New HIV Prevention Drug Could Curb Global Cases, but US Aid Cuts Pose Hurdles

According to experts speaking at the AIDS 2026 conference in Rio de Janeiro, Brazil, new advances in HIV prevention could sharply reduce new infections worldwide, but US foreign aid cuts will prevent those most in need from accessing the drugs.

A year ago, the World Health Organization (WHO) recommended that governments prioritize expanding access to lenacapavir, the injectable version of the PrEP preventive drug that requires just two shots per year. PrEP is also available as a daily pill or a bimonthly injection, and is up to 99% effective in preventing sexually transmitted HIV when taken consistently.

The WHO had noted that access to lenacapavir outside clinical trials remained limited, but still recommended that governments prioritize scaling it up because it could be a game-changer for groups facing major barriers to using existing drugs.

For the poor, the stigmatized, or those in remote rural areas far from health facilities, daily pills or bimonthly injections are nearly impossible. Lenacapavir allows patients to visit a health facility just twice a year while staying well protected. A mathematical modeling study by the WHO and the United Nations estimates that widespread rollout of lenacapavir could avert 41% of new HIV infections in South Africa, Zimbabwe, and western Kenya.

Notably, when the WHO issued its recommendation for global investment in lenacapavir in 2025, the administration of President Donald Trump had begun dismantling the US Agency for International Development (USAID), which provided 73% of global funding for HIV prevention, according to a study in The Lancet Global Health. As of July 2026, multiple reports indicate that investments in HIV prevention have dropped sharply around the world.

Beatriz Grinsztejn, President of the International AIDS Society, an infectious disease specialist and researcher at Fiocruz in Rio de Janeiro, said at a press conference during the conference: “We have major achievements in prevention. But on the other hand, we face severe funding cuts that deeply affect not only the delivery of new prevention technologies, but also reduce the number of people accessing treatment and prevention services.”

The budget cuts affect not only the supply of drugs but also the ability of organizations to reach those in need. Ailish Brennan, policy analyst at Harm Reduction International, stressed: “When budgets are cut, one of the areas hit hardest is the community outreach workforce—those who play a key role in reaching people who inject drugs, building trust, and connecting them to services.”

People who inject drugs face a very high risk of HIV infection, especially when clean needles and syringes are unavailable. A report by the International Network of People Who Use Drugs (INPUD) shows that organizations often respond to funding losses by cutting community outreach services.

Brennan said many harm reduction and HIV prevention organizations worldwide have been forced to close some sites, including mobile units, causing clients at risk of HIV to lose trust. She noted: “When they have to travel further, they lose their local point of contact. That means the innovations we are seeing—these long-acting injectable drugs that bring so much hope and opportunity—will not reach the people who need them most.”

Also at the conference, Grinsztejn pointed out that even before USAID was dismantled, many Latin American countries were excluded from agreements with US pharmaceutical companies to lower prices for innovative HIV prevention drugs. Gilead Sciences provides generic drugs to low- and middle-income countries at prices far below list price, but excludes Brazil, Colombia, Mexico, Peru, and Argentina from the preferential list, citing their “upper-middle-income” status. HIV activists have pushed back against this reasoning, partly because people in these countries played crucial roles in clinical trials for these drugs.

Speaking at the conference, Grinsztejn affirmed: “We have prevention technologies we have dreamed of, and we could have met UNAIDS’ long-standing goal of ending AIDS as a public health threat by 2030.” However, she added: “In my personal view, I think it is very difficult to achieve those goals in the current context.”