For over a decade, taking a pill like Truvada every day has been the standard of care for HIV prevention efforts. In clinical trials, this type of preventive drug, called pre-exposure prophylaxis (PrEP), can be 99% effective in stopping new HIV infections from sex. In the real world, however, that is not always the case.
People don’t always take their pills. In a study in South Africa, women said they felt there was a stigma to the pill —- a sexual partner might assume they’re taking it because they already have HIV or because they have other partners. Now a new trial —- called PURPOSE 1 —- points the way to a new preventive strategy —- a twice yearly injection of a drug called lenacapavir.
The trial was sponsored by Gilead Sciences, the California-based maker of the drug. In this double-blind, randomized study of 5,300 cisgender women in South Africa and Uganda, 2,134 got the injection and the others took one of two types of daily PrEP pills. The trial began on August 2021 and, so far, not a single woman who received the injections has contracted HIV.
The participants who received either of the oral PrEP options, Truvada and Descovy, had infection rates of about 2% — consistent with the infection rates of oral PrEP in other clinical trials. These results were significant enough for the Data Monitoring Committee —- an independent group of experts appointed to assess the progress of clinical trials —- to recommend that Gilead halt its blinded trial and offer .