A New HIV Prevention Option: Just Two Injections a Year
- Exploring the potential of long-acting lenacapavir
FHS Communications, Nkosiphile Ndlovu
Daily pills known as pre-exposure prophylaxis (PrEP) have helped transform HIV prevention, but they only work if people remember to take them regularly. Many at-risk individuals struggle with this, which can limit PrEP’s effectiveness.
A new option could make things much easier in HIV prevention: lenacapavir, a drug that can be given as an injection just twice a year. It has already proven effective in protecting cisgender women from HIV, but its potential for cisgender men, transgender women, transgender men, and nonbinary individuals was not clear. Until now.
Overview
This study tested how well twice-yearly lenacapavir works to prevent HIV in cisgender men and gender-diverse individuals, groups that still face high rates of new HIV infections and often have uneven access to or difficulty sticking with daily PrEP.
Participants were randomly assigned to either get a lenacapavir injection every six months or to take daily PrEP pills (a combination of emtricitabine and tenofovir disoproxil fumarate, known as F/TAF). Researchers tracked how many new HIV cases occurred in each group and monitored safety and side effects.
Key findings
Participants receiving lenacapavir had fewer new HIV infections compared to both the group taking daily PrEP and a control group that did not receive PrEP. This highlights the strong protective effect of the twice-yearly injection.
No new safety concerns were identified with lenacapavir. The most common side effect was mild reactions at the injection site, which led to a small number of people to stop treatment. Overall, both the injection and daily PrEP groups had low dropout rates and similar experiences with side effects.
The takeaway? Twice-yearly lenacapavir looks to be a highly effective and well-tolerated HIV prevention option for men and gender-diverse individuals. Its long-acting nature could help overcome the challenges of daily pill-taking and potentially change how HIV prevention is delivered going forward.
Original Article In: New England Journal of Medicine