A large clinical trial in South Africa and Uganda has shown that a twice-yearly injection of a new pre-exposure prophylaxis drug gives young women total protection from HIV infection.
Lenacapavir is a fusion capside inhibitor. It interferes with the HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication. It is administered just under the skin, once every six months. The trial had three arms. Young women were randomly assigned to one of the arms in a 2:2:1 ratio in a double blinded fashion. This means neither the participants nor the researchers knew which treatment participants were receiving until the clinical trial was over.
The results at a recent independent data safety monitoring board review led to the recommendation that the trial’s “blinded” phase should be stopped and all participants should be offered a choice of PrEP. For young people, the daily decision to take a pill or use a condom or take a pill at the time of sexual intercourse can be very challenging.