Advantages Disadvantages
Improved adherence

•Decrease in pill intake exhaustion

•Improved consistency in drug intake

•Decrease in virologic failure

Pain, erythema, nodule formation at site injection
Reduced hepatic, GI and renal toxicity from first pass metabolism Need for competent injection technique and for trained health care workers
Early detection of non-adherence with lower rates of virologic failure Long periods of low drug concentration if injection is missed, likely leading to high risk of resistance
Reduced uncertainty about adherence to cART Longer time to maximum concentration (can be dealt with oral lead in period)
Improved bioavailability Potential for development of resistance when doses are missed
Decreased overall drug exposure Difficulty with withdrawal of drug in the event of toxicity
Lower dose API are typically more suitable for , which could lead to potentially reduced costs of ARVs in resource limited settings Need for increased clinic visits with monthly injections versus quarterly visits for stable ART patients on oral medications
Increased patient confidentiality in situations where stigma or discrimination might exist Improved cost with lesser need for active ingredient
Can be considered for PreP use Use as a PreP option could potentially lead to resistance given subtherapeutic levels if HIV is acquired
Nanoemulsions can be injected with reduced volume Manufacturing of antibodies can be costly
Possibility for painful subcutaneous or subdermal implantation Missing a dose may lead to longer coverage-free periods compared to oral doses
Much shorter tail of drug exposure in cases where loss-to-follow-up occurs  
Table 2: Advantages and Disadvantages of Long-Acting Arvs.