There are daily pills to prevent HIV — but injectable options could change what prevention looks like

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Once a day, Tim Lagman takes a pill that reduces his risk of contracting HIV, a precaution he's taken since 2017.

Pre-exposure prophylaxis, or PrEP, is part of the daily routine for a growing number of Canadians at risk of exposure to HIV through sex or injection drugs. 

While most people take it in pill form, Lagman, a sexual health educator and podcaster in Scarborough, Ont., is hopeful about a new, longer-lasting injectable option given every two months.

"The option of injectable PrEP would help people at risk of HIV to not worry about it so much," he said.

"Every other month would be a lot easier for me, my peace of mind and my schedule."

The long-acting injectable drug for PrEP, cabotegravir, sold under the brand name Apretude, was approved by Health Canada in 2024 to reduce the risk of sexually acquired HIV. The antiretroviral medication is administered every two months through intramuscular injections.

Quebec is the first province to cover the costs of injectable Apretude under its public prescription drug insurance plan. 

"This is the first treatment by injection for prevention for HIV, so it is very, very special," said Dr. Réjean Thomas, co-founder of Montreal sexual health clinic L'Actuel.

Thomas has been at the forefront of the fight against HIV and AIDS for decades and in that time has seen life-saving advances in treatment and prevention.

Quebec's coverage of injectable PrEP is an important step, he says, and it could be a game-changer for some patients who struggle to take daily pills. The drug is among a number of recent advances in the treatment and prevention of HIV.

"It is very important because I think it's the future in the fight against AIDS," said Thomas.

In Canada, the number of new HIV infections increased by 35 per cent between 2022 and 2023, according to the Public Health Agency of Canada.

In explaining the rise, experts point to limited testing during the COVID-19 pandemic, new immigrants who may not have known their status or didn't have access to treatment in their home country, and insufficient access to screening and prevention tools.