First long-acting, injectable option for PrEP is now FDA approved!

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First long-acting, injectable option for PrEP is now FDA approved!

The FDA approval of Apretude (cabotegravir extended-release injectable suspension) makes it the first long-acting injectable option for HIV prevention. Injectable cabotegravir provides an exciting opportunity to offer PrEP to people who are looking for an alternative to oral medications, have significant renal disease, and/or have challenges with maintaining PrEP adherence.

Apretude is administered as a single 600 mg (3 mL) gluteal intramuscular injection one month apart for the first two months and then every two months thereafter. There is an option to offer cabotegravir oral tablets (Vocabria) for the month prior to initiating injectable cabotegravir to assess side effects and tolerability. The estimated cost for Apretude is $3,700 per 3 mL injection, which is comparable to annual costs for branded Truvada and Descovy. Patient assistance program information to cover the cost of the medication is not yet available. Health plans regulated by the California Department of Insurance are required to cover all PrEP drugs and related clinical services without cost sharing – including injectable PrEP.

Refer to the FDA-approved full prescribing information and updated 2021 CDC PrEP Guidelines for more details.

The SF City Clinic website has resources to help with PrEP prescribing including a provider guide and patient educational handout. If you would like help from SFDPH with how to prescribe PrEP or get out-of-pocket costs covered, please contact the City Clinic Biomedical Prevention Coordinator at

Thank you for prescribing PrEP and helping to prevent HIV!

The San Francisco Monthly STI Report ( Monthly reports can be found by visiting and scrolling midway down the page.