In a major advancement for global HIV prevention, the World Health Organisation (WHO) has officially recommended injectable lenacapavir (LEN) as a new pre-exposure prophylaxis (PrEP) option. Announced at the 13th International AIDS Society Conference (IAS 2025) in Kigali, Rwanda, the new guidelines mark a transformative moment in the fight against HIV.
Lenacapavir, the first PrEP product requiring only two injections per year, offers a long-acting, highly effective alternative to daily oral pills. This innovation is especially promising for individuals who face challenges with daily adherence, stigma, or limited access to healthcare. With its extended protection and simplified dosing, LEN could dramatically improve prevention outcomes for people at high risk of HIV.
The recommendation comes amid troubling statistics showing 1.3 million new HIV infections globally in 2024, with disproportionate impact on key populations such as sex workers, men who have sex with men, transgender individuals, people who inject drugs, and adolescents. WHO’s endorsement of LEN signals a bold move to diversify prevention strategies and empower individuals with more flexible, accessible options.
To support rollout, WHO has also recommended a simplified HIV testing approach using rapid tests. This removes a major barrier to access by eliminating complex procedures and enabling community-based delivery of long-acting PrEP through pharmacies, clinics, and telehealth platforms.
Lenacapavir now joins a growing arsenal of WHO-recommended PrEP tools, including daily oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring. While access to LEN outside clinical trials remains limited, WHO is urging governments, donors, and global health partners to begin integrating it into national HIV prevention programmes immediately, while collecting data on uptake and impact.
Additional updates include new treatment guidelines recommending long-acting injectable cabotegravir and rilpivirine (CAB/RPV) as an alternative for people living with HIV who have achieved viral suppression on oral therapy. These options aim to support individuals facing adherence challenges and offer greater flexibility in treatment.
WHO also introduced new service delivery recommendations to integrate HIV care with noncommunicable diseases such as hypertension, diabetes, and mental health conditions. Updated STI management guidelines now recommend routine screening for gonorrhoea and chlamydia in key populations. For individuals with mpox and HIV, WHO strongly advises rapid initiation of antiretroviral therapy and early HIV testing.
To address the broader challenges of sustaining HIV programmes amid declining funding, WHO has released operational guidance to help countries prioritise services, assess risks, and adapt systems to protect health outcomes.
With 40.8 million people living with HIV globally and 630,000 deaths in 2024, the urgency remains high. WHO’s new guidelines offer a practical, evidence-based roadmap to strengthen prevention, treatment, and service delivery. The call to action is clear: bold implementation is needed now to turn these policy advances into lasting public health impact.
