Cabenuva (injectable cabotegravir plus rilpivirine) administered by a health care provider once monthly or every other month may be a feasible option for people who can’t maintain viral suppression using daily pills due to difficulties with adherence or other challenges. The Food and Drug Administration approved Cabenuva in 2021 but only as a switch option for those who already have an undetectable viral load. A recent case series described 12 people with unsuppressed virus who started Cabenuva as salvage therapy at the University of Mississippi Medical Center. They received extensive support, including case management, telephone follow-up and transportation assistance. All achieved viral suppression within three months, and none experienced viral rebound. The mean CD4 count rose by 184. Adherence was good despite a history of poor adherence to oral meds. Based on these and similar findings, some experts suggest changing treatment guidelines to include Cabenuva for people without viral suppression when other options aren’t working.