Brazil study finds fewer HIV infections with long-acting injections

Long-acting HIV prevention injections were linked to more consistent protection and fewer new infections in a Brazilian study conducted in public health clinics.

Published in The Lancet HIV, the Fiocruz-led research followed adults aged 18 to 30 in six Brazilian cities. It examined how cabotegravir could fit into everyday care, beyond the controlled conditions of clinical trials.

Cabotegravir is a form of PrEP, medicine taken before possible exposure to prevent HIV. After the initial doses, injections are given every two months. Researchers found that 92% of injections were delivered on time.

Participants using injections had prevention coverage for roughly 91% of follow-up days, compared with about 35% in a separate comparison group using oral PrEP in routine public care. The rate of new HIV infections was equivalent to about two per 1,000 people followed for a year, versus about 15 in that comparison group.

The findings do not mean injections are inherently better than pills. Participants chose their method, and researchers emphasised that both options are highly effective when used consistently. The opportunity is to offer an alternative for people who struggle with daily tablets, not replace oral PrEP.

Brazil is still evaluating whether to add cabotegravir to its public health system. Oral PrEP remains available there free of charge; neither form protects against other sexually transmitted infections.