A new type of long-acting injectable PrEP for HIV prevention, Yeztugo® (drug name: lenacapavir), was recently approved by the FDA. Yeztugo® has been making major headlines for one simple reason: it effectively prevents HIV with just two injections per year.
If you've seen Yeztugo® in the news, it might be the first time you've heard about long-acting injectable PrEP. However, Yeztugo® isn't the only injectable PrEP out there — Apretude® (drug name: cabotegravir), another form of injectable PrEP, has been available since 2021. Yet Apretude has not seen widespread uptake, and daily oral PrEP pills remain by far the most commonly prescribed form of PrEP.
Despite that, there is a high level of optimism from the healthcare community that Yeztugo® will find more mainstream adoption. What's different about Yeztugo® that's drawing so much attention?
Yeztugo® & Apretude®: What's the Difference?
First, let's cover what's the same: the medications in both Yeztugo® and Apretude® were both previously approved for use in treatment of HIV-positive patients, under different formulations and brand names (Sunlenca® and Cabenuva® respectively) and always in combination with other drugs. What's changed is that both medications are now also approved for use as PrEP to help prevent HIV.
Yeztugo® and Apretude® are completely different medications, but the primary differences for patients are how often doses are required (Yeztugo® requires less frequent doses), and how those doses are injected.
Required Dosing
- Yeztugo®: One injection every six months.
- Apretude®: One injection every two months (plus an additional injection after the first month).
While both Yeztugo® and Apretude® are considered to be long-acting due to the length of time their doses remain effective, Apretude® requires 3x the number of doses per year that Yeztugo® requires to provide protection over the same period of time.
This one difference is the major reason why Yeztugo® is generating so much buzz. Adherence to dosing schedules is essential for PrEP to provide protection, and while Yeztugo’s twice-yearly dosing schedule may help some people stay on track, it is still critical to follow the prescribed injection timeline exactly. Talk to a healthcare provider to see if this option is right for you.
How Doses Are Injected
- Yeztugo®: Delivered by a subcutaneous (just beneath the skin) injection in the abdomen or thigh.
- Apretude®: Delivered by an intramuscular injection directly into the buttock muscle.
Both Yeztugo® and Apretude® can have side effects occur around the injection site, detailed below.
Common Side Effects
All types of PrEP — whether injectable or oral pills — can cause some side effects, which typically clear up on their own within days or weeks. These include:
- fever
- headache
- fatigue
- muscle, bone, or back pain
- nausea
- diarreha
- difficulty falling or staying asleep
- dizziness
- weight gain
For injectable PrEP specifically, there may be some pain or discomfort around the site of the injection. The level of pain or discomfort may vary depending on the type of injection and the individual. Some people might find intramuscular injections (like Apretude®) to cause more discomfort than subcutaneous injections (like Yeztugo®), or vice versa.
Yeztugo® has one unique side effect around the site of injection: it can leave a small, painless bump, which may be more visible on people with low body fat. This bump is where the medication itself is stored as it is released into the body over a long period of time (hence, long-acting injectable PrEP). While it’s painless and harmless, some people may simply dislike the bump.
This is not a complete list of side effects, and different people may react to the same medication differently. In rare cases, some individuals may experience more severe side effects. Talk to a healthcare professional about potential side effects of taking PrEP, or if you ever have concerns about side effects you’re experiencing.
Efficacy
Yeztugo® and Apretude® are both considered highly effective at preventing HIV when taken exactly as prescribed. They have never been directly compared so it is not possible to claim one is more effective than the other at this time.
While Yeztugo® and Apretude® can both be used by all genders and body types, Yeztugo® is the first form of PrEP shown to be 100% effective in a clinical trial with cis women.
It’s important to note that daily oral prep pills are also just as effective as injectable PrEP when taken as prescribed. The key phrase is as prescribed: in clinical studies, injectable PrEP is shown to be more effective than oral PrEP pills in large part due to oral PrEP users more frequently missing doses, i.e. not taking the pill every day. Some people may find the less frequent dosing schedule of injectable PrEP more manageable.
Want to know more about how Yeztugo® works?
Check out our complete explainer on Yeztugo® →
Cost
Let’s cover out-of-pocket costs for injectable PrEP. This is the cost of the drug as sold, without considering any health insurance coverage or financial assistance.
- Yeztugo®: ~$28,000 per year (~$14,000 per dose)
- Apretude®: ~$24,000 per year (~$4,000 per dose)
Yeztugo® costs about 17% more than Apretude® does out-of-pocket.
Due to the high costs currently associated with injectable PrEP, many people will rely on health insurance or financial assistance programs to access it. Coverage can vary depending on your plan and location, and not all insurers currently cover every form of injectable PrEP. A healthcare provider or PrEP navigator can help you explore options based on your situation.
Apretude® has been on the market for several years, and is covered by many major insurance providers. However, getting it covered may require communication from your doctor explaining what makes it a better fit for you than oral PrEP.
Yeztugo® is very, very new — it was just approved by the FDA in June 2025. That means many insurance providers do not currently cover it, although this will likely change in the near future. As soon as there’s more information on coverage for Yeztugo®, you’ll find it here.
Should I Wait for Yeztugo®?
Overall, Yeztugo® (lenacapavir) provides the same high level of protection against HIV as Apretude® (cabotegravir), with less frequent doses. Both forms of injectable PrEP have extremely similar side effect profiles.
However, Yeztugo® costs more, and is not yet widely covered by insurance providers. Many healthcare providers cannot yet access the drug to prescribe. This could make accessing Yeztugo® difficult until it is more broadly covered and distributed, which we expect to see later in 2025.
If you’re interested in injectable PrEP, here are your current options:
- Start with Apretude® first. For most people, Apretude® will likely be easier to access than Yeztugo® for some time. Even if you want to switch to Yeztugo® later when it becomes more widely available, you can start with Apretude® now. A healthcare provider can help determine the right option for your needs.
- Start with oral PrEP pills, and switch to injectable PrEP later. Oral PrEP pills are much more widely accessible today. When taken as prescribed, they’re just as effective as injectable PrEP. And you can switch from oral PrEP to injectable PrEP — either Yeztugo® or Apretude® — at any point down the line.
Some people may be inclined to wait for Yeztugo® before starting PrEP at all. However, this will mean that you aren’t protected against HIV while you wait to start, while there could be more accessible PrEP options available to you right now — potentially for free, depending on your coverage and location.
Freddie is actively working to make Yeztugo® accessible to patients as soon as possible. Freddie already provides access to Apretude® and oral PrEP pills.
If you think you’re at risk of HIV and that PrEP could be right for you, the most important thing to do is contact a healthcare professional to discuss your options, so you can start protecting yourself as soon as possible.
Yeztugo® and Sunlenca® are registered trademarks of Gilead Sciences, Inc.
Apretude® and Cabenuva® are registered trademarks of ViiV Healthcare.
