Key Takeaways

Researchers stopped the study early after finding that a shot of cabotegravir every two months worked better than daily Truvada pills to help keep women from catching HIV from an infected sex partner. They announced last week that this shot was 89% more effective than the pills.

Cabotegravir belongs to a class of drugs known as integrase strand transfer inhibitors,Jonathan Appelbaum, MD, a professor of internal medicine and director of the clinical sciences department at the Florida State University College of Medicine who was not involved in the study, tells Verywell.

How Is HIV Transmitted?

What This Means For YouIf you are at high risk of contracting HIV, cabotegravir may eventually be a better option for you than Truvada. However, these shots are not yet available. Until then, speak to your doctor about what is right for you.

What This Means For You

If you are at high risk of contracting HIV, cabotegravir may eventually be a better option for you than Truvada. However, these shots are not yet available. Until then, speak to your doctor about what is right for you.

Traditional HIV Treatment and Prevention

Since the beginnings of the HIV pandemic in the 1980s, an estimated 75.7 million people have been infected with the virus, and 32.7 million people have died because of it.

The first ray of hope for HIV treatment arrived in 1987, when the Food and Drug Administration (FDA) approved the use of the antiretroviral therapy zidovudine (AZT) to treat the virus. Zidovudine and its successors revolutionized HIV care, turning the virus from a death sentence into a chronic condition.

One of those successors was Truvada, which is taken in pill form to either treat HIV or prevent HIV. Besides Truvada, the only other pre-exposure prophylaxis (PrEP) treatment available is Descovy, Volberding and Appelbaum tell Verywell. Descovy is only approved for use in gay men and transgender women, although “studies are currently being done on women to determine if it works for prevention of HIV through vaginal sex,” Appelbaum says.

But as anyone who has ever been on medication knows, adhering to a daily regimen is easier said than done. Who hasn’t forgotten to take a pill once or twice?

How HIV Is Treated

That’s the advantage of an injectable drug such as cabotegravir,Paul Volberding, MD, professor of epidemiology and biostatistics at the University of California San Francisco School of Medicine and a pioneer in the development of antiretroviral therapy, tells Verywell.

“PrEP (oral) works well, but non-adherence—forgetting to take the pill—is a common problem,” Volberding says. If you opt for cabotegravir, there’s “less obligation to remember to take the medication every day,” Appelbaum adds.

The Benefits of Cabotegravir

The NIH study was conducted in 3,223 sexually active women between the ages of 18 and 45 at 20 sites in the sub-Saharan African countries Botswana, Kenya, Malawi, South Africa, Eswatini, Uganda, and Zimbabwe. Sub-Saharan Africa was presumably chosen because it has long had the highest concentration of HIV-positive individuals of any region in the world, a statistical fact that prompted the Population Review to dub it “the world’s epicenter of HIV/AIDS” in 2002. In 2019, there were 730,000 new HIV infections and 300,000 AIDS-related deaths, according to the most recently available data.

The women were assigned to either receive an injection of cabotegravir once every two months or take Truvada daily. (To ensure objectivity, those receiving cabotegravir injections took placebo pills daily and those taking Truvada received placebo injections once every two months.) Over the course of the study, 38 women contracted HIV, of whom 34 were taking Truvada and 4 were injecting cabotegravir. From those numbers, the researchers determined that there was an HIV incidence rate of 0.21% in women injecting cabotegravir and 1.79% in women taking Truvada, meaning that cabotegravir was 89% more effective at preventing HIV than Truvada.

Why Is It So Hard to Make an HIV Vaccine?

“While oral PrEP is highly effective in preventing HIV in women when taken as prescribed, some women find it difficult to take a daily tablet and inconsistent use of oral PrEP reduces the prevention effect,” the World Health Organization wrote of the findings. “A long-acting injectable formulation has the potential to improve the prevention effect without relying on adherence to a daily oral PrEP regimen, and to increase prevention choices and acceptability among women.”

Indeed, many women in the study seemed to prefer cabotegravir to Truvada for its ease of use.

What Is HIV Pre-Exposure Prophylaxis (PrEP)?

“Many participants in the trial of the injection said they preferred it over taking a pill,” Volberding says.

