Taking PrEP: Long-Acting Options
For some of us who use PrEP, “long-acting PrEP (LA PrEP)”, “injectable PrEP” or “PrEP Shots” might be an option for us. As of February 1 2026, there is only one available LA PrEP option available to us in BC; Apretude. Apretude is a long-acting formulation of cabotegravir, an HIV antiretroviral medication. Apretude is unique in that it is the first long-acting injectable form of HIV-PrEP that has been approved by Health Canada, however, many LA PrEP options are currently under Health Canada review and may soon be widely available.
Currently, there is no “free” program for LA PrEP in BC. However, many of us who have access to extended health benefits through employment benefits, private insurance or First Nations status (NIHB) may have full or partial coverage. Additionally, Apretude has a patient support program that can cover some costs of the medication that your benefits do not cover. Apretude is not currently covered under Blue Cross. (DIN# 02547473)
• Before receiving Apretude, one must be HIV-1 negative
• Apretude does not prevent the transmission of other STIs
• Continuous testing of HIV and other STIs is recommended with each injection of Apretude or at the discretion of our healthcare providers.
• In most cases, most of us can start the injection right away. For some, our healthcare provider may suggest an oral lead-in.
• Apretude is initially given as an injection into the muscle of the buttock 1 time every month for the first 2 months, then as an injection 1 time every 2 months.
• It is important that we receive Apretude as scheduled. If Apretude treatment is stopped, oral PrEP should be used to prevent HIV for 12 months.
• Common side effects of Apretude include but are not limited to pain, tenderness, hardened mass or lump, swelling, bruising, redness, and itching.
• Specific inquiries about Apretude and other medication interactions should be consulted with our healthcare providers.
Is Long-Acting PrEP for Me?
If you have never taken PrEP before, we recommend following the tips found in the “Accessing PrEP Step by Step” guide and talking to a prep prescriber about starting oral PrEP. Oral PrEP is available free of charge for most queer guys* in BC.
If we are currently on PrEP, we may benefit from long-acting PrEP if we find it hard to take oral PrEP pills every day. Some of us may instead prefer to take one injection every 2 months. Injectable options may benefit those of us on PrEP who also have severe kidney disease or whose kidney function is affected by daily oral PrEP.
People taking LA PrEP are more likely to report side effects than those taking oral PrEP. Common side effects include injection site reactions, fever, headache, fatigue, rash, and muscle pain. Apretude clinical trials were conducted among populations of HIV negative cis-men, cis-women and trans-women. There is no available clinical trial data about trans men specifically.
Talk to your PrEP prescriber if you think LA PrEP might be right for you.
References:
Government of Canada (2024). Drug Decision Portal: Regulatory Decision Summary for Apretude. Retrieved from:
https://dhpp.hpfb-dgpsa.ca/review-documents/resource/RDS1732302431707
Landovitz RJ., Donnell D., Clement ME., et al. (2021). Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women. New England Journal of Medicine. 12;385(7):595-608.
Apretude (2024). What is Apretude? Retrieved from: