bangkok services

6. 2027
   Wider access expected

   Global Fund plans supply; generics begin to enter the market

Things change fast. If you are at risk now, don't wait for injections; oral PrEP works very well.

Who is likely to benefit from injections?

• People with ongoing risk who struggle to take tablets every day
• People who cannot easily keep medicine at home, or are worried about privacy
• People with stomach problems or difficulty swallowing tablets
• People whose kidney function rules out some oral regimens, as assessed by a doctor

Limitations you need to know

• The pharmacokinetic tail: after the last injection, drug levels fall slowly over many months, even more than a year. If you are still at risk during that time, you must switch to oral PrEP straight away. Otherwise, if infection happens, the virus may become resistant.
• An HIV test is needed every time so the injection is not given to someone who is already infected.
• It does not protect against other sexually transmitted infections, just like oral PrEP. Have regular STI tests, and for some groups consider Doxy-PEP.
• It is still expensive and access is limited in many countries.

How the clinic can help

At Dr. Kris Clinic I currently provide mainly oral PrEP, both daily and 2-1-1, with follow-up tests every 3 months. If you are interested in injectable PrEP, I can help assess whether it suits you and point you to services that actually offer it at that time. English-speaking consultations are available. In the meantime, if you had a risk within the last 72 hours, contact us about PEP straight away. Compare all the options in PrEP vs PEP.