This chart tracks pricing for oral PrEP as tenofovir disoproxil and emtricitabine (TDF/FTC) as compared to generic pricing in low- and middle-income countries (LMICs) since 2005.
Oral PrEP Prices in LMICs
Avac Event
I Am More Than HIV Prevention – Results from the HPTN 091 Study with Transgender Women
HPTN 091, the I Am study, evaluated the impact of a multicomponent HIV prevention strategy to increase the uptake and adherence of pre-exposure prophylaxis (PrEP) among transgender women. The strategy included HIV prevention services, gender-affirming hormone therapy, and peer health navigation.
This webinar will feature Dr. Tonia Poteat, study co-investigator, who will review the study findings and discuss implications.
Speakers:
- Tonia Poteat, Ph.D., Duke University School of Nursing, Division of Healthcare in Adult Populations
This webinar will feature Portuguese and Spanish translation thanks to HPTN.
Introducing the Gears of Lenacapavir Rollout and The People’s Research Agenda
This World AIDS Day, the HIV/AIDS response stands at a crossroads, with injectable lenacapavir set to transform HIV prevention. But as the new UNAIDS report highlights, it also comes at the same time as restrictive policies, economic instability, and geopolitical challenges threaten to frustrate access and rollback so much of the progress that has been achieved over the past two decades.
AVAC’s 2025 advocacy agenda prioritizes collaboration and strategies for equitable and accelerated product introduction that maximize the public health potential of new prevention options and simultaneously sustains investment in critical research and development. AVAC’s newest publication, The Gears of Lenacapavir for PrEP Rollout, provides a clear pathway for the speed, scale and equity needed to translate exciting science into public health impact, while our recent The People’s Research Agenda (PRA) meets this high-stakes moment for HIV prevention with a clear, concise and collaboratively developed set of priorities for how prevention research should be conducted and what products should be developed in the future.
Despite the challenges, 2025 holds immense potential for ensuring the equitable rollout of new options and the accelerated development of a pipeline of additional options, the combination of which can help move the field closer to ending HIV/AIDS.
For the latest information on injectable lenacapavir for PrEP, be sure to join us for our webinar Tuesday, December 3. And read more below about both the Gears of LEN for PrEP Rollout and The People’s Research Agenda.
The Gears of Lenacapavir for PrEP Rollout: Driving Speed, Scale, and Equity
Lenacapavir’s rollout is not just about making a new drug available as quickly as possible; it is about ensuring that it reaches the people who need it most, as swiftly and equitably as possible. Gilead has announced its readiness to manufacture up to 10 million doses for 2026, but this potential hinges on coordinated action by governments, donors, and civil society. The roadmap outlines the essential gears driving this effort, from robust demand generation and procurement strategies to equitable distribution and community-driven implementation. Crucially, the roadmap emphasizes lessons learned from previous PrEP interventions: that availability alone is not enough. With global HIV targets still unmet and disparities persisting, this effort demands decisive action and long-term planning.
The People’s Research Agenda: A Community-Driven Vision
The People’s Research Agenda (PRA) brings the voices of affected communities to the forefront of HIV prevention research and product development. With limited resources, the stakes for decisions about which products to develop and eventually deliver become even higher for funders, communities, policy makers and governments. The PRA offers a bold vision for aligning scientific innovation with community needs. By amplifying the perspectives of those most affected by the epidemic, the PRA is a tool for driving accountability among funders, developers, and policymakers. As a living, adaptable framework, it ensures that evolving needs and challenges in the prevention landscape remain at the center of decision-making.
A Call to Action
The rollout of lenacapavir and the implementation of the PRA come at a critical moment in the global HIV/AIDS response. Achieving their full potential will require sustained collaboration, strategic investments, and unwavering commitment to equity. Together, we can transform this pivotal moment into lasting progress.
The Gears Framework for Lenacapavir for PrEP Rollout
The gears framework for lenacapavir scale-up brings together a coalition of essential stakeholders, each contributing to the successful, sustainable integration of this HIV prevention tool into global health systems.
Excerpted from the Gears of Lenacapavir for PrEP Rollout report.
Gears of Lenacapavir for PrEP Rollout
The Gears of Lenacapavir for PrEP Rollout outlines a transformative opportunity in the global fight against HIV, coming at a pivotal moment when the scale-up of PrEP has shown remarkable progress but remains insufficient to achieve a transformational impact on HIV incidence and the trajectory of the epidemic. This effort demands a coordinated response from governments, donors, civil society, and the private sector to ensure rapid implementation, equitable access, and sustainable impact. By leveraging lessons from previous PrEP interventions, aligning financing mechanisms, and prioritizing underrepresented regions, stakeholders can overcome systemic barriers and maximize the public health potential of this innovative long-acting prevention tool.
With anticipated regulatory approvals and production scaling, the plan targets over 2.5 million LEN users in low- and middle-income countries by 2027. With a focus on addressing structural barriers like stigma, healthcare inequities, and restrictive policies, alongside integrating generics into national programs, the roadmap aims to build on existing progress while accelerating the pace of HIV prevention.
PrEP Initiations by Country Worldwide
AVAC tracks global PrEP use by conducting quarterly surveys of ongoing oral PrEP demonstration and implementation projects, and collecting data from manufacturers and government agencies. This graphic shows data on PrEP initiations around the globe. For more trends in oral PrEP uptake, visit PrEPWatch.
PrEP Price Comparison
Comparing the annual price of oral TDF/FTC vs. the dapivirine vaginal ring and injectable cabotegravir. For product approvals, volumes, implementation, and price comparisons of long-acting PrEP, visit our dashboard on PrEPWatch.org.
Cabotegravir Implementation
Implementation studies completed, ongoing, or planned for cabotegravir as of October 2024. For product approvals, volumes, implementation, and price comparisons of long-acting PrEP, visit our dashboard on PrEPWatch.org.
Dapivirine Vaginal Ring Implementation
Ongoing and planned implementation studies for the dapivirine vaginal ring as of October 2024. For product approvals, volumes, implementation, and price comparisons of long-acting PrEP, visit our dashboard on PrEPWatch.org.
Cabotegravir Volume
Allocation of non-commercial cabotegravir for PrEP supply in low- and middle-income countries, 2023-2026, as of October 2024. For product approvals, volumes, implementation, and price comparisons of long-acting PrEP, visit our dashboard on PrEPWatch.org.