In July 2024, results from the PURPOSE 1 trial showed that a six-monthly injection of Lenacapavir was 100% effective in preventing HIV among women, a groundbreaking finding for advancing HIV prevention.
Now, Gilead, the company that developed the drug, informed that a second study found similarly high efficacy of Lenacapavir. The PURPOSE 2 trial included cis gender men, transgender men, transgender women, and gender-diverse individuals. According to the company press release, out of 2,180 participants who received the six-monthly injection, only two acquired HIV. This means that HIV incidence was 96% lower than the background HIV incidence in this population.
These results on long-acting injectable prevention mark a critical step forward in HIV prevention. “This innovation addresses one of the significant barriers to adherence—daily pill use—and could transform HIV prevention efforts globally” says Angeli Achrekar, Deputy Executive Director Programmes, UNAIDS. “We welcome these developments of additional prevention options, that can increase choice for people in need of HIV prevention, if we make these new options available equitably and at scale”, she says.
Lenacapavir is a new type of HIV prevention medication currently being tested in several studies. It works by blocking the virus at multiple stages of its life cycle, offering a long-acting solution for people who want to reduce their risk of acquiring HIV. Daily pills have been the standard for pre-exposure prophylaxis (PrEP) and found to reduce HIV incidence substantially if taken. Lenacapavir is administered just twice a year, making it a convenient alternative for people who find it challenging to adhere to daily medication.
These results underscore the critical need for more HIV prevention options becoming available. Mitchell Warren, co-chair of the Global Prevention Coalition and Executive Director of AVAC, says that” innovative tools like lenacapavir must be made accessible with speed, scale and urgency to those who need them most, especially in regions with high HIV incidence”.
The Global HIV Prevention Coalition, which is co-convened by UNAIDS and UNFPA, looks forward to the release of full results from PURPOSE 2. The Coalition calls for rapid and thorough guidelines and approval processes to make new long-acting options available – along-side existing PrEP options, condoms, contraceptives, harm reduction and other effective HIV and sexual health services for women and men in settings with high HIV as well as key populations.
As the world recorded 1.3 million new HIV infections in 2023 – three times more than the global target – the Global HIV Prevention Coalition will work across partners to ensure long-acting HIV prevention options become available, affordable and accessible to key and priority populations in countries as part of an overall new push to accelerate HIV prevention.