The National Health Service (NHS) will begin offering a new long-acting injection to prevent HIV in England and Wales for the first time, bringing the two nations in line with Scotland’s existing policy.
The injection, known as cabotegravir (CAB-LA), will be administered every two months as an alternative to daily pills currently used for HIV prevention. The move is part of the UK’s goal to end new HIV cases by 2030.
Health Secretary Wes Streeting described the approval as a major milestone for public health. “The approval of this game-changing injection perfectly embodies what this government is determined to deliver – cutting-edge treatments that save lives and leave no one behind,” he said. “For vulnerable people who are unable to take other methods of HIV prevention, this represents hope.”
The new treatment is a form of pre-exposure prophylaxis (PrEP), used by HIV-negative people to prevent infection. While PrEP pills have been available for years and are highly effective, they are not always practical for everyone due to accessibility issues, stigma, or lifestyle challenges.
For many, taking a pill daily can be difficult. Factors such as homelessness, domestic violence, or concerns about privacy have made adherence to the oral regimen challenging. The injection offers a discreet and convenient alternative, lasting for two months at a time.
Cabotegravir, developed by ViiV Healthcare, will be used alongside safe sex practices, such as condom use. The NHS has secured a confidential discount from the manufacturer, with the treatment’s list price set at around £7,000 per patient per year.
The injections will be available to adults and adolescents at high risk of sexually acquired HIV who are eligible for PrEP but face difficulties with daily tablets. It is estimated that about 1,000 people will initially receive the jab, while others will continue with or begin oral PrEP.
The National Institute for Health and Care Excellence (NICE) approved the injection for NHS use, stating that sexual health clinics will begin offering the treatment “in the coming months.”
Some advocacy groups, however, have urged the government to ensure the rollout is swift and inclusive. Richard Angell, of the Terrence Higgins Trust, said the treatment’s success depends on accessibility. “It’s highly effective and acceptable for patients, and a vital tool for tackling inequalities – with the potential to reach those who are not currently accessing other HIV prevention,” he said.
Campaigners have also called for expanding availability beyond sexual health clinics, as some people face long waiting times for appointments.
Dom Baldwin, a PrEP user, welcomed the development. “I think the fact that there’s still so much work being done on HIV treatment and prevention is fantastic,” he said. “When you look at where we are now compared to the epidemic in the 80s… HIV is no longer a death sentence.”
Data from NHS England shows a steady rise in PrEP usage. In 2024, 146,098 HIV-negative people using sexual health services were identified as needing PrEP, with 76% (111,123 people) starting or continuing treatment — a 7.7% increase from 2023.
However, uptake remains unequal across demographic groups. PrEP use is highest among white and ethnic minority gay and bisexual men, while much lower among black African heterosexual women (34.6%) and men (36.4%).
The NHS is also expanding routine HIV testing across hospital emergency departments, with 89 facilities now screening all patients who have blood drawn, particularly in areas with high HIV prevalence.
Meanwhile, early trials of another injection, lenacapavir, suggest that annual HIV prevention shots may soon be possible, marking another step toward the UK’s goal of ending new infections within the decade.
