What Is Yeztugo? Who Can Get It and What It Costs
Yeztugo (lenacapavir) is a twice-yearly HIV PrEP shot. Find out who can get it, how the subcutaneous injection works and what it costs in 2026.
By Mpact Global12 min read
Taking a pill every day is hard for a lot of people. Missed doses leave gaps in HIV protection, and for some people a daily bottle of pills brings stigma or privacy worries at home.
Yeztugo is a prescription HIV prevention injection that a healthcare provider gives twice a year. Here's who can get it, how it's given and what it costs, in the United States and beyond.
What is Yeztugo?
Yeztugo is the brand name for lenacapavir, made by Gilead Sciences. The U.S. Food and Drug Administration (FDA) approved it in June 2025 for HIV pre-exposure prophylaxis, usually called PrEP.
PrEP means taking HIV medicine before a possible exposure to lower the chance of getting HIV. According to the official prescribing information, Yeztugo is approved to reduce the risk of sexually acquired HIV-1 in adults and adolescents who weigh at least 35 kg (about 77 pounds) and are at risk for HIV.
Three points matter from the start:
Yeztugo is for people who do not have HIV. It is not approved to treat HIV.
It is not a vaccine. It's a long-acting medicine that has to be repeated every 6 months.
It does not protect against other sexually transmitted infections (STIs) such as syphilis, gonorrhea or chlamydia.
Lenacapavir is also sold under the brand name Sunlenca, which is used to treat HIV in certain people. Sunlenca and Yeztugo contain the same active ingredient but are approved for different purposes and are not interchangeable.
Why Yeztugo matters for gay, bisexual and queer communities
Gay and bisexual men have carried a disproportionate share of the HIV burden since the epidemic began, and Yeztugo was tested directly in these communities. The PURPOSE 2 trial enrolled cisgender men, transgender women, transgender men and gender nonbinary people who have sex with men. According to the prescribing information, 22% of participants identified as gender-diverse.
The twice-yearly schedule may help people who struggle with daily pills. The CDC notes that less frequent dosing could improve how consistently people stay on PrEP. For some people it also means no pill bottle at home and fewer pharmacy trips, which matters where privacy is a concern.
Access is the open question. Mpact's 10-Year PrEP Report found that PrEP improved health and quality of life for people who could get it, while deep gaps remained for many others. Some of Mpact's partners, including Lighthouse in Vietnam, are already raising awareness of injectable PrEP among young men who have sex with men.
Mpact is an advocacy organization. It doesn't prescribe, supply or pay for Yeztugo. The sections below point to the providers and programs that do.
How does Yeztugo work?
Lenacapavir is a capsid inhibitor. The capsid is the protein shell that protects HIV's genetic material. Lenacapavir binds to that shell and blocks several steps the virus needs to copy itself, which stops HIV from taking hold if it enters the body.
The long protection comes from how the drug is given. After a subcutaneous injection, lenacapavir forms a small drug store (a depot) under the skin and releases slowly into the blood over months. That slow release is why one round of injections lasts about 6 months.
The drug can also stay in the body for 12 months or longer after the last injection, which matters if you ever stop.
In the two large clinical trials behind the approval (PURPOSE 1 and PURPOSE 2), Yeztugo cut new HIV infections sharply compared with daily Truvada pills. PURPOSE 1 enrolled young cisgender women in South Africa and Uganda and recorded zero infections in the Yeztugo group. PURPOSE 2 enrolled cisgender men, transgender people and gender nonbinary people who have sex with men, across 7 countries including the U.S. and Brazil, and recorded 2 infections among 2,179 people on Yeztugo. The label still states that Yeztugo is not always effective, and the time it takes to reach full protection is unknown.
Yeztugo at a glance
This table sums up the key facts from the FDA-approved prescribing information (revised August 2026). Your own plan may differ, so check details with your provider.
Detail | What the label says |
Brand name | Yeztugo |
Generic name | Lenacapavir |
Made by | Gilead Sciences |
Approved use | HIV PrEP to lower the risk of sexually acquired HIV-1 |
Who it's for | Adults and adolescents at risk for HIV who weigh at least 35 kg |
How it's given | Subcutaneous injection (under the skin) in the belly or thigh, plus tablets at the start |
How often | 2 injections every 6 months after a 2-day start |
HIV test needed | Yes, before starting and before every injection |
Treats HIV? | No |
Protects against other STIs? | No |
Who can get Yeztugo?
