On November 9, 2025, health authorities in Northern Ireland confirmed a significant step forward in the fight against HIV: the rollout of a long-acting injection, cabotegravir (CAB-LA), designed to prevent HIV transmission. This announcement aligns Northern Ireland with the rest of the United Kingdom, where the injection has already been approved in England, Wales, and Scotland, marking a new chapter in public health efforts to curtail the spread of the virus.
The cabotegravir injection, administered every two months, offers an alternative to the daily oral HIV prevention pill known as PrEP (pre-exposure prophylaxis). For many, the pill regimen has been effective, but it’s not always practical or accessible. Some individuals find it difficult to adhere to a daily schedule, whether due to personal routines, concerns about privacy, or more pressing issues like homelessness. According to BBC, the introduction of the injectable form is expected to address these barriers, making HIV prevention more convenient and discreet for those who need it most.
The National Institute for Health and Care Excellence (NICE) has issued final guidance on administering cabotegravir, and the Northern Ireland Department of Health (DoH) has begun the formal process to endorse these recommendations. While the exact date for when the injections will become available is still unknown, the move has been met with widespread support from advocacy groups and healthcare professionals alike.
Scott Cuthbertson, chief executive of The Rainbow Project, Northern Ireland’s leading LGBT health organization, called the new injection a “game-changer.” In his words, “For those who can’t take or struggle with current HIV prevention methods, it adds a further option in the growing arsenal of preventative medication.” Cuthbertson emphasized that “providing more accessible options for HIV prevention brings us one step closer to [the] goal” of ending new HIV cases by 2030—a target to which Northern Ireland has officially committed.
The impact of this new option could be considerable. According to The Rainbow Project, between 1,000 and 2,000 people are currently living with HIV in Northern Ireland, and approximately 50 new transmissions occur each year. These numbers, while lower than in some other regions, underscore the continuing need for effective prevention strategies. The hope, shared by many in the community, is that the new injection will help drive these figures down even further.
Jacquie Richardson, CEO of the HIV charity Positive Life, echoed the sense of optimism but also issued a note of caution. “Any healthcare innovation which empowers people to proactively look after their sexual health must be supported and actively promoted. This new injection will make seeking and taking the drug much more straightforward,” she told BBC. However, she added that there is still a need for “a sharper focus on HIV prevention in Northern Ireland,” calling for a “focused and adequately funded effort” to ensure that the benefits of these medical advances are fully realized.
While the science behind HIV prevention has advanced rapidly in recent years, practical challenges remain. The oral form of PrEP, introduced in Northern Ireland in 2018, has helped many people reduce their risk of contracting HIV. But as Alexa Moore from The Rainbow Project explained to The Irish News, “PrEP is not accessible to all.” She noted that the new injection could be particularly helpful for people who are homeless or who struggle with routines, such as taking tablets daily or difficulties swallowing medication. “So this could potentially be a game changer for prevention,” Moore said.
Stigma, however, continues to cast a long shadow over HIV prevention efforts. “The problem is maybe people not wanting to go to get tested or to be aware of their status and maybe people just don’t know about PrEP,” Moore observed. She reflected on the dramatic shift in public perception over the past several decades: “If we look back to 40-50 years ago, back then it [HIV] was a death sentence. Now, people live happy, healthy and long lives, living with HIV.”
Reducing stigma and increasing awareness are seen as crucial next steps. Cuthbertson, for his part, stressed that “more work must be done, particularly in the area of education on HIV prevention and treatment, reducing stigma, and increasing the uptake of sexual health testing.” The Rainbow Project has been at the forefront of these efforts, working to improve the physical, mental, and emotional health and well-being of lesbian, gay, bisexual, and transgender people in Northern Ireland.
The introduction of cabotegravir is not just about making medication easier to take; it’s about broadening the reach of HIV prevention to those who might otherwise fall through the cracks. For some, taking a daily pill is a manageable routine. For others, it’s a daily reminder of stigma, or simply not practical given their living conditions. The new injection, taken every two months, could provide a lifeline for these individuals.
There’s a sense of renewed energy and hope within the community. Moore described the mood as “really excited,” saying, “It has really energised and animated the community and particularly those at a high risk… we could end new HIV transmissions for 2030 and that’s an exciting prospect.”
Of course, the rollout is only the beginning. The Department of Health’s endorsement of NICE’s guidance is a critical procedural step, but the real challenge will be ensuring that the injection is accessible to everyone who needs it. This means not only funding and logistical planning but also ongoing public education to combat misinformation and encourage uptake.
Experts and campaigners agree that the new injection is a powerful tool in the fight against HIV, but it’s not a silver bullet. As Richardson of Positive Life pointed out, “This new injection will make seeking and taking the drug much more straightforward,” but it must be accompanied by a broader, well-funded strategy to tackle the epidemic from all angles.
With Northern Ireland joining the rest of the UK in offering cabotegravir injections, there’s a palpable sense of progress. The hope is that, by making HIV prevention more accessible and less stigmatized, the region can move closer to the ambitious goal of ending new HIV transmissions by 2030. The journey isn’t over, but with each new option and every new conversation, that goal comes a little closer into view.
