‘Antiretrovirals Alone Will Not End the HIV Pandemic’

4 key takeaways from 5th HIV Research for Prevention Conference

ANALYSIS | SETHI NCUBE | The 5th HIV Research for Prevention Conference (HIVR4P 2024) held in Lima, Peru from 6 to 10 October, marked a significant milestone in the global fight against HIV, bringing together more than 1,300 scientists, advocates, community representatives, and policymakers. This dynamic gathering provided a platform for experts to share cutting-edge evidence and discuss the latest tools and strategies in HIV prevention science.

The week-long event included 16 invited-speaker sessions, 26 oral abstract sessions, 26 satellite sessions, and almost 650 posters and e-posters, offering participants a deep dive into the evolving landscape of HIV prevention. Notably, 203 scholarship recipients from more than 50 countries attended, representing an array of professions and organisations. These individuals are set to bring the knowledge gained at the conference back to their communities, enriching the global HIV response.

As highlighted by the International Aids Society, here are the four key takeaways from the science presented at HIVR4P 2024:

1. Long-Acting Prevention Options – A Game Changer

One of the groundbreaking developments presented was the advancement of long-acting HIV prevention methods. Long-acting injectables, a discreet alternative to daily medications, are expected to transform HIV prevention approaches, especially in low-resource settings. The twice-yearly injectable lenacapavir from Gilead Sciences emerged as a significant innovation, showing promising results in preventing HIV acquisition.

Lenacapavir’s potential to be a “game changer” in the HIV prevention landscape was emphasised throughout the conference. However, accessibility remains a major challenge, with advocates calling for affordability and availability in low-income regions where the need is most critical.

2. PEP and PrEP Implementation – Scaling Access

The implementation of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) was discussed at HIVR4P 2024. While PEP and PrEP have been successful in reducing HIV transmission, barriers to access persist, particularly in low- and middle-income countries. Sessions highlighted innovative strategies to improve access, focusing on expanding these prevention tools to underserved populations in Africa and Latin America.

3. Prioritising Choice in HIV Prevention

A recurring theme throughout the conference was the importance of offering choice in HIV prevention. The HIV Prevention Choice Manifesto for Women and Girls in Africa, which emphasises providing several prevention options, was a focal point of discussion. Ensuring individuals can choose the prevention methods that best suit their unique circumstances is essential for empowering communities and enhancing uptake.

Recognising that people’s preferences and needs change, the conference underscored the need for accessible, adaptable prevention tools that cater to these shifts. This is especially important for women and girls, who often face unique vulnerabilities to HIV acquisition. By prioritizing choice, HIV prevention efforts can be more responsive and inclusive.

4. HIV Vaccine R&D and the Role of Broadly Neutralizing Antibodies (bNAbs) in Prevention

Despite remarkable progress in HIV prevention, one key tool remains elusive – a highly effective HIV vaccine. However, research in this area is gaining momentum, with the field experiencing what some call a “scientific renaissance”. Researchers are exploring new immunogens and innovative approaches aimed at developing vaccines capable of eliciting bNAbs, which could potentially prevent HIV infection.

Looking Ahead

HIVR4P 2024 offered a powerful reminder of the progress made in HIV prevention, and the challenges that remain. The conference highlighted the importance of expanding access to life-saving prevention tools like long-acting injectables and PrEP, while also emphasizing the need for ongoing research into innovative solutions like HIV vaccines and bNAbs.

As delegates return to their respective countries, the knowledge shared at the conference will help shape future HIV prevention strategies. With continued collaboration, advocacy, and scientific innovation, the global community is moving closer to the ultimate goal of ending the HIV pandemic.

“… antiretrovirals alone will not see the end of an HIV pandemic. We need a vaccine, we need a cure…,” said Sharon Lewin from the Peter Doherty Institute for Infection and Immunity in Australia, at the closing plenary session titled `Realising The Promise’.

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Sethi Ncube interviewed Prof Mugo during HIVR4P 2024, the 5th HIV Research for Prevention Conference in Lima, Peru, after receiving a scholarship from the IAS.