Daily oral PrEP works. For many people, it works very well. But daily adherence is genuinely difficult for some: people whose routines are irregular, who travel frequently, who drink socially, who share living spaces that make privacy difficult, or who simply find that the daily pill habit does not stick no matter how many alarms they set.

For these people, CAB-LA, injectable cabotegravir long-acting, changes the picture entirely. It is a single injection into the muscle of the buttock every two months, providing continuous, highly effective HIV protection with no daily task attached to it. It is available on request through Zivoko in Nigeria.

The science behind the injection.

Cabotegravir is an antiretroviral drug in the integrase inhibitor class. The long-acting (LA) formulation is an injectable suspension that is absorbed slowly from the muscle into the bloodstream over weeks, maintaining protective drug levels without any daily dosing.

Unlike oral PrEP, which relies on remembering a pill every day, CAB-LA works as a depot: each injection establishes a sustained drug level that gradually releases over about two months. When the next injection is given on schedule, the cycle repeats, maintaining uninterrupted protection.

The evidence is strong. The HPTN 083 trial (in men who have sex with men and transgender women) and the HPTN 084 trial (in cisgender women) both found CAB-LA to be superior to daily oral TDF/FTC PrEP. HIV infections were about 66% lower in HPTN 083 and about 89% lower in HPTN 084 compared with the daily pill. That is largely not because the drug is inherently more potent, but because it is much easier to stay on schedule with an injection every two months than with a pill every day.

How the injection schedule works in practice.

How they compare, and how to choose.

CAB-LA is particularly well suited to people who struggle with daily pill adherence, those who value complete privacy (nothing to carry or store), people who travel frequently, and anyone for whom a clinic visit every two months is easier to maintain than a daily habit. Our team will help you assess which option genuinely fits your life, and you can compare all three side by side in which PrEP is right for you.

What to expect from the injection.

The most common side effect of CAB-LA is an injection site reaction: pain, swelling, or tenderness in the buttock muscle. These are usually mild to moderate and settle within a few days to a week or two. They tend to become less noticeable with later injections.

Other side effects are generally uncommon. Because the drug bypasses the stomach, there are few digestive side effects. Headache has been reported in a small proportion of people. Cabotegravir does not carry the kidney or bone considerations associated with tenofovir.

If injection site reactions are severe or worsen with later doses, a nurse or doctor should review the injection technique and site.

Why stopping CAB-LA requires careful planning.

After your final CAB-LA injection, the drug keeps releasing slowly from the muscle for a year or longer. During this tail period, drug levels are present but gradually falling. The concern is that if HIV exposure occurs while levels are too low to protect, the drug may partially suppress HIV rather than block it, which can make an infection harder to detect on standard tests and raise the risk of drug resistance.

For this reason, stopping CAB-LA is not simply a matter of skipping your next injection. If you could still be exposed to HIV, the standard recommendation is to start daily oral PrEP (TDF/FTC) within two months of your last injection, when the next one would have been due, and continue it through the tail period, which commonly means around 12 months. Our team will plan this transition with you so there is no gap in your protection. See how to stop PrEP safely.

Questions about CAB-LA in Nigeria.