HIV Injections Show Stronger Viral Suppression Compared With Daily Pills, Study Finds

Eight-weekly HIV injections kept the virus suppressed more effectively than daily tablets among adolescents in a clinical trial conducted across four African countries, while also being strongly preferred by participants. Researchers said the findings could support wider access to long-acting HIV treatment in low- and middle-income settings.

Published in The Lancet, the LATA trial involved 476 adolescents aged 12 to 19 years across five clinics in Kenya, South Africa, Uganda and Zimbabwe. Participants were randomly assigned to continue daily antiretroviral tablets or receive injections containing the long-acting HIV medicines cabotegravir and rilpivirine every eight weeks.

After 96 weeks, confirmed viral rebound occurred in two adolescents, or 1%, in the injectable group, compared with 15, or 6%, among those taking daily tablets. Viral rebound refers to an increase in HIV levels in the blood after the virus has previously been suppressed.

All participants had been on tablet treatment for more than a year, had fully suppressed HIV and had no previous treatment failure. Almost all had acquired HIV at birth.

The injectable treatment was also strongly preferred. About 94% of adolescents receiving injections reported that treatment every eight weeks was much easier than taking medicine every day. Researchers noted that daily pills can be difficult for adolescents because of stigma, bullying and the challenge of maintaining regular treatment.

However, wider access faces several barriers. The injectable medicines are more expensive than standard tablets, remain under patent and require trained healthcare workers for administration. Rilpivirine also requires refrigeration during storage and transport. Generic versions are not currently widely available.

The World Health Organization recommends long-acting injectables as an alternative for adults and adolescents who have suppressed HIV on daily treatment and do not have active hepatitis B.

Longer-term studies and improved access, pricing, supply chains and healthcare infrastructure will be important for broader implementation.

REFERENCE: Bwakura-Dangarembizi M, Chappell E, Kityo C et al.; Switch to injectable cabotegravir–rilpivirine given every 8 weeks in adolescents living with HIV with virological suppression in sub-Saharan Africa (LATA): a randomised, open-label, multicentre, 96-week non-inferiority trial; The Lancet, 2026; DOI: 10.1016/S0140-6736(26)01537-0