Study: Long-Acting HIV Treatment Offers Strong Protection

A Food and Drug Administration-approved, long-acting injectable antiretroviral therapy offers strong protection to people with HIV, according to new findings presented at IDWeek 2026.  

Researchers observed 7,995 people with HIV who were receiving oral antiretroviral therapy and switched to a combination of every one- or two-month injectable cabotegravir plus rilpivirine between January 2021 and December 2025. Eighty-seven percent of these switches to long-acting injections involved patients who were virologically suppressed at the time of the switch, the current on-label indication for the long-acting injectable cabotegravir plus rilpivirine. Of this initial group, 6,362 completed their two initiation doses of cabotegravir plus rilpivirine and were followed throughout the remainder of the study.   

The great majority of people (94%) who received at least two injections had undetectable levels of HIV at their last virologic load test. Throughout the study period, 81% of this group remained at or below undetectable levels of HIV at every virologic load test. Only 1% of those included in the study had confirmed detectable virologic levels.  

Ninety-five percent of patients received all injections on time or within one week of the recommended dosing interval. Seventy-seven percent of patients remained on their injections at study end with a median of 18 cumulative months on cabotegravir plus rilpivirine. The most common provider-reported reasons for discontinuation of the injectable were nonadherence, loss to care and, infrequently, efficacy concerns or injection site reactions. 

“HIV affects millions globally, so having multiple clinically proven treatment options available is key to meeting the unique needs of each person and ending the epidemic,” said Ricky Hsu, MD, national medical director at the AIDS Healthcare Foundation and lead author of the study. “By adding real-world data that reflects everyday challenges facing patients in accessing care to the evidence-base, these findings further validate randomized clinical trials that show cabotegravir plus rilpivirine as an effective and valuable option for those living with HIV.”  

Prior to cabotegravir plus rilpivirine’s approval in 2021, no long-acting, complete antiretroviral regimens were available to people with HIV. Cabotegravir plus rilpivirine, also known as Cabenuva, remains the only long-acting, complete treatment option available, with other therapies requiring daily or otherwise more frequent dosing. An estimated 1.2 million people in the United States and 42 million people globally have HIV. 

The study suggests clinicians should have additional confidence in prescribing cabotegravir plus rilpivirine to patients with suppressed HIV, while additional research is warranted to study the effectiveness of this long-acting injectable treatment in patients with difficulty taking oral medications and who have detectable viral loads, according to researchers.  

In addition to Dr. Hsu, study co-authors include: Michael Sension, MD; Jennifer Fusco, BS; Michael Osterman, PhD, MPH; Quateka Cochran, MSN; Gayathri Sridhar, MBBS, MPH, PhD; Vani Vannappagari, MBBS, PhD, MPH; Kimberley Brown, PharmD; Jean van Wyk, MBChB, MFPM; Laurence Brunet, PhD; Michael Wohlfeiler, MD, JD; and Gregory Fusco, MD, MPH. 

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About IDWeek 

IDWeek is the joint annual meeting of the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, the HIV Medicine Association and the Pediatric Infectious Diseases Society. IDWeek is a recognized forum for peer-reviewed presentations of new research on scientific advances and bench-to-bedside approaches in prevention, diagnosis, treatment and epidemiology of infectious diseases, including HIV, across the lifespan. For more information, visit idweek.org.