The HIVR4P 2024 conference in Lima, Peru, has been a pivotal event for understanding advancements in HIV prevention, with a focus on access and choice. Key discussions and data presentations revealed the ongoing challenges and innovative solutions in the fight against HIV.
One of the standout moments came from the presentation of the PURPOSE 2 trial results, which evaluated the efficacy of injectable lenacapavir (LEN) for pre-exposure prophylaxis (PrEP). Co-chaired by IAS President Beatriz Grinsztejn and advocate Jim Pickett, the session highlighted the potential impact of a twice-yearly injection that could significantly enhance prevention efforts. Colleen Kelley from Emory University presented compelling data: among 2,179 trial participants receiving LEN, there were only two new HIV infections, marking a remarkable 96% risk reduction compared to the background incidence.
Despite this success, advocates underscored the need for diverse options in HIV prevention. “More choices are needed to translate options and access into impact,” emphasized Pickett, signaling a call for equitable access for all populations.
The conference also showcased emerging HIV prevention technologies. Presentations included research on a now-defunct monthly oral islatravir (ISL) option, with safety data indicating it was well-tolerated. While the program was halted due to concerns over T-cell lymphocyte levels, follow-up data revealed that these levels returned to normal after participants ceased using ISL.
Moreover, the acceptability of an on-demand, single-dose tenofovir rectal douche was discussed, suggesting it may serve as a practical alternative for specific populations who prefer not to engage in daily oral PrEP.
The session titled “Manifest Choice: Enabling a Future Free of HIV” highlighted the diverse needs of various populations at risk. Veteran advocate Yvette Raphael emphasized the historical significance of the moment, stating, “We’re at a historic turning point—but only if countries and funders listen to evidence-based calls for programs that prioritize choice.” The African Women Prevention Community Accountability Board’s HIV Prevention Choice Manifesto served as a crucial advocacy tool for integrating all proven HIV prevention methods into national strategies.
In a stirring moment, Laio Magno from Brazil emphasized that individuals have a right to choose their prevention methods, which resonated deeply with attendees.
Exciting insights emerged regarding HIV vaccine development. Larry Corey from the HVTN highlighted the importance of vaccines, stating that reaching high coverage for HIV prevention would be nearly impossible without one. The session on early-phase vaccine research underscored the need for continued investment in these trials, particularly in light of the increasing HIV incidence among populations previously thought to be at low risk.
As the conference progressed, it became clear that while global uptake of PrEP has increased, it remains insufficient to meet the needs of those at risk. AVAC’s Catherine Verde Hashim discussed global trends, revealing a mixed picture: while some regions see declining incidence linked to effective programming, others are experiencing rising rates.
NIAID Director Jeanne Marrazzo called for urgency in addressing these challenges, highlighting the need for innovative solutions to reach those most vulnerable to HIV.
The energy and passion evident at HIVR4P 2024 serve as a reminder of the vital work still ahead in HIV prevention. With groundbreaking research and advocacy efforts driving forward, the conference inspires hope for a future where access and choice in HIV prevention become a reality for everyone, everywhere. The collective call for action resonates strongly: to prioritize diverse options and equitable access is paramount to achieving meaningful progress in the fight against HIV.