Experts at an international AIDS conference in Brazil highlighted the potential impact of lenacapavir, an injectable HIV prevention medication, while expressing concern about funding constraints limiting its availability. The medication, which requires only two injections annually, has been shown to be 99% effective in preventing sexually transmitted HIV for consistent users. A mathematical modeling study estimated that widespread availability could prevent 41% of new HIV infections in South Africa, Zimbabwe and western Kenya.
The World Health Organization recommended in 2025 that governments prioritize expanding access to lenacapavir, particularly for populations facing barriers to existing HIV prevention methods. The injectable formulation could provide a significant advantage for people experiencing poverty, stigma, or living in remote areas, as it requires healthcare visits only twice yearly compared to daily pills or bimonthly injections. However, major reductions in US foreign aid for HIV prevention have complicated these expansion efforts, with USAID having previously provided 73% of donor-funded resources for global HIV prevention programs.
Funding cuts have impacted both medication availability and the outreach infrastructure necessary to reach vulnerable populations. Organizations have been forced to reduce peer outreach workers who are essential for building trust with high-risk groups, including people who inject drugs. Loss of local service locations and mobile clinics has further eroded community engagement, potentially undermining the ability to deliver new prevention technologies to those who need them most.
Additional barriers exist in certain regions, as pharmaceutical company agreements to provide affordable versions of long-acting medications exclude countries classified as upper-middle-income, including several Latin American nations where community members participated in clinical trials. These combined obstacles—funding reductions, service cutbacks, and pharmaceutical pricing restrictions—have created a challenging environment despite the availability of potentially transformative prevention tools.
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