Last updated: July 2026
Injectable PrEP (Apretude): Every-Two-Months HIV Prevention
Apretude (long-acting cabotegravir) replaces the daily pill with an injection at a clinic every two months. In head-to-head trials it prevented more HIV infections than daily oral PrEP — not because the drug is inherently stronger, but because showing up six times a year is easier than perfect daily pill-taking.
The short version
- Gluteal injection: two starter shots a month apart, then every 2 months.
- Superior real-world effectiveness vs daily pills in both major trials (HPTN 083/084).
- Approved for all populations, including cisgender women.
- Requires in-person visits for each shot — telehealth handles the consult, not the injection.
Who it's best for
Apretude shines for people who struggle with daily pills (the honest majority of us at some point), can't have pill bottles around due to privacy or housing situations, have kidney issues that complicate oral tenofovir, or simply prefer a set-and-forget approach. The trade: you're committing to an appointment every two months, and missing shots matters more than missing pills — drug levels decline slowly, creating a "tail" period of partial protection where a breakthrough infection could develop resistance.
What the process looks like
- HIV testing first, as with all PrEP — Apretude started during undiagnosed infection risks resistance to an important treatment class.
- Two initiation injections one month apart (an optional oral lead-in is largely phased out).
- Maintenance shots every two months, with rapid HIV testing at each visit.
Injection-site soreness for a day or two is the most common side effect; serious problems are rare. Full comparison in the side-effects guide.
Cost and access
List price is high (roughly $4,000 per injection), but as a USPSTF-recommended preventive service it's increasingly covered at $0 by insurance, with prior authorization common; ViiV's assistance program (ViiVConnect) covers eligible uninsured patients. The practical barrier is finding a clinic that stocks it — call ahead. More on costs here.
Pills or shots?
There's no wrong answer — the best PrEP is the one you'll actually use. If your pill bottle judges you from the shelf, get the shot. If clinic visits are the friction point, take the pill. A telehealth consult can walk through the fit and, if injectable is right, locate an administering clinic near you.
See your options — pick your state
Where you live determines who can prescribe for you via telehealth.
Good news: our reviewing clinical team at The Practice serves your state directly by telehealth.
Book a telehealth visit with The PracticeOr call (904) 877-1100
The Practice doesn't prescribe in your state yet. These established telehealth services do:
MISTR — free PrEP & DoxyPEP online, most states Wisp — sexual-health telehealth & pharmacy CallonDoc — same-day online prescriptions