Expanding HIV Prevention Beyond Daily Oral PrEP: The Role of Long-Acting Injectables

The language used in clinical practice to describe medication adherence may reveal underlying assumptions about patient behavior, according to Kevin Hatfield, MD, a primary care physician and family medicine physician based in Seattle, Washington. In a recent interview with Patient Care Online, Hatfield emphasized that the need to retire the term "non-compliant patient."

"We used to label patients as non-compliant because they weren't taking their pills," Hatfield said. "But it's not a character flaw. It's just human nature."

Long-acting injectable pre-exposure prophylaxis (PrEP) offers protection for two months with a single shot—and that's changing the game for patients who need HIV prevention but find it difficult to manage daily tablets. In the video above, Hatfield even explains that when he prescribes a simple week-long antibiotic course, younger patients forget doses. They do not have established medication routines, so remembering a daily HIV prevention pill becomes nearly impossible—despite their risk.

Then there's what Hatfield calls "bandwidth of worry"—that constant mental background noise of wondering if you took your pill, checking the bottle again, worrying about running out. Injectable PrEP silences all of that.

But perhaps the most overlooked barrier to daily oral PrEP adherence is privacy. "Young adults with roommates, people in family situations where they're not ready to discuss this—they need protection that doesn't require physical evidence in their living space," Hatfield said. Watch the video above for more details.

For more of our conversation with Hatfield, check out:

• Primary Care Physician Kevin Hatfield, MD, on Barriers to Daily Oral PrEP Adherence
• How Long-Acting Injectable PrEP Reshapes the Patient–Provider Relationship
• When Daily Oral PrEP Is Not the Best Fit: Lessons From Clinical Practice
• Needle Anxiety and Injection Site Pain: Evidence-Based Strategies for Patient Counseling on Injectable PrEP