In the U.S., Yeztugo is approved for adults and adolescents who weigh at least 35 kg, are at risk for HIV and test HIV-negative before starting. There's no upper age limit on the label, and it isn't limited to one gender or sexual orientation.
The Centers for Disease Control and Prevention (CDC) backs it too. In September 2025 the CDC strongly recommended lenacapavir as a PrEP option for anyone weighing at least 35 kg who would benefit from PrEP. It also tells providers to talk about PrEP with all sexually active adults and adolescents, and to prescribe it to anyone who asks.
The label describes HIV risk broadly. Examples include sex without condoms, a past or current STI, having partners whose HIV status or viral load you don't know and sexual activity in a network or area where HIV is common. You can also simply tell your provider you feel at risk.
Yeztugo is not right for someone who:
Already has HIV or doesn't know their HIV status
Can't commit to HIV testing and an injection visit every 6 months
Weighs less than 35 kg
Pregnant and breastfeeding people were studied in PURPOSE 1, and the label did not find a drug-related risk to pregnancy, though the numbers were small. Anyone pregnant, planning a pregnancy or breastfeeding should go over this with their provider.
Insurers can also set their own rules. For example, one Georgia Medicaid plan requires members to be at least 16 and not a good fit for daily PrEP pills before it approves Yeztugo. Ask your plan what it requires.
Here are the main eligibility checks under the U.S. label and CDC guidance. Rules in other countries can differ.
Check | What's required | Next step |
HIV status | Confirmed HIV-negative before the first dose | Get an HIV test at your clinic, ideally on the day you start |
Ongoing testing | A negative HIV test before every injection | Book each 6-month visit with testing included |
Body weight | At least 35 kg (77 lb) | Your provider records this at the first visit |
HIV risk | At risk of getting HIV through sex | Talk openly with your provider about your sexual health |
Other medicines | Some drugs change lenacapavir levels | Bring a full list of medicines and supplements |
Insurance rules | Some plans need prior authorization | Ask your provider to check before your first visit |
How is Yeztugo given?
Yeztugo starts with a 2-day schedule that mixes injections and tablets, then moves to injections every 6 months. A healthcare provider gives every injection. You can't inject Yeztugo yourself.
Day 1: You get 2 subcutaneous injections (just under the skin, usually in the belly) and take 2 tablets by mouth.
Day 2: You take 2 more tablets at home, with or without food.
Every 6 months after that: You go back for 2 more injections, within 2 weeks either side of the 26-week mark, plus an HIV test each time.
The current label allows the thigh as an alternative to the belly. Each injection is 1.5 mL, and both are needed for a full dose.
If you know you'll miss an injection by more than 2 weeks (travel, for example), call your provider first. The label allows 1 Yeztugo tablet once a week as a short-term bridge for up to 6 months until injections restart. If more than 28 weeks pass with no injection and no bridging tablets, you start again from Day 1.
What does Yeztugo cost?
In the U.S., Yeztugo's list price is about $28,000 a year. With insurance or assistance, many people pay much less, and some pay nothing for the drug itself.
Gilead set the launch list price at $28,218 per year in June 2025. Reports from 2026 still cite roughly $28,000. In October 2026, Drugs.com listed the cash price at about $14,189 for one injection dose (2 vials) and about $2,371 for a bottle of 4 starter tablets. These are cash prices without insurance. They change over time and vary by pharmacy.
The list price is what the drug costs before insurance, discounts and assistance. Your out-of-pocket cost is what you actually pay, and it depends on several things:
Cost factor | What you should know |
List price | About 28,000ayearintheU.S.(28,218 at launch, June 2025) |
Insurance | Coverage depends on your plan and its drug list (formulary) |
Out-of-pocket costs | Copays, coinsurance and deductibles vary by plan |
Clinic and lab fees | Injection visits and HIV tests may be billed on their own |
Gilead copay program | Up to $8,000 a year for eligible commercially insured patients |
Free drug program | Possible for eligible uninsured people with lower incomes |
Does insurance cover Yeztugo?
Many U.S. plans now cover Yeztugo, but not all of them. Coverage grew slowly after launch because of the price. CVS Caremark first left it off its standard drug lists, then added it in January 2026 after a deal with Gilead. A 2026 report noted that Optum was still keeping it off its formulary over cost, while Gilead said coverage had passed 85%.
