Injectable PrEP (Cabotegravir): The Long-Acting Option Now Available in Bangkok

Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician, Doctor Bangkok. Last reviewed: August 2026

If you have been on daily oral PrEP and find yourself skipping doses, losing pills during travel, or just tired of the daily routine, you are not alone. I hear this from expats every week. Injectable PrEP is what a lot of people in Bangkok have been waiting for.

Cabotegravir long-acting injectable, or CAB-LA, became available through licensed private providers in Thailand in early 2025. It is one injection every two months. No daily pill, no pharmacy runs, no dose-counting. For medical tourists, frequent travellers, and expats with irregular schedules, that matters. Here is what you need to know before booking your first appointment.

What Is CAB-LA and How Is It Different from the Pill

The injectable version, Apretude, is given as a slow-release injection into the muscle of your buttock. The drug stays active in your body for weeks. That is why two-monthly dosing works.

The pill you may already know, TDF/FTC sold as Truvada or generic equivalents, has to be taken every single day to stay effective. CAB-LA removes that daily commitment entirely. For people who struggle with adherence, that is not a small thing.

How Effective Is It

Very. Two large clinical trials, HPTN 083 and HPTN 084, compared CAB-LA against daily oral TDF/FTC. HPTN 083 followed gay and bisexual men and transgender women. HPTN 084 followed cisgender women. In both trials, CAB-LA outperformed daily oral PrEP, and the difference in HPTN 083 was statistically significant.

The reason it outperformed is straightforward. People received every dose because there was nothing to remember. That is the real-world advantage, and it is the most important thing to understand about why this option exists.

The Dosing Schedule

Your first injection is on day one. Your second injection comes four weeks later, not two months. This loading phase builds drug levels in your system quickly. After that, you come in every two months.

If you are more than seven days late for a scheduled injection, do not just show up and get the shot. Come in, get tested, and talk to the doctor first. You may need to bridge with oral PrEP until your next injection. Missing an injection is not the same as missing a pill. The protection window does not simply stretch.

What Tests Do You Need Before Starting

I will not start anyone on injectable PrEP without the right pre-screening. This is not box-ticking. It is genuinely important.

You need a confirmed HIV-negative result, and it needs to be recent. We use a fourth-generation HIV test, which picks up both the virus itself and your antibody response. If you had a risk event recently, we need to factor timing in before starting. We also check your hepatitis B status, because TDF/FTC (the oral pill) also treats hepatitis B and CAB-LA does not. Switching to injectable PrEP without covering hepatitis B first can cause problems. We run kidney function tests and a full STI screen as well. A confidential sexual health screen at Doctor Bangkok covers the full panel in one visit.

Injectable PrEP vs Oral PrEP: Which One Is Right for You

This depends on your life, not on which drug is theoretically better.

Oral PrEP, including on-demand 2-1-1 dosing, is still the right choice if you want flexibility, lower cost, or only need protection occasionally. Generic TDF/FTC is affordable in Thailand and works very well when taken correctly. Injectable PrEP makes more sense if your travel schedule makes pill routines fall apart, if pill burden affects your mental health, if you have privacy concerns about keeping pills at home, or if your past adherence to oral PrEP has been poor. It costs significantly more per cycle than generic oral PrEP. That is a real consideration. But for the right person, it is worth every baht.

Stopping Injectable PrEP: The Part Nobody Tells You

This is the section I wish more Bangkok clinics would publish.

When you stop CAB-LA, the drug does not leave your body straight away. Cabotegravir lingers in your tissues for up to 12 months after your last injection, slowly dropping to levels that are too low to protect you fully. During this period, if you were to acquire HIV, the low-level drug in your system could push the virus to develop resistance to an important class of HIV treatment drugs. This is not a theoretical risk.

Current guidance recommends transitioning to 12 months of oral TDF/FTC after your last CAB-LA injection to cover this period. You do not just stop coming for appointments. If you are thinking about stopping injectable PrEP for any reason, talk to a doctor first. We handle this regularly at Doctor Bangkok and can map out a safe transition.

Who Should Not Use Injectable PrEP

CAB-LA is not suitable for everyone. The clearest reason not to use it is active HIV infection. Starting PrEP when HIV is already present but undetected can drive drug resistance. This is exactly why careful pre-start testing matters.

