On World AIDS Day, a potential game changing HIV prevention tool stepped into the fight against HIV, with people in three southern African countries beginning to swap a daily pill for twice yearly injections.
According to a report by AFP journalist Hillary Orinde, South Africa, Zambia and Eswatini are among the first places in the world to offer lenacapavir shots as a public HIV prevention option. The drug is given as an injection every six months, and large clinical trials have shown it can cut the risk of HIV transmission by more than 99 percent when used as directed.
In the United States, the list price for a year of lenacapavir prevention runs above $28,000 which makes it cost prohibitive for most. A separate deal backed by the Gates Foundation aims to bring generic versions to more than 100 low and middle income countries starting around 2027, at an estimated price of about $40 per person per year.
For people who have tried, and struggled, to stay on daily oral PrEP, the appeal is obvious. Instead of remembering to take a pill every day, or timing doses around sex, you simply schedule two clinic visits a year for your shot. Public health experts hope that long acting tools like lenacapavir (and cabotegravir) will bring prevention within reach for even more people who have been left out so far, especially women and young people in high incidence regions.
This is undoubtedly welcome news in West Hollywood, a city and community that has lived through every chapter of the HIV story, from the worst years of the AIDS crisis to the more recent push to cut new infections and expand access to PrEP.
That said, no shot or pill, on its own, will solve the structural problems that keep people from care. We still need more testing sites, trusted healthcare providers, and systems that do not shut them out. But for those who might struggle with a daily regimen, a shot every six months could be the next game-changing tool in HIV prevention.
