Long-acting injectable medications enable people living with HIV to stop taking daily oral treatments. Currently, such injectables can be administered just six times a year. This novel therapy can be a godsend for those who’ve experienced adherence issues with their meds, including unhoused individuals, who may have nowhere to store their meds, as well as anyone with an unpredictable schedule or who travels a lot for work.

Matthew is not one of those people. In fact, after 11 years living with HIV, he rarely missed a dose. “I was really good about taking my meds,” he says. “I almost never, ever forgot. Maybe twice a year, I would have forgotten to take my pill.”

It turns out, Matthew, a Pennsylvania-native who moved to France before he tested HIV positive in 2013, was a prime candidate for injectables. That’s chiefly because after a decade on oral HIV meds, his kidneys were showing signs of strain.

“When my doctors found out the injectables would become available, they said I was a really good candidate, since I’ve been undetectable for a long time,” he says. “And if this reduces the risk to the kidneys, it’s a better choice for me. It’s probably worth dealing with some of the pain in the ass, literally, in the short term.”

Matthew is referring to the fact that injections are given in the buttocks. Although he says the first injections made him sore “for a few weeks,” he is past that discomfort and remains undaunted.

“The nurses said that some of the patients they’ve had, every time they’ve gotten the injections, the pain lasts less and less,” he adds optimistically.

But more than anything, Matthew enjoys the convenience of injectables, especially when he’s traveling. That includes a recent two-and-a-half-week trip to North America to visit New York and Montreal as well as his first road trip after starting injectables.

“We were in Spain, where meals come at irregular hours,” he explains. “So it was nice to not have to think about having a pill on me in the evening or if we were going downtown or if we were at the beach or whatever. I didn’t have to worry about any of that. So that’s the real convenience for me.”

It’s worth noting that Matthew’s husband and traveling companion, a Frenchman, has remained HIV negative throughout their relationship. 

“Indétectable = Intransmissible,” Matthew notes, uttering the French version of “Undetectable = Untransmittable” with an impeccable French accent. People who have an undetectable viral load do not transmit HIV via sex.

And, unlike many of his fellow Americans living with HIV, Matthew has access to high-quality health care paid for by the state.

“It’s nice to know that if you have a serious disease or illness, you don’t have to worry about going bankrupt just to stay alive.” Matthew adds. “When you are sick, being stressed out makes things worse. And so the fact that you don’t have to be stressed about how am I going to pay? How am I going to pay my doctor’s bills, etc. It’s a literal nonissue.”

Nearly a year into his experiment with long-acting injectables to manage his HIV, Matthew is already looking forward to formulations administered only twice a year. “I would welcome that with open arms,” he said.