New Study Shows Injectable HIV Treatment is Safe, Preferred, and Could Save Lives in Africa

A new study done in three African countries has found that injectable HIV treatment, Cabotegravir/Rilpivirine (CAB LA + RPV LA), administered every two months, is safe, well-tolerated, and preferred by most HIV patients. The Month-12 results from study sites in Kenya, Uganda and South Africa, offers renewed hope for adherence to HIV treatment, reduced HIV related deaths, and enhanced overall quality of life for people living with HIV.
The IMPALA study, a 24-month randomized controlled trial, was conducted in partnership with the Medical Research Council and the Uganda Virus Research Institute, which served as the coordinating center. It was sponsored by the London School of Hygiene & Tropical Medicine and funded by the Janssen Pharmaceutical Companies of Johnson & Johnson.
Despite major strides in treatment, the global HIV response remains at a crossroads. WHO estimates that in 2024, 40.8 million people were living with HIV, 1.3 million acquired HIV, and 630,000 died from HIV-related illnesses.
Currently, HIV treatment involves taking a daily pill that combines three or four medicines that work together to control the virus. This combination includes Dolutegravir (DTG), which WHO recommended in 2016 because it has fewer side effects, fewer drug interactions, and a high barrier to resistance. While this once-a-day pill revolutionized treatment and remains Kenya’s first-line regimen, daily adherence remains a persistent challenge for many people, particularly among adolescents, young adults, and marginalized populations. These challenges lead to increased hospitalizations, higher healthcare costs, and contributed to the 680,000 HIV-related deaths recorded in 2022.
UNAIDS has set 95-95-95 targets by 2030, where 95% of people who have HIV should be diagnosed, 95% of people who have HIV should be on treatment, and 95% of people who have HIV and are on treatment should be virally suppressed. However, at the end of December 2021, just 71% of people living with HIV globally were diagnosed, on treatment, and virally suppressed–far below the target.
To close this gap, researchers have been exploring simpler, more flexible treatment options, and the long-acting injectable HIV medication has been found to be among the most promising.
The IMPALA study focused on adults whose viral load had remained unsuppressed for two years despite previous antiretroviral therapy (ART)—suggesting a history of adherence challenges. The goal was to assess whether the injectable HIV treatment CAB LA + RPV LA could work for this group in sub-Saharan Africa.
According to the findings, the injectable HIV treatment was non-inferior to standard oral regimen–dolutegravir-based therapy (TLD) in African patients who had previously struggled with adherence. In other words, the injectables worked at least as well as the daily oral medication, while reducing the daily medication burden.
Dr. Loice Ombajo, an infectious disease specialist, co-director at the Center for Epidemiological Modelling and Analysis (CEMA) at the University of Nairobi, and the study’s principal investigator for Kenya emphasized the significance: “Many HIV patients in Africa struggle with taking multiple drugs, stigma, and side effects, which can make it difficult to stay on treatment and may eventually lead to resistance and treatment failure. Injectable therapy offers a promising solution—by reducing the burden of daily pills, adherence becomes easier, hence improving quality of life, and helps prevent HIV-related deaths.”
“These results show that transformation is not only possible—it’s within reach. Long acting injectables offer a real opportunity to accelerate progress toward the UNAIDS 95-95-95 targets and help people living with HIV lead longer, healthier lives. This year’s World AIDS Day theme—‘overcoming disruption, transforming the AIDS response’—calls on all of us to stay united and focused on the goal. Studies like IMPALA demonstrate how innovation can re-energize the HIV response, ensuring that no one is left behind,” she concluded.