A groundbreaking new trial called PURPOSE 1 has unveiled a promising strategy for preventing HIV infections in women in sub-Saharan Africa. The trial, sponsored by Gilead Sciences, introduced a twice-yearly injection of a drug called lenacapavir as an alternative to the daily pill regimen like Truvada for HIV prevention.

Traditionally, pre-exposure prophylaxis (PrEP) pills have been used for HIV prevention, showing up to 99% effectiveness in clinical trials. However, real-world challenges such as pill adherence and stigma have hindered the success of this method, especially among women in South Africa who felt stigmatized for taking the pill.

In the PURPOSE 1 trial, 5,300 cisgender women in South Africa and Uganda participated in a double-blind, randomized study. Those who received the lenacapavir injections showed zero HIV infections, while participants on oral PrEP options had infection rates of about 2%, consistent with previous clinical trials.

These groundbreaking results prompted the Data Monitoring Committee to recommend halting the trial and offering lenacapavir to all study participants. Following this recommendation, Gilead announced the positive outcomes, allowing all participants to opt for the injection.

The focus on women in sub-Saharan Africa is crucial due to the region’s high HIV prevalence, with two-thirds of global HIV cases found in this area. Every week, approximately 4,000 young women in Africa are newly infected with HIV, highlighting the urgent need for effective prevention strategies.

While the trial results are yet to undergo peer review, experts like Dr. Jason Zucker from Columbia University Vagelos College of Physicians and Surgeons have expressed enthusiasm, emphasizing the potential of lenacapavir as a game-changer in HIV prevention.