If you are currently being treated for tuberculosis with rifampicin, you cannot use CAB-LA. Rifampicin is the standard first-line TB drug used across Southeast Asia including Thailand, and it significantly reduces cabotegravir levels in the blood. If you have any history of TB treatment or are being assessed for TB, tell your doctor before starting. CAB-LA is approved for adults and adolescents weighing at least 35 kg, and it is suitable for people of any gender or sexual orientation. The HPTN 084 trial specifically showed strong protection for cisgender women.

Side Effects

The most common side effect is injection site pain, swelling, or a lump in the buttock. This is reported by the majority of patients in trials, but it typically settles within a few days. It is uncomfortable, not dangerous.

Some patients report headache, fatigue, or dizziness in the first day or two after an injection. These are mild and short-lived. Serious adverse events are rare based on current trial and post-marketing data.

What About Lenacapavir: The Six-Monthly Option

Lenacapavir is a different long-acting injectable that works every six months. Trial data from the PURPOSE 1 and PURPOSE 2 studies showed remarkable results, and it is now approved in some countries.

Lenacapavir is not yet widely available through private providers in Bangkok at the time this article was written. If that changes, we will update this page. For now, cabotegravir remains the long-acting injectable PrEP option you can access here.

Injectable PrEP at Doctor Bangkok: What to Expect

At Doctor Bangkok, we offer injectable PrEP consultations with English-speaking doctors. The process starts with a consultation and full pre-start testing: HIV, hepatitis B, kidney function, and STI screening. If all results are clear, we schedule your first injection.

We are centrally located in Bangkok and accessible by BTS. Most patients see us for the loading dose, return at four weeks, then every two months. If you travel frequently, we can work around your schedule and discuss bridging options if you will be outside Bangkok near an injection date. You can also ask us about DoxyPEP, an antibiotic taken after higher-risk sexual encounters to reduce STI risk, as part of a broader sexual health plan. If you are currently on oral PrEP and thinking about switching, book a consultation. Switching is straightforward but needs to happen in the right order, and we will walk you through it.

FAQ

Is injectable PrEP cabotegravir available in Bangkok right now?

Yes. CAB-LA (Apretude) has been available through licensed private providers in Thailand since early 2025. It is not currently available under the Universal Coverage Scheme and is a private-pay service. Doctor Bangkok offers it with English-speaking doctor consultations and full pre-start testing.

What happens if I miss my two-month injection or I am late?

There is a seven-day window on either side of your scheduled date. If you are within that window, come in and get the shot. If you are more than seven days late, you need to see a doctor first, get tested, and potentially bridge with oral PrEP before your next injection. Do not skip a cycle and come back the following month.

How do I stop using injectable PrEP safely?

You cannot simply stop showing up for appointments. Cabotegravir stays in your body at low levels for up to 12 months after your last injection, and during that time it can no longer fully protect you but may still be present in enough concentration to cause drug resistance if you acquire HIV. Most guidelines recommend 12 months of oral PrEP after your last injection to cover this period. Talk to a doctor before stopping.

Can women use injectable PrEP, or is it mainly for gay men?

Anyone can use it. The HPTN 084 trial specifically tested CAB-LA in cisgender women and showed strong protection. CAB-LA is approved for adults and adolescents of any gender or sexual orientation weighing at least 35 kg. The one exception to discuss with your doctor is current rifampicin-based TB treatment, as there is a significant drug interaction.

How does the cost compare to daily oral PrEP in Bangkok?

Injectable PrEP costs significantly more per month than generic TDF/FTC oral PrEP, which is widely available and affordable in Thailand. The trade-off is fewer clinic visits, no daily pill burden, and better real-world adherence. Doctor Bangkok can help you weigh cost against your individual risk profile and lifestyle.

I travel a lot and will be outside Bangkok near my injection date. What do I do?

Talk to us before your trip. If your next injection falls within seven days of your scheduled date, we can sometimes adjust timing. If the gap will be longer, we will prescribe bridging oral PrEP to keep you covered. Planning ahead is essential with injectable PrEP.

Do I still need to use condoms if I am on injectable PrEP?

CAB-LA protects very effectively against HIV when used on schedule, but it does not protect against other STIs such as gonorrhoea, chlamydia, syphilis, or herpes. Condoms remain the best protection for those. Regular STI screening every three months is also recommended for anyone on PrEP.