Even when a plan covers Yeztugo, it may require prior authorization. That means your provider sends paperwork showing you meet the plan's rules before the plan pays. Some Medicaid plans cover it, often with prior authorization.
Before your first appointment, call the member number on your insurance card and ask:
Is Yeztugo on my plan's formulary?
Is it covered under my pharmacy benefit or my medical benefit?
Do I need prior authorization?
What will I pay for the drug, the injection visit and HIV testing?
Is financial assistance available?
Yes, through Gilead's Advancing Access program (1-800-226-2056), with limits on who qualifies.
If you have private or employer insurance: the co-pay savings program covers up to $8,000 in cost-sharing per calendar year, including up to $100 per visit for the injection. It's for U.S. residents only. People on Medicare, Medicaid, TRICARE, the VA or other government programs can't use it. Gilead can reduce or end the help if your plan uses "accumulator" or "maximizer" programs, and it can change the terms at any time.
If you have no insurance: Gilead's Medication Assistance Program may provide the drug at no cost to eligible people. Drugs.com lists the income limit as at or below 500% of the federal poverty level, for U.S. residents. Approval isn't guaranteed, so call Advancing Access to check.
Local HIV prevention programs, community health centers and state PrEP programs may also help with visit and lab costs. What's available depends on where you live.
What about outside the United States?
Everything above applies to the U.S. only. Yeztugo's approval, price and assistance programs differ in every country, and in many places it isn't registered yet.
In September 2025, Unitaid and the Gates Foundation announced deals with Indian drugmakers Hetero and Dr. Reddy's to supply generic lenacapavir for about $40 a year in 120 low- and middle-income countries, starting in 2027. Until then, Gilead is supplying branded lenacapavir through the Global Fund and PEPFAR in some countries. South Africa, for example, planned to start its rollout in April 2026.
Advocates have pointed out that many high-HIV countries fall outside the licensing deal, including some middle-income countries. If you live outside the U.S., your national health ministry, a local HIV clinic or a community organization is the best place to ask about availability.
For community organizations pushing for lenacapavir in national programs, Mpact's Global Fund Toolkit explains how key populations can take part in Global Fund decisions. Its PrEP demand training curriculum covers barriers to PrEP for gay and bisexual communities and how PrEP pricing is set.
What should you know before getting Yeztugo?
The biggest safety rule is regular HIV testing. Yeztugo carries an FDA boxed warning: if someone has HIV and doesn't know it, using Yeztugo alone can lead to drug-resistant HIV that's harder to treat. That's why you'll be tested before you start and before every injection.
Tell your provider if you've had flu-like symptoms (fever, tiredness, rash, sore throat, swollen glands) in the past month. These can be signs of a very recent HIV infection that some tests miss.
Common side effects
The most common side effects in the trials were injection site reactions, headache and nausea. Most people get some reaction where the shot goes in. It may include:
A lump or bump under the skin (nodule), reported in about 63% to 64% of trial participants
Pain, swelling, redness or itching
Hardened skin
Most reactions were mild or moderate. The lumps come from the drug depot, can last for months and may be felt more than seen. Rarely, an injection given into the skin instead of under it has caused serious skin damage, which is one reason a trained provider must give it.
Other things to raise with your provider
Other medicines: Some drugs, including certain seizure and tuberculosis medicines, lower lenacapavir levels. Yeztugo can also raise levels of some other drugs for up to 9 months after your last shot. Share a full list, including supplements.
Pregnancy and breastfeeding: Small amounts pass into breast milk. Talk through your plans with your provider.
Stopping Yeztugo: The drug fades slowly and can stay in your body for a year or more. If you stop but still need protection, the label advises starting another PrEP option within 28 weeks of your last injection to avoid a gap.
Other STIs: Yeztugo doesn't prevent syphilis, gonorrhea, chlamydia or other STIs. Condoms and regular STI testing still matter.
Useful questions to bring to your appointment:
Is Yeztugo a good fit for me compared with daily pills or other injectable PrEP?
What HIV test will you use before each injection?
Will any of my current medicines interact with it?
What happens if I need to travel or miss my 6-month visit?
What will my visits, tests and the drug cost under my plan?
Frequently asked questions
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