My PrEP
What it is
A capsid inhibitor — a different class from every other PrEP — formulated so that one injection lasts six months.
Twice a year
Lenacapavir is injected under the skin of the abdomen, in two injections given at the same visit. It forms a depot that releases slowly, keeping a protective level for 26 weeks.
A new class
It blocks the capsid, the shell that protects HIV's genetic material — a different mechanism from tenofovir or cabotegravir. That also means resistance to other PrEP drugs does not affect it.
It only protects against HIV
No effect on other sexually transmitted infections. Screening stays on the programme at each visit — which, with only two visits a year, is worth planning separately.
Who it is for
Adults and adolescents weighing at least 35 kg who are exposed to HIV through sex.
The trials that led to approval were run in cisgender women and adolescent girls in South Africa and Uganda, and in men, trans and non-binary people across several countries — an unusually broad base for a PrEP product. It fits particularly well when:
How the protocol runs
Injections plus two days of tablets to start, then one injection every 26 weeks.
- 1Baseline testsHIV antibody test and viral load, plus STI screening. As with every PrEP, starting with an undetected infection risks resistance.
- 2Day 1 — injection and tablets927 mg subcutaneously, given as two injections at least 5 cm apart, plus 600 mg by mouth (two 300 mg tablets) the same day.
- 3Day 2 — tablets600 mg by mouth again. This second day is not optional: efficacy was only established with the full loading schedule.
- 4Then every 26 weeksOne injection every six months, with two weeks of leeway either side of the due date.
One injection every 26 weeks, counted from the date of the last injection, with two weeks of leeway either side. The tablets are only for the first two days.
Time to protection
Protective levels are reached by day 2 — provided the loading tablets are taken.
- InjectionDays 1–2
- +6 monthsProtected — until the next injection
With both days of loading tablets, protection is established from day 2 and lasts until the next injection is due.
That is the whole point of the two-day oral loading: with it, protective concentrations are reached about two hours after the day-2 dose. Without it, the estimate stretches to three or four weeks. If you miss the day-2 tablets, take them as soon as you can and tell the team — this is the one part of the schedule where a missed dose really changes the timeline.
What we know about how well it works
The strongest results any PrEP product has produced in a trial.
As with cabotegravir, the comparison is against a correctly prescribed daily tablet, so part of the advantage comes from adherence: two injections a year is a far lower bar than 365 tablets. The World Health Organization recommended lenacapavir for PrEP in July 2025 on the strength of these results.
Side effects
Mostly reactions where the injection goes in, including lumps that can take months to settle.
Monitoring
An HIV test before every injection — with only two visits a year, plan STI screening separately.
Two visits a year is the attraction and the catch: it is convenient, but it removes the three-monthly rhythm that normally catches asymptomatic STIs. Most services therefore keep STI screening on its own schedule rather than tying it to the injections.
Availability where you live
This is the section that matters most for lenacapavir: approval and actual access are two very different things right now.
Lenacapavir is very new: although it holds a European marketing authorisation, it is so far reimbursed almost nowhere in Europe and is barely obtainable outside clinical trials. We could not confirm the exact situation in United Kingdom — oral PrEP remains the option to rely on, and a sexual health clinic can tell you more.
And oral PrEP, meanwhile
Oral PrEP, by contrast, is free in United Kingdom through public sexual health services.
In United States, lenacapavir has been approved since 2025 and is marketed. Coverage goes through health plans, and cost sharing depends on your plan — it is not covered by the no-cost-sharing rule that applies to the older PrEP formulations.
And oral PrEP, meanwhile
Oral PrEP and cabotegravir, by contrast, must be covered without cost sharing by compliant plans in United States.
Lenacapavir is very new: although it holds a European marketing authorisation, it is so far reimbursed almost nowhere in Europe and is barely obtainable outside clinical trials. We could not confirm the exact situation in Ireland — oral PrEP remains the option to rely on, and a sexual health clinic can tell you more.
And oral PrEP, meanwhile
Oral PrEP, by contrast, is free in Ireland through public sexual health services.
Lenacapavir is very new: although it holds a European marketing authorisation, it is so far reimbursed almost nowhere in Europe and is barely obtainable outside clinical trials. We could not confirm the exact situation in Canada — oral PrEP remains the option to rely on, and a sexual health clinic can tell you more.
And oral PrEP, meanwhile
Oral PrEP is available in Canada; a sexual health clinic can explain how it is paid for.
Lenacapavir is very new: although it holds a European marketing authorisation, it is so far reimbursed almost nowhere in Europe and is barely obtainable outside clinical trials. We could not confirm the exact situation in Somewhere else — oral PrEP remains the option to rely on, and a sexual health clinic can tell you more.
And oral PrEP, meanwhile
Oral PrEP is available in Somewhere else; a sexual health clinic can explain how it is paid for.
Late injections, stopping, switching
Two weeks of leeway; beyond that, weekly tablets bridge the gap.
A late injection
Up to two weeks either side of the due date, nothing changes. If a longer delay is expected, a 300 mg tablet once a week bridges the gap for up to six months, and the injection resumes within a week of the last tablet.
A missed injection
More than 28 weeks since the last injection with no bridging tablets means starting the full initiation schedule again — injection plus two days of loading.
Stopping
The drug fades over months, too low to protect but still present. If you remain exposed, another form of PrEP should start within about six months of the last injection.
Common questions
What people ask about the six-monthly injection.
Why tablets as well, if it is an injection?
Because the injection alone takes weeks to reach a protective level. The two days of tablets bridge that gap, which is why the loading schedule is not optional: the trials only established efficacy with it.
Where does the injection go?
Under the skin of the abdomen — two injections at the same visit, at least 5 cm apart. It is subcutaneous, not into muscle like cabotegravir, and it must not be given into the skin itself.
Are the lumps a problem?
They are common and usually harmless, but they can last: in the trials nodules took several months to disappear. They became less frequent with successive injections. Anything painful or persistent is worth showing to the team.
Can I switch from cabotegravir or from tablets?
Switching from oral PrEP is straightforward — the loading schedule covers the transition. Switching between the two injectables is not described in the product information, so it is handled case by case in clinic.
Why can I not get it where I live?
Approval and availability are separate steps. Lenacapavir is authorised across the European Union, but each country then negotiates a price and a reimbursement decision — and several, including France, have not concluded one. The availability section above has what we could confirm for your country.