Lenacapavir for HIV Preexposure Prophylaxis

Earlier in 2024, the PURPOSE-1 trial results — which found no HIV acquisitions in cisgender women who received the HIV capsid inhibitor lenacapavir for preexposure prophylaxis (PrEP) — galvanized the field. Now, the PURPOSE-2 study (conducted in cisgender men, transgender people, and nonbinary persons who have sex with men) shows similarly exciting results.

Almost 3300 participants were randomized to receive twice-yearly subcutaneous lenacapavir or daily oral FTC-tenofovir disoproxil fumarate (FTC/TDF). In the lenacapavir group, HIV incidence was 96% lower than background incidence and 89% lower than in the FTC/TDF group. Two people who received lenacapavir and nine people who received FTC/TDF acquired HIV. Injection-site nodules occurred in…