By Lily H-A
From PHN Issue 58, Fall 2024
Dear Prison Health News,
I am writing to ask how I can get the new HIV one-shot (monthly) medication? And
can you do an article about how the shot is given and cost compared to the pill?
–R
Dear R,
Thank you for writing to us and for asking this great question. The HIV injectable medication that you are probably thinking of is a combination of two HIV medications: rilpivirine and cabotegravir. In the U.S., it’s known by the brand name Cabenuva and it gained FDA approval in 2021. This is the only complete, long-acting, injectable HIV treatment currently available, but there are others being studied.
Cabenuva is only approved right now for adults who are already undetectable (viral load of less than 50 copies/mL) while taking oral HIV medication (pills) and with no history of treatment failure or resistance to either rilpivirine or cabotegravir.
The benefit of Cabenuva is that you only have to get injections once a month or once every two months, instead of taking a daily pill. This can be more convenient and give you more privacy. So far, studies have shown that this injection is just as effective as daily pills for HIV, and may be more effective for people who have issues with taking a pill everyday.
There is a very small risk of treatment failure with the injections, even when taken as directed, meaning your viral load could go up and you could develop resistance to the medications
used in the injections. According to one study of injections every two months, this risk is 1 in 70 (1.4%) in the first year, and 1 in 60 (1.6%) in the second year of treatment.
Cabenuva is given by a healthcare professional as two injections (one injection of each drug) into the muscle of the buttocks. Injection site reactions (like a bump, swelling, or soreness) are common but usually go away within a few days. Other common side effects include
headaches, raised body temperature, or feeling hot.
The monthly cost of Cabenuva is currently higher than the cost of most oral HIV pills. We weren’t able to find much information about Cabenuva’s availability in prisons, which likely varies state by state. We did find that it is currently included in the formulary (list of available medications) for California Correctional Health Care Services. Because Cabenuva is relatively new, you may need to advocate to get access to it. Hopefully, this information will help you decide if this medication is right for you, and if so, to get it at your facility.✦
Prison Health News 