Lenacapavir: A Global Breakthrough in HIV Prevention and the Ethical Imperative of Equitable Access – A Literature Review

By Eljo PAJA, Lumturi MERKURI, Leidon SHAPO

Abstract
Introduction: Since the early 1980s, the global HIV epidemic has posed persistent challenges to prevention efforts. Despite the progress achieved through oral pre-exposure prophylaxis (PrEP), adherence issues, stigma, and limited access have hindered its widespread success. Lenacapavir, a long-acting capsid inhibitor,represents a breakthrough innovation that offers six months of continuous protection through a single subcutaneous injection, that would potentially transform HIV prevention worldwide.
Aim: This study aims to evaluate the clinical effectiveness, safety, and global impact of lenacapavir as a new generation PrEP agent.                                                                                                                        Methodology: We conducted a literature review that was primarily based on results from a systematic literature review and meta-analysis that included 26 international sources, including The New England Journal of Medicine, Nature, and The Lancet. Data from the PURPOSE-1 and PURPOSE-2 trials were also reviewed comparatively to assess the drug’s efficacy, side effects, and population outcomes, while descriptive statistics illustrated predicted epidemiological trends.
Results: The major finding has derived from the meta-analyses showing that lenacapavir had an extremely high (99,9%) efficacy in preventing HIV infection among participants using it, with a significantly lower rate of adverse events compared to oral PrEP regimens. Global modelling studies predict up to a 60% reduction in new HIV infections by 2030 if lenacapavir is implemented more widely, especially in Sub-Saharan Africa.
Conclusions: Lenacapavir represents a paradigm shift in HIV prevention, combining scientific innovation with public health equity. If affordability and access barriers are addressed, this treatment may become a cornerstone of global HIV elimination strategies in the future.