World Health Org. Recommends Recently Approved Twice-Yearly Injection For HIV Prevention

According to a WHO press release, the agency has issued new guidelines endorsing injectable lenacapavir (LEN) administered twice a year as an additional pre-exposure prophylaxis (PrEP) option, marking a significant expansion of HIV prevention tools worldwide. The recommendations, announced at the 13th International AIDS Society Conference in Kigali, Rwanda, aim to improve protection for people at risk by offering an alternative to daily oral regimens that can be challenging to adhere to. The policy change also calls for streamlined HIV rapid testing to support community-based delivery and reduce access barriers.

Injectable lenacapavir is the first long-acting PrEP product requiring only two administrations per year, compared with daily pills or monthly injections. This schedule is expected to benefit individuals who struggle with daily medication routines, face stigma when collecting pills, or have limited access to health services, particularly in regions with high HIV incidence. By lowering the frequency of clinical visits, LEN could improve overall adherence and expand prevention coverage among priority populations.

As part of the new guidance, WHO recommends adopting a public health approach to HIV testing by using rapid diagnostic tests to facilitate administration of long-acting PrEP products, including lenacapavir and cabotegravir. Simplifying testing protocols removes logistical hurdles, cuts costs, and enables pharmacies, clinics, and telehealth platforms to deliver these injections directly in communities, strengthening decentralized HIV prevention efforts.

WHO urges governments, donors and global health partners to integrate injectable lenacapavir immediately into their combination prevention programmes, even as wider access is established. Countries are encouraged to collect data on uptake, adherence and real-world outcomes to inform future scale-up. LEN joins existing WHO-recommended options such as daily oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring, creating a diversified toolkit to help curb the 1.3 million new infections recorded in 2024.

Additional WHO updates at the Kigali conference include recommending long-acting injectable cabotegravir plus rilpivirine as an alternative ART switch for virally suppressed adults and adolescents without active hepatitis B, reinforcing strategies to support those facing adherence challenges. Guidelines also advise integrating HIV services with noncommunicable disease and mental health care, and recommend routine screening for gonorrhoea and chlamydia in key populations to enhance comprehensive sexual health services.

For people living with HIV who present with mpox or have interrupted treatment, WHO strongly advises rapid ART initiation and concurrent HIV and syphilis testing. To sustain progress amid tightening budgets, the agency has issued operational guidance to help countries prioritize essential HIV services, assess funding risks, and adapt systems to ensure continuity of care.

Article by multiple contributors, based upon information from the World Health Organization

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