Apretude vs Cabenuva: Same Ingredient, Completely Different Drug
If you've searched for the injectable form of PrEP, you've probably seen both of these names — they sound alike, they're both cabotegravir injections from the same manufacturer, and even some pharmacies mix them up. But one prevents HIV and the other treats it, and the difference is not a technicality.
The short version
- Apretude = cabotegravir alone, used as PrEP — HIV prevention for people who are HIV-negative. This is the injectable PrEP you may be looking for.
- Cabenuva = cabotegravir plus rilpivirine, used as treatment — for people already living with HIV whose virus is fully suppressed.
- They are never interchangeable. A person with HIV cannot use Apretude, and an HIV-negative person should never receive Cabenuva.
Apretude: injectable PrEP (prevention)
Apretude is a long-acting injection of a single drug, cabotegravir, approved by the FDA in late 2021 for HIV pre-exposure prophylaxis in at-risk adults and adolescents weighing at least 35 kg (about 77 lb). The schedule is two starter injections one month apart, then one injection every two months, given by a healthcare provider. In the landmark HPTN trials it outperformed daily oral PrEP, largely because there are no pills to remember. One detail matters more than any other: you must have a confirmed negative HIV test before every injection. Our full Apretude guide covers the schedule, side effects, and costs.
Cabenuva: injectable HIV treatment
Cabenuva is a two-drug injection — cabotegravir plus rilpivirine — approved by the FDA in 2021 as a complete regimen for treating HIV-1 in people who are already living with HIV and whose viral load is fully suppressed on their current regimen. It replaces daily treatment pills with an injection every month or every two months, also given by a provider. It is not prevention, and it is not a starting point: it's an option for people with established, controlled HIV who want to switch off daily tablets.
Side by side
| Apretude | Cabenuva | |
|---|---|---|
| Drugs inside | Cabotegravir alone | Cabotegravir + rilpivirine |
| Purpose | HIV prevention (PrEP) | HIV treatment |
| Who it's for | HIV-negative people at risk of HIV | People living with HIV, virus already suppressed |
| Schedule | Two starters a month apart, then every 2 months | Every month, or every 2 months |
| Key requirement | Confirmed negative HIV test before each dose | Suppressed viral load before switching |
| Both | Long-acting gluteal injections given by a healthcare provider; injection-site soreness is the most common side effect of each | |
Why one drug prevents HIV but it takes two to treat it
This is the part that makes the distinction more than branding. Treating an established HIV infection requires at least two active drugs, because HIV mutates constantly — on a single drug, resistant virus would emerge and the treatment would fail. That's why Cabenuva pairs cabotegravir with rilpivirine. Prevention is different: in an HIV-negative person there is no infection to suppress, so one well-chosen drug is enough. But that logic only holds if the person is truly HIV-negative — which is exactly why Apretude requires a fresh HIV test before every injection, and why taking Apretude with an undiagnosed infection is a genuine clinical problem: it can breed cabotegravir-resistant HIV.
The mix-up worth avoiding
Because both names are new, both are "the cabotegravir shot," and both come from ViiV Healthcare, confusion shows up in search results, forums, and occasionally in clinic paperwork. If you're looking for injectable prevention, the word you want is Apretude — say "Apretude, the PrEP injection" and any prescriber will know exactly what you mean. If a source refers to Cabenuva as PrEP or HIV prevention, that source is wrong, full stop. And if you're living with HIV and reading about prevention options, the relevant question for you isn't Apretude at all — it's treatment, where undetectable virus means HIV cannot be sexually transmitted (U=U).
How to move forward
If you're HIV-negative and interested in the two-month injection, the path is a telehealth consult, baseline HIV and kidney testing, and a prescription — here's how getting PrEP online works, including injectable options. If pills fit your life better, generic Truvada and Descovy are the daily alternatives, and all of them are about 99% effective when taken as prescribed.