hiv prevention drug shows 100 per cent efficacy for cisgender women in latest trial
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adherence to daily prep medications is not always easy, and when the medication is not taken as prescribed, its ability to prevent hiv transmission lessens dramatically.
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a new drug used to prevent hiv transmission in cisgender women has shown 100 per cent efficacy in its phase 3 purpose 1 trial. the injectable drug, known as lenacapavir, is a new form of prep (pre-exposure prophylaxis) that can be taken twice per year.
the prep medication was developed by gilead sciences canada, a pharmaceutical company based in ontario. the number of new hiv cases in canada continues to rise, further solidifying a need for better awareness and access to hiv prevention.
purpose trial results
gilead’s purpose program is “the most comprehensive and diverse hiv prevention trial program,” with five specific prevention trials being conducted around the globe.
lenacapavir, which is being tested in the trials, is another form of prep. these medications are designed to prevent hiv transmission. as of writing, there are two oral prep medications available in canada which have shown tremendous efficacy against the spread of hiv when taken as prescribed. a third option, the injectable once-monthly apretude, was approved by health canada earlier this year.
in the purpose 1 phase 3 double-blind, randomized study, gilead sciences aimed to look at how a twice-yearly subcutaneous injection of lenacapavir could prevent hiv transmission in cisgender women between the ages of 16 and 25 in high-risk areas, including south africa and uganda.
other prep medications, once-daily oral prep options descovy and truvada, were tested alongside lenacapavir to assess the efficacy of the new injectable. the trial participants were split into three groups, each taking one of the three options.
results showed that lenacapavir was 100 per cent effective against hiv transmission, with both the daily oral medications showing less efficacy. lenacapavir saw no new incidences of hiv, whereas descovy and truvada saw 39 and 16 cases, respectively.
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the safety of the drug was also assessed, and in the trial, no significant safety concerns were highlighted in all three options.
what this means for cisgender women at risk of hiv
adherence to daily prep medications is not always easy, and when the medication is not taken as prescribed, its ability to prevent hiv transmission lessens dramatically. the two daily oral prep drugs available in the country, descovy and truvada, while effective, do not offer much convenience when it comes to medication adherence.
the third once-monthly option, apretude, is a much more desirable option for people living busy lives or those who have difficulties with taking pills every day. however, not all options are available for cisgender women at risk of hiv.
truvada and apretude are currently approved for use in cisgender women, with descovy in its investigational phase. with the results of the efficacy of lenacapavir, having another drug on the market could change drug adherence significantly since it only needs to be taken twice per year.
the introduction of the twice-yearly option adds yet another highly effective option to the toolkits of those at risk of hiv and, with it, a possible future with fewer hiv cases in the country.
according to the press release, the next step for gilead sciences researchers is to test lenacapavir in “cisgender men who have sex with men, transgender men, transgender women, and gender non-binary individuals who have sex with partners assigned male at birth.”
barriers involved in hiv prevention
people living with hiv continue to be subject to stigma and discrimination. while improving, public knowledge surrounding the disease is still not where it needs to be for everyone to understand and practice adequate prevention behaviours.
drug adherence can also be an issue for people, as the current options involve daily medication or monthly injections.
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the continued development of new drugs, such as lenacapavir, can help improve the situation. still, without more awareness about what is available and how to access it, the number of hiv cases will likely continue to rise. in 2022, cases rose by nearly 25 per cent, with estimates for 2023 and 2024 showing a continued increase.
according to reports, roughly 33 per cent of new cases of hiv occurred in cisgender women in 2022, with 36 per cent being exposed due to injectable drug use and 60 per cent through heterosexual sex.
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