UNAIDS estimates that 120 000 children globally acquired HIV in 2024, with the majority of infections occurring due to vertical transmission in southern Africa. Pregnant and lactating women have high HIV incidence in southern Africa, including in South Africa and Malawi, with pregnancy and postpartum periods doubling their risk of HIV acquisition and onward vertical transmission. New PrEP methods, including long-acting injectable lenacapavir (LEN), have shown efficacy and safety in registrational clinical trials such as PURPOSE-1 and PURPOSE-2.
A correspondence, published in The Lancet, calls on implementers, policy makers, and governments in the communities hardest hit by HIV and vertical transmission to make pregnant and lactating women a top priority in the roll-out of LEN for PrEP. This population is at high risk of HIV acquisition and transmission, yet it is consistently under-represented in prevention strategies.
The two for two approach is simple, powerful, and potentially transformative: with just two injections of LEN, we can provide sustained protection for both mother and infant across pregnancy, peripartum period, and breastfeeding. This is not only an unprecedented opportunity to protect maternal health, but also a cost-effective, targeted intervention to eliminate vertical transmission.
Access the full correspondence here.