What is Cabotegravir PrEP (CAB-PrEP)?
Cabotegravir PrEP (CAB-PrEP) is a long-acting injectable medicine used to prevent HIV. It is injected every 8 weeks. It offers an alternative to tablet PrEP for those who cannot use tablets for medical or social reasons.
How effective is Cabotegravir (CAB-PrEP) at preventing HIV?
Cabotegravir PrEP (CAB-PrEP) is estimated to be more than 99% effective when taken as prescribed. However, there are no clinical trials that directly compare those taking Cabotegravir PrEP and those who do not take any PrEP.
Who can get Cabotegravir PrEP (CAB-PrEP) in Scotland?
Cabotegravir PrEP (CAB-PrEP) is available to individuals who are unable to take tablet PrEP and who are:
- At ongoing risk of getting HIV through sex.
- Aged 18 or older.
- HIV-negative at the time of starting.
- Able to attend regular appointments to receive injections.
It is available at the Sandyford Sexual Health Services. A doctor will need to see you first. They will discuss whether Cabotegravir PrEP is the right option for you. They may discuss this with a team of other healthcare providers.
How is Cabotegravir PrEP (CAB-PrEP) administered?
- An initial injection is given on Day 1 and another after 4 weeks.
- After that, maintenance doses are given every 8 weeks.
- The injection is given into the muscle in the buttock by a healthcare provider.
Do I still need to attend regular sexual health check-ups?
Yes. In fact, you need to attend clinic more often than those who take tablet PrEP.
Those on Cabotegravir PrEP (CAB-PrEP) must attend clinic appointments every 8 weeks for injections and HIV testing.
You will also be regularly tested for other STIs.
What are the side effects of Cabotegravir PrEP (CAB-PrEP)?
Most side effects are mild and may include:
- Injection site reactions such as pain, swelling, or hardness of the skin
- Headache, fever, or fatigue (less common)
- In rare cases, allergic reactions
What happens if I miss an injection? Or what if I have a holiday planned on the day of my injection?
Missing an injection can reduce your protection. Before starting Cabotegravir PrEP (CAB-PrEP), you will be given detailed advice about the importance of taking your injections exactly on time. You will also be advised on what to do if you cannot attend your appointment.
If you miss an injection:
- Contact your clinic as soon as possible to reschedule.
- You may be advised to temporarily take daily Cabotegravir tablets to maintain protection until your next injection.
If you know you will miss your next injection due to a holiday, then it is possible to have your injection slightly early. If this isn’t possible, you may be able to take tablet Cabotegravir for a week until you can attend the clinic for an injection. It is very important to discuss this with your doctor or nurse first so that a plan can be agreed.
Is Cabotegravir PrEP (CAB-PrEP) suitable for everyone?
No. It is not suitable for people who:
- Have HIV
- Are unable or unwilling to attend regular appointments.
- Have a history of allergic reaction or serious side effects to the medication or other integrase inhibitors (a type of drug used to treat HIV infection)
Your healthcare provider will assess your suitability thoroughly before offering CAB-PrEP to you.
What happens when I stop Cabotegravir PrEP (CAB-PrEP)?
If you want to stop Cabotegravir PrEP (CAB-PrEP) it is very important that you discuss this with your healthcare provider.
This is because Cabotegravir stays in your body for a long time after you stop the injections. Even when you are no longer getting injections, small amounts of the drug can remain in your body for up to 12 months.
During this time, the amount of Cabotegravir in your body will be too low to protect you against HIV. If you become infected with HIV while small amounts of Cabotegravir are still in your body, the virus can learn how to survive the drug. This is called drug resistance, and it can make some HIV treatments less effective in the future.
After you stop Cabotegravir injections it is important that you use condoms or another type of PrEP and attend for regular HIV tests for 12 months.
Is Cabotegravir PrEP (CAB-PrEP) free on the NHS in Scotland?
Yes. Like oral PrEP, CAB-PrEP is available free of charge through NHS sexual health services in Scotland.
Non-urgent advice: For more information
Terrence Higgins Trust: www.tht.org.uk
National AIDS Trust: More PrEP choices will make HIV prevention a reality for all – National AIDS Trust