The World Health Organization (WHO) has given its backing to the use of injectable lenacapavir (LEN) as a new pre-exposure prophylaxis (PrEP) option for HIV prevention, recommending it be administered twice a year. This endorsement, which represents a significant move in the global HIV response, was announced during the 13th International AIDS Society Conference (IAS 2025) taking place in Kigali, Rwanda.
LEN stands out as the first long-acting, twice-yearly injectable PrEP, providing a highly effective alternative to the traditional daily oral pills that many at-risk individuals struggle to adhere to due to various barriers, including stigma and access issues. WHO’s Director-General, Dr. Tedros Adhanom Ghebreyesus, heralded LEN as a transformative breakthrough in HIV prevention that could significantly ease the burden on individuals at risk of HIV, particularly those who may find it challenging to maintain daily treatment regimens.
Dr. Ghebreyesus noted that while an elusive HIV vaccine is still a goal, LEN provides a promising alternative that can prevent nearly all HIV infections among individuals at risk. The recent FDA approval of LEN complements WHO’s guidelines and lays the groundwork for expanding access to this crucial prevention tool.
As efforts to reduce stagnant HIV infection rates continue, the urgency for such innovations is underscored by the alarming statistics of 1.3 million new HIV infections reported in 2024, particularly within key populations such as sex workers, men who have sex with men, transgender individuals, people who inject drugs, and adolescents.
The proactive implementation of LEN as a foundational strategy for HIV prevention aligns with recent findings from UNAIDS, particularly concerning countries like Fiji, which is currently facing the fastest-growing HIV epidemic globally. Reports indicate that the number of new infections in Fiji has skyrocketed ten-fold since 2014.
Fiji’s Health Ministry has been under increasing pressure to escalate preventive measures in response to this crisis. There are ongoing discussions on possibly utilizing new preventive tools, including LEN, in an effort to reverse the trend of new HIV transmissions. Moreover, similar strategies promoting awareness through community engagement and education about safer practices are crucial.
Addressing the intertwined issues of HIV and sociocultural challenges related to drug use and stigma will be vital for improving public health outcomes in places severely affected by the epidemic. There is hope that with decisive actions, such as the adoption of LEN and community-focused strategies, Fiji and other regions can take more significant strides in combatting HIV.
The commitment from WHO to ensure that innovative solutions like LEN are swiftly integrated into national health systems offers optimism for communities gravely impacted by the ongoing HIV epidemic, demonstrating a path forward that prioritizes health, choice, and accessibility for those at risk.
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