Side effects of both cabotegravir and Truvada were few and far between, although some women reported nausea, gastrointestinal distress, and skin reactions at the injection site. None had to discontinue participation, however. If all goes well, cabotegravir will likely be approved within a matter of months, Volberding and Appelbaum say.

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.ViiV Healthcare.ViiV Healthcare announces investigational injectable cabotegravir is superior to oral standard of care for HIV prevention in women.Updated November 9, 2020.HIV.gov.How is HIV transmitted?Updated June 24, 2019.Avert.How HIV affects the body and the lifecycle of HIV.Updated July 14, 2020.amFAR.Statistics: worldwide.Updated August 2020.Avert.History of AIDS and HIV overview.Updated January 12, 2017.Liotta, D.C., Painter, G.R..Discovery and development of the anti-human immunodeficiency virus drug, emtricitabine (emtriva, FTC).Acc Chem Res. 2016;49(10):2091-2098. doi:10.1021/acs.accounts.6b00274Goliber, T.The status of the HIV/AIDS epidemic in sub-Saharan Africa. Population Reference Bureau. Updated July 2, 2002.Avert.HIV and AIDS in East and Southern Africa regional overview. Updated October 31, 2019.World Health Organization.Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women.Updated November 9, 2020.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.ViiV Healthcare.ViiV Healthcare announces investigational injectable cabotegravir is superior to oral standard of care for HIV prevention in women.Updated November 9, 2020.HIV.gov.How is HIV transmitted?Updated June 24, 2019.Avert.How HIV affects the body and the lifecycle of HIV.Updated July 14, 2020.amFAR.Statistics: worldwide.Updated August 2020.Avert.History of AIDS and HIV overview.Updated January 12, 2017.Liotta, D.C., Painter, G.R..Discovery and development of the anti-human immunodeficiency virus drug, emtricitabine (emtriva, FTC).Acc Chem Res. 2016;49(10):2091-2098. doi:10.1021/acs.accounts.6b00274Goliber, T.The status of the HIV/AIDS epidemic in sub-Saharan Africa. Population Reference Bureau. Updated July 2, 2002.Avert.HIV and AIDS in East and Southern Africa regional overview. Updated October 31, 2019.World Health Organization.Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women.Updated November 9, 2020.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

ViiV Healthcare.ViiV Healthcare announces investigational injectable cabotegravir is superior to oral standard of care for HIV prevention in women.Updated November 9, 2020.HIV.gov.How is HIV transmitted?Updated June 24, 2019.Avert.How HIV affects the body and the lifecycle of HIV.Updated July 14, 2020.amFAR.Statistics: worldwide.Updated August 2020.Avert.History of AIDS and HIV overview.Updated January 12, 2017.Liotta, D.C., Painter, G.R..Discovery and development of the anti-human immunodeficiency virus drug, emtricitabine (emtriva, FTC).Acc Chem Res. 2016;49(10):2091-2098. doi:10.1021/acs.accounts.6b00274Goliber, T.The status of the HIV/AIDS epidemic in sub-Saharan Africa. Population Reference Bureau. Updated July 2, 2002.Avert.HIV and AIDS in East and Southern Africa regional overview. Updated October 31, 2019.World Health Organization.Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women.Updated November 9, 2020.

ViiV Healthcare.ViiV Healthcare announces investigational injectable cabotegravir is superior to oral standard of care for HIV prevention in women.Updated November 9, 2020.

HIV.gov.How is HIV transmitted?Updated June 24, 2019.

Avert.How HIV affects the body and the lifecycle of HIV.Updated July 14, 2020.

amFAR.Statistics: worldwide.Updated August 2020.

Avert.History of AIDS and HIV overview.Updated January 12, 2017.

Liotta, D.C., Painter, G.R..Discovery and development of the anti-human immunodeficiency virus drug, emtricitabine (emtriva, FTC).Acc Chem Res. 2016;49(10):2091-2098. doi:10.1021/acs.accounts.6b00274

Goliber, T.The status of the HIV/AIDS epidemic in sub-Saharan Africa. Population Reference Bureau. Updated July 2, 2002.

Avert.HIV and AIDS in East and Southern Africa regional overview. Updated October 31, 2019.

World Health Organization.Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women.Updated November 9, 2020.

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