England’s NICE has recommended the first injectable pre-exposure prophylaxis (PrEP) treatment for HIV, offering a new option for people unable to take daily oral tablets.
Developed by ViiV Healthcare, cabotegravir is administered as an injection every two months at specialist sexual health clinics. The guidance, published today, makes the jab available to adults and young people at high risk of sexually acquired HIV who cannot use oral PrEP due to medical contraindications, difficulty swallowing tablets, or other barriers such as homelessness or partner violence. NICE estimates up to 1,000 people in England could benefit each year.
Milestone in HIV care
“Today’s recommendation for cabotegravir marks a significant milestone,” said Helen Knight, Director of Medicines Evaluation, NICE. “HIV remains a serious public health challenge, but we now have powerful tools to prevent new infections.” Referring to those unable to take daily pills, she added: “This injection offers an effective option for this community.”
The drug belongs to a class of antiretrovirals known as integrase inhibitors. It works by blocking HIV’s ability to integrate into cells, offering sustained protection between doses. Patients will receive the injection alongside comprehensive sexual health services, including regular HIV testing and monitoring. NICE expects rollout to begin within three months of publishing final guidance.
PrEP usage in England
The approval comes as PrEP usage in England reaches record levels. According to the UK Health Security Agency, more than 111,000 people accessed PrEP in sexual health clinics in 2024, a 7.7% increase from 2023. Most users were men who have sex with men, while uptake remains lower among heterosexuals and young people. New HIV diagnoses fell by 2% over the same period.
Professor Yvonne Gilleece, Chair, British HIV Association, welcomed the decision, noting it will improve access for individuals with high vulnerabilities, particularly women. “This treatment will profoundly improve the lives of thousands of individuals by helping them to stay free of HIV, particularly individuals with high additional vulnerabilities,” she said.
This treatment will profoundly improve the lives of thousands of individuals by helping them to stay free of HIV, particularly individuals with high additional vulnerabilities
The NICE recommendation positions cabotegravir as a critical tool in England’s strategy to eliminate new HIV infections by 2030, providing a flexible alternative to oral PrEP for those most in need.
