Moreover, people come back for next shots. For example, more than eight in 10 people who chose the CAB-LA shot in the Cape Town study came to get their follow-up shot, while results from a trial in KwaZulu-Natal, run by the Africa Health Research Institute, show only three in 10 people who were due for a refill of pills came to fetch them. This matches trends expected from the three-year CAB-LA clinical trial in sub-Saharan African countries, which showed people find it easier to stick to a long-acting injection than having to take a daily pill.
“Injectable HIV prevention medicine provides a terrific option that is less dependent on a user taking a pill every day, and the less often you need to go to a provider for the injection, the less burden on the health system,” said Mitchell Warren from the New York-based advocacy organisation Avac.
The results of another shot, which only has to be taken once every six months, as opposed to CAB-LA’s two-monthly dose, which were also released at the conference, have made world headlines.
Not one of the 2,134 women in the study who took lenacapavir, made by the drug company Gilead, contracted HIV.
While Warren said the manufacturing process of lenacapavir is simpler than that of CAB-LA, and it would therefore be easier to produce in large quantities, no price for the medicine has been announced and generic licences have not yet been awarded.
As a treatment for drug-resistant HIV, lenacapavir is sold for between $41,000 (R753,000) and $44,000 (R808,000) in Norway, France and the US for a year’s supply.
The medicine has also not yet been registered anywhere as an HIV prevention drug. Gilead will not apply with medicine regulators until the results of a second study become available at the end of the year or early 2025, a company representative said at a press briefing at the conference last week.
But Warren said affordable, generic versions of lenacapavir could, potentially, become available in 2027 or 2028.
“We’re looking at companies competing for the market, and that’s going to drive down the price,” he said. “Can the market bear two injectables? I don’t know. That’s an askable and answerable question. That’s something we all need to be looking at over the months and years ahead.”