People with HIV-positive partners often face the daunting task of taking daily antiretroviral pills to prevent infection. However, recent advancements in HIV prevention have led to the development of a game-changing injectable drug that could significantly ease this burden. This innovative treatment, known as Sunlenca (lenacapavir), requires only two doses a year and boasts a remarkable efficacy rate.

According to clinical trial results published in the New England Journal of Medicine, a twice-yearly injection of Sunlenca reduces the risk of HIV infection by an impressive 96 per cent. This level of effectiveness surpasses that of current oral pre-exposure prophylaxis (PrEP) options, such as Truvada. Lead researcher Dr Colleen Kelley, a professor of medicine at Emory University, expressed excitement about the trial outcomes. “Seeing these high levels of efficacy – at almost 100 per cent -- in an injectable that people only have to take every six months is incredible,” she stated. “This is a considerable and profound advancement in medicine, especially for individuals whose circumstances make it difficult to adhere to daily oral medications.”

The clinical trial showcased that 99 per cent of participants receiving Sunlenca did not contract HIV. Out of 2,179 participants using the injectable, only two infections were reported, compared to nine infections among 1,086 people assigned to take Truvada. The results also indicated that adherence to the injectable treatment was significantly higher than that of the daily pills, which can become ineffective if not taken consistently.

Dr Kelley revealed the challenges associated with daily oral PrEP, noting that about half of people who begin the regimen discontinue it within a year due to various factors. “Having an effective injectable that is only needed twice annually is very significant for people who have trouble accessing healthcare or maintaining adherence to daily oral pills,” she explained.

The populations most at risk for HIV often experience barriers to healthcare access and may struggle to maintain a consistent medication schedule. “We are not reaching everyone we need to reach with our current HIV prevention interventions, particularly those disproportionately impacted by HIV and health care disparities,” Dr Kelley added. The introduction of injectable agents like Sunlenca represents a potential game changer for these individuals, offering them an effective means to stay HIV-negative.

Sunlenca was approved by the U.S. Food and Drug Administration (FDA) in December 2022 as a treatment for people living with HIV, aiding in infection management. However, these recent findings suggest that it could also serve as a preventive measure for those without HIV. Trial data have been submitted to the FDA, and Dr Kelley is optimistic about the drug receiving approval for this indication by 2025.

Dr Carlos del Rio, chair of medicine at Emory University, emphasized the importance of long-acting antiretrovirals for those unable to take oral medications. “The challenge is now to roll out and make these tools available and accessible in an equitable way — only then will we see new HIV infections dramatically decrease both locally and globally,” he stated.

The development of Sunlenca signifies a major advancement in HIV prevention, offering hope to those at risk and changing the landscape of HIV care. With its twice-yearly dosage and high efficacy, this injectable treatment could help address critical gaps in HIV prevention and provide a more manageable option for people facing challenges with daily medication adherence.

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