Yeztugo (lenacapavir)
Yeztugo is the first twice-yearly injectable PrEP — a subcutaneous injection every 6 months after initial oral loading doses. The PURPOSE clinical trials showed extraordinary results: zero HIV infections (100% risk reduction) in cisgender women in PURPOSE 1, and only 2 infections (96% risk reduction) across the diverse PURPOSE 2 population.
How it works: You start with oral lenacapavir tablets for a loading period, then receive a subcutaneous injection (into the belly) at your provider's office every 6 months. A once-yearly formulation is currently in Phase III trials (results expected 2028).
How to get Yeztugo for free or at $0
- Uninsured, income under 500% FPL: Free through Gilead Advancing Access MAP. No SSN required.
- Commercially insured: Up to $8,000/year in copay assistance plus $100/visit for injection administration through Gilead's copay program.
- Medicaid: Covered in most states, though prior authorization may be required.
- Medicare: Covered under Part B (medical benefit) for the injection. Part D may cover oral loading doses.
Gilead Advancing Access — Yeztugo
Apply online or call 1-800-226-2056
Apretude (cabotegravir)
Apretude was the first injectable PrEP approved by the FDA. It requires an intramuscular injection (into the gluteal muscle) every 2 months after an initial loading phase of two injections given one month apart.
Clinical trials (HPTN 083 and 084) showed Apretude was superior to daily oral TDF/FTC, with approximately 89% greater risk reduction compared to the already-effective daily pill.
How to get Apretude for free or at $0
- Uninsured, income under 500% FPL: Free through ViiVConnect Patient Assistance Program.
- Commercially insured: APRETUDE Savings Program reduces copay to $0.
- Injection sites: ViiV maintains an Alternate Sites of Care (ASOC) network for injection administration.
ViiVConnect — Apretude
Savings and patient assistance programs
Yeztugo vs. Apretude: Head-to-Head
| Yeztugo (lenacapavir) | Apretude (cabotegravir) | |
|---|---|---|
| Manufacturer | Gilead Sciences | ViiV Healthcare |
| FDA approved | June 2025 | December 2021 |
| Injection frequency | Every 6 months | Every 2 months |
| Injection type | Subcutaneous (belly) | Intramuscular (gluteal) |
| Loading phase | Oral tablets, then injection | 2 injections 1 month apart |
| Efficacy | 96–100% in trials | ~89% superior to oral PrEP |
| List price/year | ~$28,218 | ~$24,000 |
| Free for uninsured? | Yes (Gilead MAP, <500% FPL) | Yes (ViiVConnect, <500% FPL) |
| $0 copay for insured? | Yes (up to $8,000/yr + $100/visit) | Yes (APRETUDE Savings) |
| SSN required? | No (Gilead MAP) | Check ViiVConnect |
| Approved populations | All adults & adolescents at risk | All adults & adolescents at risk |
Who is injectable PrEP best for?
Injectable PrEP is ideal if you find it difficult to take a daily pill consistently, value privacy (no pill bottles), travel frequently, or simply prefer fewer healthcare interactions. The 6-month Yeztugo schedule means just 2 clinic visits per year after the loading phase.
Important considerations
You still need quarterly lab monitoring. Even with injectable PrEP, you'll need HIV testing and other labs every 3 months. Some providers can coordinate this via at-home test kits.
Insurance coverage varies. Injectables are newer and more expensive, so some insurers require prior authorization. Your provider can usually handle this, but it may take a few extra days.
Descovy is not approved for vaginal sex PrEP. For people assigned female at birth at risk through vaginal sex, oral TDF/FTC or injectable options (Apretude or Yeztugo) are the approved choices.
On the horizon: once-yearly injection
Gilead is developing a once-yearly formulation of lenacapavir for PrEP. Phase III trials are underway with results expected in 2028. If approved, this would mean just one injection per year for HIV prevention.