WHO Recommends Twice-Yearly Injection for HIV Prevention

The World Health Organization on 14 July 2025 issued new guidelines recommending twice-yearly injectable lenacapavir as an additional pre-exposure prophylaxis (PrEP) option for HIV prevention. The announcement was made at the 13th International AIDS Society Conference (IAS 2025) in Kigali, Rwanda, and adds a long-acting choice for people who struggle with daily pills.

Lenacapavir is a long-acting antiretroviral given as just two injections per year. In the large PURPOSE 1 and PURPOSE 2 trials, the overwhelming majority of participants who received the drug remained HIV-negative, with researchers reporting that it prevented almost all infections among those at risk. "While an HIV vaccine remains elusive, lenacapavir is the next best thing," said WHO Director-General Dr Tedros Adhanom Ghebreyesus, calling it a long-acting antiretroviral shown in trials to prevent nearly all HIV infections among people at risk.

The appeal of a twice-yearly shot lies in adherence. Daily oral PrEP is highly effective, but many people find it hard to take a pill every day, face stigma at pharmacies or struggle with frequent clinic visits. A discreet injection given only twice a year could reach populations that existing options have missed, including young women and marginalized groups who bear a heavy share of new infections.

Important caveats temper the optimism. A WHO recommendation is a crucial step, but real-world impact depends on price, manufacturing capacity and getting the product to the countries with the greatest need — challenges sharpened by uncertainty over global HIV funding. Generic-access agreements and scale-up plans were still being negotiated as the guidance was released. Lenacapavir is a prevention tool, not a cure, and it must be paired with testing and broader services. Even so, public-health experts described the long-acting injectable as one of the most promising advances in HIV prevention in years.