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The Food and Drug Administration has approved a twice-yearly preventive HIV shot that could protect millions from the virus.
People at risk for HIV may choose to take PrEP, a medication that helps prevent HIV infection. PrEp has been prescribed as a daily pill or a shot given every two months. This new twice-yearly drug called lenacapavir is now the longest-lasting type of PrEP.
Ian Haddock, a Houston man who participated in a study of the drug, told The Associated Press it “expands the opportunity for prevention.”
“Now I forget that I’m on PrEP because I don’t have to carry around a pill bottle,” he said.
The shot, made by Gilead Sciences, is injected under the skin of the abdomen. It leaves a small “depot” of medication that slowly absorbs into the body.
“This really has the possibility of ending HIV transmission,” Greg Millett, public policy director at amfAR, The Foundation for AIDS Research, told the AP.
But the upheaval in U.S. healthcare — including cuts to public health agencies and Medicaid — and slashing of American foreign aid to fight HIV are clouding the prospects.
Millett said "gaping holes in the system" in the U.S. and globally "are going to make it difficult for us to make sure we not only get lenacapavir into people’s bodies but make sure they come back” even as little as twice a year.
Gilead’s drug already is sold to treat HIV under the brand name Sunlenca. The prevention dose will be sold under a different name, Yeztugo.
Gilead didn't immediately announce its price. The drug only prevents HIV transmission – it doesn’t block other sexually transmitted diseases.
Global efforts at ending the HIV pandemic by 2030 have stalled. There still are more than 30,000 new infections in the U.S. each year and about 1.3 million worldwide.
Only about 400,000 Americans already use some form of PrEP, a fraction of those estimated to benefit. A recent study found states with high use of PrEP saw a decrease in HIV infections, while rates continued rising elsewhere.
About half of new infections are in women, who often need protection they can use without a partner's knowledge or consent. One rigorous study in South Africa and Uganda compared more than 5,300 sexually active young women and teen girls given twice-yearly lenacapavir or the daily pills. There were no HIV infections in those receiving the shot while about 2% in the comparison group caught HIV from infected sex partners.
A second study found the twice-yearly shot nearly as effective in gay men and gender-nonconforming people in the U.S. and in several other countries hard-hit by HIV.
Haddock, who leads the Normal Anomaly Initiative, a nonprofit serving Black LGBTQ+ communities, had tried PrEP off and on since 2015 but he jumped at the chance to participate in the lenacapavir study and continues with the twice-yearly shots as part of the research follow-up.
“Men, women, gay, straight – it really just kinds of expands the opportunity for prevention,” he added. Just remembering a clinic visit every six months “is a powerful tool versus constantly having to talk about, like, condoms, constantly making sure you’re taking your pill every day.”
“Everyone in every country who’s at risk of HIV needs access to PrEP,” Dr. Gordon Crofoot of Houston, who helped lead the study in men, told the AP. “We need to get easier access to PrEP that’s highly effective like this is.”
