HIV Prevention News Around The Globe

Tested in Africa, used in America

At the recent annual International AIDS Conference, a startling presentation about the newest wonder drug in HIV prevention brought a raucous standing ovation. Lenacapavir, a novel drug given as an injection under the skin every six months, was 100% successful in preventing HIV in adolescent girls and young women in two countries in Africa.

It felt to many like a generational moment. After years of failed vaccine trials, this was something nearly as valuable, a shot given twice yearly that substantially prevents HIV infections. That the drug was so beneficial in young women in Africa made the finding particularly monumental.

When the results first came out, Gilead, the manufacturer of lenacapavir, stated it was too early to discuss licensing and offering vague plans about its production and availability in Africa. Just recently, a second study among men who have sex with men and predominantly conducted in the Northern Hemisphere showed similarly promising results.

The drug, which has a manufacturing cost estimated at about $40 per year, is currently licensed as an HIV treatment for more than $42,000 per year in the United States. In South Africa, health care expenditures in the public sector are approximately $230 per person per year. Advocates and the study scientists have strongly urged Gilead to make lenacapavir swiftly available in sub-Saharan Africa at an affordable price. But with over 3,000 women infected with HIV each week in the region according to UNAIDS estimates, there is no time to waste.

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This preventive drug could be a 'game changer' in ending the HIV epidemic

Can we eliminate the HIV epidemic?

It’s a question that dates back to the start of the epidemic in the 1980s. With 1.3 million new infections a year, the epidemic continues … and the world is not on track to meet the ambitious U.N. goal of ending HIV/AIDS by 2030.

But now there’s rising optimism among leading infectious disease experts after the latest groundbreaking clinical trial results for a drug called lenacapavir which have shown it to be capable of virtually eliminating new HIV infections through sex.

PURPOSE 2, the name for the latest trial sponsored by Gilead Science, the California-based maker of lenacapavir, found the drug to be 96% effective in preventing HIV infections in the newly released results of a clinical trial of more than 3,200 cisgender men, transgender men, transgender women and gender non-binary individuals who have sex with partners assigned male at birth. The study was conducted across sites in Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the United States.

These results follow equally dramatic findings from a previous lenacapavir trial called PURPOSE 1 which followed 5,300 cisgender women in South Africa and Uganda. In news which headlined July’s AIDS 2024 conference in Munich, early results indicated 100% efficacy, after Gilead Sciences revealed that not a single woman who had received the drug since the trial began in August 2021, had contracted HIV.

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Mpumalanga Province grapples with highest HIV prevalence rate in SA, data reveals

The Human Sciences Research Council (HSRC) released the key findings of the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for Mpumalanga, revealing the highest HIV prevalence rate in South Africa. According to the findings, Mpumalanga had the highest HIV prevalence of any province in 2022 — 17.4% — which corresponds to an estimated 890 000 people living with HIV (PLHIV) in the province.

Professor Khangelani Zuma of the HSRC, the study’s overall principle investigator, reported that the survey revealed that in 2022, the province’s HIV prevalence among adolescents aged 15 to 24 years was 7.8% overall, with males having a 1.5-fold greater prevalence (9.8%) than girls (6.3%) in the same age range. Among adults aged 25–49 years, HIV prevalence was 26.4% overall and 1.6-fold higher among females (31.9%) than males (19.9%).

By locality, HIV prevalence was higher among those residing in rural formal/farms (21.1%) and rural informal areas (18.4%) and lower in urban areas (15.5%), but the difference was not significant. “A concerning state is that HIV prevalence peaked at 40.8% among those aged 45–49 years in 2022 compared to 39.0% in 2017 among those aged 35–39 years, suggesting a possibility of continued new infections. There was a notable downward shift in the epidemic curve in 2022 among respondents aged 15–44 years,” said Zuma.

The data presented are for three priority districts in Mpumalanga, namely Ehlanzeni, Gert Sibande and Nkangala districts, where oversampling was undertaken to enhance the precision of the HIV prevalence estimates. In 2022, HIV prevalence among all ages was highest in Gert Sibande (20.5%) and Ehlanzeni (16.0%) and lowest in Nkangala (13.1%).

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US Commits to Buying HIV Drugs Through African Suppliers

The US government is throwing its weight behind African production of antiretrovirals as the continent grapples the world’s largest HIV epidemic.

The US President’s Emergency Plan for AIDS Relief program — known as Pepfar — has committed to expand its purchase of ARVs from local suppliers to cover 2 million African patients, said Stavros Nicolaou, the head of strategic trade at Aspen Pharmacare Holdings Ltd.

This is key because it will boost production on the continent and because Pepfar, which then-President George W. Bush initiated in 2003, only got short-term reauthorization in March after months of political debate over its reach.

The program has saved more than 25 million lives with the more than $110 billion it has provided over the past two decades and allowed at least 5.5 million children to be born free of the HIV virus that causes AIDS.

While sub-Saharan Africa carries the bulk of the world’s HIV/AIDS population, less than 1% of the $750 million spent by Pepfar on the disease each year is on products sourced from Africa until now. “HIV/AIDS still remains one of the most menacing pandemics on the continent,” Nicolaou said in an interview. “In Africa, you’ve got such a disproportionate disease burden that when you also aim to grow the economy inclusively, it becomes a dual need” to make drugs on the continent, he said.

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Injectable PrEP Better Than Daily Pills, Study Finds

A new study reveals that two yearly injections of the drug lenacapavir is more effective at preventing HIV than a daily pill regimen.

A recent study has found that lenacapavir, an injectable medication administered twice a year, is more effective at preventing HIV among gay, bisexual, and transgender people than a daily regimen of Truvada, taken orally, as a form of pre-exposure prophylaxis. The study examined cisgender men, transgender men and women, and nonbinary individuals who have sex with partners assigned male at birth. The participants hailed from Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the United States.

Participants in the trial were randomized to either receive lenacapavir or Truvada on a placebo-controlled, double-blind basis, meaning that neither they nor the researchers were aware of who was getting which drug. An analysis of the trial results found that only two out of 2,180 participants who had received lenacapavir seroconverted, meaning they acquired HIV during the trial, compared to 9 of the 1,087 people who received Truvada.

For the former group, this represented an 89% lower HIV infection rate than those in the Truvada group, and what Gilead estimated was a 96% lower infection rate than what would be expected had participants received neither HIV prevention drug. Given the statistical superiority of lenacapavir over Truvada, researchers will end the trial’s blinded phase several months early.

They will then inform participants of which drug they received and offer all participants the option of receiving lenacapavir as a form of PrEP. Jen Kates, the director of global health and HIV policy at the health policy research nonprofit KFF, called the results “nothing short of amazing.”

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Opportunities

Share Your Work at the African Workshop on Women & HIV

The African Workshop on Women & HIV is a unique opportunity to contribute to advancing care and research for women living with HIV in Africa. This workshop, designed in connection with the prestigious International Workshop on Women & HIV, brings together local and international healthcare providers, researchers, government, industry leaders, and community representatives to tackle the most pressing issues facing women living with HIV.

We invite you to become part of the conversation by submitting your abstract. Whether you are conducting cutting-edge research or have valuable “lessons learned” from your experience in the field, this workshop is the ideal platform to showcase your work, network with experts, and inspire future collaboration.

There will be two types of accepted abstracts:

Research Abstracts: Present your latest findings and receive feedback from a diverse expert audience.

“Lessons Learned” Abstracts: Share your practical insights and experiences in implementing strategies for women living with HIV. What worked? What didn't? Help shape future practices by exchanging knowledge with a multidisciplinary community.

You can read more about the abstract categories and how to submit here