Men who have sex with men (MSM) bear a disproportionate burden of the HIV/AIDS epidemic. Though oral pre-exposure prophylaxis (PrEP) has been available to prevent HIV in HIV-negative individuals since 2012, MSM continue to report barriers to uptake. In 2021, the U.S. Food and Drug Administration (FDA) approved injectable PrEP as a new mode of PrEP administration to prevent HIV. Using a community-based research approach, I draw from six focus groups with 24 English-speaking MSM in California to elicit salient barriers to injectable PrEP uptake. I find MSM lacked knowledge about injectable PrEP, proposed needle burdens, and raised concerns regarding accessibility, stigma, and medical mistrust in relation to this medication. I argue that the implementation of a new mode of PrEP administration presents new barriers to accessing PrEP including needle burden, vaccine administration location, and drug use relapse.