WHO Recommends a Twice-Yearly Injection to Prevent HIV

The World Health Organization has recommended a new tool that could reshape the global fight against HIV: injectable lenacapavir, a long-acting medicine given just twice a year to prevent infection. The recommendation, issued at the International AIDS Society conference in Kigali, Rwanda, makes lenacapavir the first twice-yearly injectable option for pre-exposure prophylaxis, or PrEP.

The appeal of a twice-yearly shot lies in how hard daily prevention can be to sustain. Existing PrEP options — daily oral pills, the injectable cabotegravir given every two months, and the dapivirine vaginal ring — all work, but adherence is a persistent barrier for many people who face stigma, disrupted routines or limited access to care. A medicine that needs only two doses a year removes much of that burden. In its recommendation, WHO also called for simplified HIV rapid testing to make it easier for people to start and stay on prevention.

“The recommendation, issued at the International AIDS Society conference in Kigali, Rwanda, makes lenacapavir the first twice-yearly injectable option for pre-exposure prophylaxis, or PrEP.”

The clinical case is strong. In large trials, lenacapavir prevented the overwhelming majority of HIV infections among participants at risk, with side effects largely limited to pain or swelling at the injection site. WHO framed it as a way to reach people who have not been well served by existing tools, at a time when the world still recorded roughly 1.3 million new HIV infections in 2024.

“Lenacapavir is the next best thing: a long-acting antiretroviral shown in trials to prevent almost all HIV infections among those at risk,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, who has said the goal now is to get the medicine to everyone who could benefit. The hard work of affordability, manufacturing and access remains ahead — but for the first time, ending HIV as a public health threat feels less like a distant hope and more like a practical plan.