Sandro Niederer, Project Manager Sexual Health of trans persons, Swiss AIDS Federation

Lenacapavir consists of two capsid blockers, disabling the virus capacity to correctly package its RNA. Without the protection of the capsid the RNA degrades before being successfully integrated in the host cell, making a successful infection of the target cell impossible.  

Lenacapavir was compared to two oral PrEP therapies (F/TDF and F/TAF) that must be taken daily. 

From the more than 2000 study participants receiving Lenacapavir not a singe one was infected with HIV over the span of the study, making the drug highly effective.

Both oral methods saw a greatly diminished adherence over the span of the study, making the drug ineffective. A lack of adherence was largely attributed to the stigma associated with HIV prevention and the daily inconvenience. 

Lenacapavir could be a game changer as it only needs to be injected every six months. The subcutaneous injection is easy to administer and shows little to no irritation of the injection site. 

Pregnant women on Lenacapavir had similar outcomes to those in the general population, suggesting the drug is suitable for people during pregnancy. 

The drug has the potential to be a much-needed advancement for marginalized communities when it comes to HIV prevention, offering a discreet, efficient and long acting protection against HIV. But only if Gilead makes it available at a price that is affordable for middle- and low-income countries.