Prep has existed for years in the form of a daily pill, but a newer option is changing how people think about HIV prevention. Lenacapavir, also marketed under the names Yeztugo and Sublenca, is used for patients who are HIV negative and want to avoid infection; and those who are HIV positive, specifically for those with multi-drug-resistant HIV. It was approved by the FDA in 2025 and offers protection through just two injections a year. Many people find that this rhythm feels more manageable, especially if life makes daily medication hard to remember. Early reporting through the Associated Press and clinical summaries shared by The Body Pro show strong effectiveness and positive feedback from people in studies.
In North Carolina the need for more prevention choices is real. The NC Department of Health and Human Services reports that Black adults and adolescents account for more than half of new HIV diagnoses statewide. Young adults between 20 and 34 continue to have the highest diagnosis rate. In Mecklenburg County, health officials point out that gay and bisexual men, especially men of color, experience higher diagnosis rates and lower viral suppression compared to other groups. Those numbers tell us that flexible prevention options can play a meaningful role in closing gaps.
Before deciding whether twice a year Prep is right for someone it helps to break down the basics in a simple way.
What it is…
- A long acting injectable medication given twice per year.
- Designed for people who are HIV negative and want ongoing prevention.
- Requires HIV testing before each injection to ensure safe use.
How it works…
- Two office visits a year for the injection.
- Occasional labs as part of routine monitoring.
- Strong protection shown in studies referenced by News Medical and Gilead’s published trial results.
Who may benefit most?
- People who have trouble sticking to a daily pill.
- People who prefer privacy and fewer pharmacy visits.
- Those in communities facing higher HIV risk, such as young adults or Black and Brown LGBTQ residents in North Carolina.
What can you expect to pay?
Cost is one of the most common concerns. The list price is a little over fourteen thousand dollars per injection which totals more than twenty eight thousand dollars a year before insurance or financial assistance. Traditional daily Prep can cost around twenty two thousand dollars per year. As healthcare costs rise, this difference matters. A study in JAMA Network Open found that drops in Prep access could lead to thousands of additional infections nationwide within a decade and billions in added medical expenses. This means that real access will depend on insurance coverage, state programs, local clinic capacity and education. People often want to understand the trade-offs clearly, so here is a simple comparison.
Potential advantages…
- Only two doses a year.
- High effectiveness.
- Reduces stress about forgetting daily pills.
- May support people in rural areas or places with limited pharmacy access.
- Can feel discreet and easier for people worried about stigma.
Potential drawbacks…
- High cost without insurance or assistance.
- Requires lab work and clinic visits.
- Offers HIV prevention but not protection from other sexually transmitted infections.
- Some clinics are still learning how to administer it.
- Access may vary depending on insurance, geography and provider familiarity.
The bigger picture matters too. Because North Carolina continues to face disparities in HIV rates, access to prevention that meets people where they are can make a difference. For some, this new option could be freeing. For others, the cost might feel like a barrier. Rising healthcare expenses, limited coverage networks and transportation challenges can all shape whether someone can actually receive the medication. This is why local support organizations like Regional AIDS Interfaith Network (R.A.I.N) remain so important. They help people navigate insurance, provide testing and offer emotional support for those sorting through decisions about their health.
Twice a year PrEP does not replace every other prevention method and it is not perfect. Still it offers a meaningful alternative for people who want reliable protection that fits their schedule. Anyone considering it should start with a conversation with a provider or clinic that understands PrEP, costs and eligibility. With the right guidance people can figure out what truly fits their life.
Charlotte Area Support Resources
Eastway Medical Clinic and Urgent Care, Charlotte, NC, (704) 228-3675: Prep, HIV testing, STI screenings and follow up support.
Mecklenburg County Public Health HIV and STI Program, Charlotte, NC; (980) 314-9296: Prevention services and testing for insured and uninsured residents.
RAIN Regional AIDS Interfaith Network, Charlotte, NC, (704) 372-7246: Emotional support, community programs, counseling groups and navigation services.RAO Community Health, Charlotte region, (704) 237-8793: Prep navigation, HIV and STI testing, and medical support for uninsured and underinsured patients.