Aditya Gaur, MD, discusses the benefits of injectable HIV therapy

In a Contemporary Pediatrics video interview, Aditya Gaur, MD, medical director at St. Jude Children’s Research Hospital, discussed the importance of offering long-acting injectable HIV treatment options for adolescents and highlighted findings from recent clinical research evaluating this approach.

Gaur emphasized that having multiple treatment options is essential for all patients living with HIV, but is particularly meaningful for adolescents, who often face unique developmental, social, and adherence challenges. The injectable regimen discussed involves 2 intramuscular injections administered once every 2 months, eliminating the need for daily oral medication.

According to Gaur, this level of flexibility and freedom is highly appealing to adolescents who may struggle with remembering to take pills every day or who feel burdened by the constant reminder of their HIV status. In the study referenced, adolescents who transitioned from lifelong daily oral therapy to injectables showed overwhelming satisfaction. Notably, 100% of participants who completed one year of injectable treatment reported a preference for injections over daily pills.

From a safety and tolerability standpoint, the results in adolescents were consistent with those observed previously in adults. The study included adolescents who were already virologically suppressed before switching to injectable therapy. No unexpected adverse effects were identified.

The most common side effect was mild injection-site pain or soreness, reported by approximately one-third of participants, which typically resolved within the first week after administration. Overall, the regimen was well tolerated and did not raise new safety concerns.

Gaur also explained how injectable treatment may substantially improve quality of life for adolescents. While taking a daily pill may seem minor, it can serve as a recurring reminder of HIV and reinforce feelings of stigma that still exist in society. Reducing treatment-related reminders to once every 2 months allows adolescents to focus more fully on school, social development, and other aspects of daily life without constant concern about medication adherence or disclosure.

Looking ahead, Gaur outlined several important directions for future research. Current data are limited to patients with well-controlled HIV, and studies are needed to evaluate injectable therapy in adolescents who struggle with adherence and have detectable viral loads. Additional research is also exploring ways to decentralize care to make injectables more accessible outside traditional clinic settings.

Finally, efforts are underway to develop even longer-acting formulations, potentially extending dosing intervals to 6 months or even 1 year. While a cure for HIV remains the ultimate goal, Gaur concludes that expanding easy-to-use treatment options offers real hope and meaningful progress for adolescents living with HIV.

No relevant disclosures.

References

1. Studies show that less frequent, all-injectable treatment for HIV is safe and preferred by adolescents. St. Jude Children’s Research Hospital. January 15, 2026. Accessed January 19, 2026. https://www.eurekalert.org/news-releases/1112878
2. Gaur AH, Baltrusaitis K, Capparelli EV, et al. Safety, antiviral activity, and pharmacokinetics of long-acting injectable cabotegravir–rilpivirine in virologically suppressed adolescents living with HIV-1 (IMPAACT 2017/MOCHA): 48-week results of a multinational, phase 1/2, single-arm study. The Lancet HIV. 2026. doi:10.1016/S2352-3018(25)00242-5