Everything You Ever Wanted to Know About Long-Lasting, Injectable PrEP to Prevent HIV

When it first came out in 2012, Truvada — the first-to-market pre-exposure prophylactic (PrEP) — was a gamechanger for HIV prevention. Since then, the CDC reports that more than 300,000 people in the U.S. take PrEP in the form of a daily pill. The FDA also ultimately approved both generic Truvada and a gentler-on-the-kidneys PrEP medication known as Descovy.

In 2022, a new player hit the field: Apretude, a brand of long-lasting, injectable PrEP.

To learn more about long-lasting, injectable PrEP, I spoke with DAP Health PrEP Navigation Manager Andrew Glorioso, who has worked in HIV care for 25 years, and who has lived with HIV for even longer.

What is Apretude?

Apretude is an injectable medication that’s used to prevent someone from acquiring HIV. It involves coming to the clinic once every two months for an injection.

What’s the benefit of injectable PrEP over taking a pill? Isn’t oral PrEP enough?

It’s all about lifestyle and being able to provide more options. There was a time when all we had to provide were condoms. Then we got PrEP. We’ve been continuing to expand what’s available.

Both oral and injectable PrEP protect against HIV with the same level of efficacy — both are 99.9% effective [if taken daily]. However, what Apretude has is the benefit of medication adherence. People who are on oral medication are taking one pill once a day, but are they really taking it once a day? Having to come into the clinic every two months for Apretude helps with medical adherence.

Who exactly is injectable PrEP for?

It can help people in situations where it’s difficult to adhere to a regimen. It’s not a one size fits all kind of thing. It takes talking to each individual and determining what makes sense based on their lifestyle. We deal with many individuals who may have mental health, substance use, or housing stability issues. Apretude might be a great option because they don’t have to worry about storing their medication or keeping track of pills.

Also, if somebody comes in and they’re interested in Apretude, one of the first things I ask them is: How do you feel about getting a shot? If you really don’t like needles, Apretude is not the thing for you.

Do the shots hurt? Are there any other side effects?

It’s a regular gauge shot. It’s not like a little pin prick in the shoulder. Some people have reported having injection-site soreness for a couple of days and maybe a little nodule developing under the skin. So, it’s not completely without its possibility of adverse effects. That said, we also have people who are using Apretude and love it. They love knowing they don’t have to worry about taking their PrEP for two months.

Is injectable PrEP more expensive? Is it covered by insurance?

Our ability to get Apretude for individuals depends on the type of health care coverage they have. If somebody is on the state’s Medicaid program (MediCal), or IEHP out here in the Coachella Valley, those programs actually give individuals the option of injectable or oral PrEP, so it’s great. Medicare will cover both versions of PrEP. For people who have private insurance, it depends on the plan. And then for people who are uninsured, we don’t really have a mechanism right now to get them access to Apretude. We can easily get them access to oral PrEP medication for little to no cost. Anybody who wants PrEP can be on oral PrEP.

To learn more about the benefits of long-lasting, injectable PrEP, please click here.

To get long-lasting injectable PrEP from DAP Health, please click here.