With Lenacapavir 'You've Basically Got a Vaccine.' But Reaching the People Who Would Benefit Is Difficult, Says Gates Foundation Expert

In this interview with Managed Healthcare Executive, Peter Ehrenkranz, M.D., M.P.H., deputy director, HIV, at the Gates Foundation, discusses twice-a-year lenacapavir for HIV preexposure prophylaxis (PrEP). The FDA approved the preventive medication on June 18. Gilead Sciences is marketing it under the brand name Yeztugo. Ehrenkranz described Yeztugo as "really well tolerated, incredibly efficacious," and not requiring refrigeration. "If you can figure out a way to identify the people who need it and encourage them to come twice a year, you've basically got a vaccine for those folks," he said. Ehrenkranz referenced the once-a-year formulation of lenacapavir that Gilead is developing as being "right around the corner."

But Ehrenkranz balanced his enthusiasm for lenacapavir with cautionary remarks about the difficulty of reaching people who would benefit from HIV PrEP. "Preventing HIV is not the highest thing on everybody's radar," he said. Ehrenkranz noted that some people's HIV risk fluctuates. "Somebody who is at risk today is not necessarily the same person who is at risk tomorrow," he said. He specifically mentioned women at the "edge" of sex work who don't see it as a profession but "circumstances have required them to do things that they wouldn't normally do."