Spain takes a historic step: injectable PrEP against HIV will be free

The Ministry of Health funds injectable pre-exposure prophylaxis. Spain is a European pioneer with this advance. The treatment prevents HIV in people at high risk. The measure seeks to facilitate access and reduce new infections.

The Spanish Government’s decision to fund pre-exposure prophylaxis (PrEP) in injectable form marks a turning point for people living in Barcelona and other cities. Free access to this preventive HIV treatment can change the reality for thousands of people at risk, especially in urban settings where incidence remains a concern.

The medicine, known as Apretude (long-acting cabotegravir), is aimed at people who do not have HIV but are at high risk of infection through sex. Spain thus becomes the first European country to include this innovation in its public health portfolio, a move that may influence prevention strategy across the city.

Injectable PrEP is administered every two months by intramuscular injection, removing the need to take a daily pill. This method facilitates adherence to treatment, especially among population groups that find it difficult to maintain an oral routine. International clinical trials have shown that long-acting cabotegravir offers superior efficacy in preventing HIV, particularly in contexts where daily consistency is difficult.

The Interministerial Commission on Medicine Prices was responsible for approving this agreement, ensuring that injectable PrEP is incorporated as a pharmaceutical benefit under conditions of equity and universal access. However, centres that provide oral PrEP in Barcelona have recently warned of long waiting lists to access the pill, adding urgency to the arrival of the new injectable option.

This measure responds to the recommendations of the World Health Organization and UNAIDS, which insist on broadening access to effective preventive strategies in order to move towards eliminating HIV. In addition to prevention, the fight against infection in the city also requires early diagnosis, antiretroviral treatment and reducing social stigma.

In Barcelona, the news may bring relief to people who have spent months waiting to access oral PrEP and see the injectable version as a more convenient and effective alternative. The challenge now will be to ensure that demand does not exceed the capacity of the centres and that access is truly universal.

Long-acting cabotegravir, marketed as Apretude, represents a new generation of preventive treatments against HIV. Its bimonthly administration responds to the need to simplify prevention among groups with difficulties maintaining daily pill-taking. In recent years, innovation in preventive therapies has been key to reducing HIV transmission in major European cities, and Spain’s commitment to injectable PrEP may set a trend on the continent.