A “game-changing” HIV-prevention injection that offers months of protection with a single shot is set to be approved for use in England and Wales, a move hailed by health leaders as a major step towards ending new transmissions of the virus.
The National Institute for Health and Care Excellence (Nice) has recommended the drug, Cabotegravir (CAB-LA), for use in its draft guidance published on Friday. The injection, administered every two months, provides a crucial alternative to the daily pills currently used as pre-exposure prophylaxis (PrEP).
For many of the over 111,000 people who accessed PrEP in England last year, the daily tablet regimen is highly effective. However, health experts emphasise that the pill is not suitable for everyone. Some at-risk individuals face medical contraindications, while others find the daily routine challenging due to lifestyle, stigma, or privacy concerns.
Cabotegravir, a long-acting injectable, solves this by offering discreet and sustained protection, requiring just six clinic visits a year.
“This is a game-changing approval,” said Health Secretary Wes Streeting. “For vulnerable people unable to take other methods of HIV prevention, this injection represents hope. England will be the first country to end HIV transmissions by 2030, and this breakthrough treatment is another powerful tool in our arsenal to reach that crucial goal.”
The draft guidance from Nice, the body that determines which treatments represent value for money for the NHS, marks the first time it has approved a PrEP medicine. CAB-LA is expected to become available on the NHS around three months after Nice publishes its final guidance, expected later this year.
A Global Shift in HIV Prevention
The move by England and Wales places them among a growing number of nations adopting this powerful new prevention tool, signalling a significant shift in the global fight against HIV.
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South Africa, which has the world’s largest HIV epidemic, approved CAB-LA in late 2023 and has already begun rolling it out in a phased approach, prioritising key population groups.
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The United States approved the injection in 2021, and it has been available there for several years, with studies showing high uptake and effectiveness in real-world settings.
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Other countries, including Canada, Australia, and Zimbabwe, have also granted regulatory approval and are in various stages of implementing the jab into their national HIV prevention programmes.
Deborah Gold, chief executive of the National AIDS Trust, welcomed the UK decision. “The introduction of a long-acting injectable form of PrEP is a monumental step forward,” she said. “It gives people more choices in how they protect themselves from HIV, which is vital for reaching everyone who can benefit from PrEP. Choice reduces barriers and empowers individuals.”
According to the UK Health Security Agency (UKHSA), more than 111,000 people accessed PrEP in sexual health clinics in England last year, a 7% increase on the previous year. The addition of an injectable option is expected to boost these numbers further, particularly among groups where pill-taking can be a barrier.
The final guidance from Nice is now undergoing a public consultation, with full approval anticipated to be a formality, paving the way for the jab to become a staple of HIV prevention in the UK by early 2025.
