Monthly or bimonthly injections of cabotegravir combined with rilpivirine demonstrated sustained viral suppression in HIV patients who struggle with daily oral medication adherence. The injectable regimen maintained undetectable viral loads in participants who had documented histories of missed doses or treatment interruptions with traditional antiretroviral therapy. This represents a significant advance in HIV management, addressing one of the most persistent challenges in achieving optimal treatment outcomes. Poor medication adherence remains a primary driver of treatment failure, drug resistance development, and HIV transmission risk. Long-acting formulations could transform care for populations disproportionately affected by adherence barriers, including those with mental health conditions, substance use disorders, unstable housing, or complex medication regimens. The injectable approach also reduces daily HIV medication visibility and stigma. However, the therapy requires healthcare infrastructure for regular injection visits and may not suit all patient preferences. While this builds on previous long-acting HIV treatment successes, targeting the adherence-challenged population specifically could substantially improve population-level viral suppression rates and reduce HIV transmission networks.