Abstract

Human immunodeficiency virus (HIV) infection remained a persistent global health challenge despite significant 
progress in antiretroviral therapy. While daily oral antiretroviral regimens have substantially improved survival 
and reduced transmission, long-term adherence difficulties continue to compromise treatment and prevention 
outcomes. Long-acting antiretroviral therapies emerged as an innovative pharmacological approach aimed at 
overcoming these limitations. This review examined the biochemical rationale, clinical efficacy, and implementation 
considerations of long-acting antiretroviral therapies for both HIV treatment and prevention. A narrative review 
methodology was utilized to synthesize and critically analyze existing scientific literature on long-acting 
antiretroviral agents, including pharmacological studies, clinical trials, and implementation research. Evidence 
indicated that long-acting antiretroviral therapies achieved virologic suppression comparable to conventional oral 
regimens while offering advantages in adherence, patient satisfaction, and prevention efficacy. Injectable long-acting 
agents also demonstrated superior effectiveness in HIV prevention compared to daily oral pre-exposure prophylaxis. 
Nonetheless, challenges related to resistance risk, healthcare infrastructure, cost, and equitable access persist. Long
acting antiretroviral therapies represented a transformative advancement in HIV care, but their optimal impact will 
depend on strategic implementation and health system adaptation.