Global HIV Prevention Quarterly Newsletter

The first quarter of 2025 has been characterized by substantial shifts in the funding landscape for HIV prevention. With significant funding declines for HIV services particularly prevention, a majority of the Global HIV Prevention Coalition (GPC) countries prioritized treatment and prevention of mother-to-child transmission of HIV. UNAIDS is collecting data from countries on the impact of the funding shifts on the HIV response and collaborating with partners through the GPC country platform – HIV Multisector Leadership Forum – to advance HIV prevention efforts as a priority for sustainability in countries. UNAIDS and partners developed the recommendations for 2030 HIV global targets to inform the development of the 2026 - 2031 Global AIDS Strategy– towards ending AIDS pre and post 2030. At CROI 2025, scientific updates on data for HIV prevention were presented including the once-yearly Lenacapavir for prevention, long-acting cabotegravir implementation studies among others. Detailed updates below:

Impact of US funding halt on the global HIV Prevention response

Globally, the United States government contributes two-thirds of international financing for HIV prevention in low- and middle-income countries. The GPC warned that without U.S. funding for the entire response, and no alternate funding secured, UNAIDS estimates showed that by end of 2029, there would be additional: 350 000 new HIV infections, 8.7 million new HIV adult infections, 6.3 million AIDS-related deaths and 3.4 million additional AIDS orphans.

The UNAIDS situation report in the third week of March highlighted countries predominantly in Eastern and Southern Africa with severe disruptions in HIV prevention services and the impacts are being felt across other countries in multiple regions. These were reported to have more than an estimated 60% reliance on U.S. funding. There are countries that have been reported to be using alternate donor sources of funding for HIV prevention and others transitioning to domestic financing.

Of all HIV prevention commodities, Pre-exposure Prophylaxis (PrEP), is expected to face severe disruptions. Governments and partners will need to collectively ensure that existing oral PrEP platforms are preserved, CAB-LA and DVR introduction activities to operationalize PrEP choice are re-started and sustained, Global Fund investments for PrEP increase and the PEPFAR/Global Fund announcement to reach 2 million people with Lenacapavir for PrEP is operationalized.

New long-acting technologies for HIV prevention – game changers for the response

In January 2025, the World Health Organization (WHO), convened a guideline development group for injectable lenacapavir, a 6-monthly injectable, as pre-exposure prophylaxis (PrEP) for HIV and the optimization of HIV testing services for long-acting prevention products. The recommendations from WHO are expected to be launched by mid-2025.

In February 2025, the Gilead Sciences issued a press release stating that the U.S. FDA had granted a priority review status for Lenacapavir for HIV prevention with a decision expected in June 2025. Also in February, the European Medicines Agency (EMA) validated Gilead’s marketing authorization application and EU-Medicines for All application.  

At the 2025 Conference on Retroviruses and Opportunistic Infections (CROI), long-acting PrEP formulations were a hot topic.  Additional findings from the PURPOSE Trials showed that the 6-monthly injections of lenacapavir for PrEP were just as effective among a cohort of 16–17-year-old females as adults in the broader study.

New clinical data from a Phase 1 clinical trial for the 12-monthly intramuscular formulation of injectable lenacapavir for HIV prevention was presented at CROI 2025. Findings showed that median plasma concentrations exceeded those associated with efficacy in phase 3 studies of the 6-monthly subcutaneous lenacapavir formulation for at least 56 weeks. The data showed potential for the once yearly lenacapavir for PrEP, increasing choices for people in need of HIV prevention.

ViiV Healthcare presented data from Real-world implementation studies for long acting injectable cabotegravir (CAB-LA) for prevention showing a very high effectiveness and adherence.

Other scientific highlights at CROI 2025 included: a modelling study of on demand PrEP for vaginal exposure among women. In the model, taking PrEP for an additional (fourth day) to the dosing regimen increased protection. For example, a 2-1-1-1 regimen showed 84% protection, increasing to 95% for a 2-2-2-2 regimen. This modeling study builds on evidence presented last year for the effectiveness among cis-gender women with a non-perfect daily adherence. Animal and Phase 1 trial data for MK-8527, a once monthly PrEP pill by Merck, was presented suggesting that a 6mg oral dose would protect against HIV acquisition in at least 90% of people. Read more HIV prevention research on AVAC’s blog.

In March 2025, WHO organized a webinar on, “PrEP among adolescents and young people” that aimed at Educating, to facilitate comprehension of information and knowledge increment on PrEP, Exploring best practices, models and key actions to emphasize learning points while also addressing barriers and Enhancing solutions to accessing PrEP. You may access the webinar resources using this link.

Accelerating HIV Prevention towards 2030 global targets

The world is off-track to meet the 2025 prevention targets. However, by 2023, at least eight countries of the Global HIV Prevention Coalition had a 66% reduction in new HIV infections and were on track to meet 2025 goals. Building on the 2025 HIV Prevention Road map, the GPC is developing a 2030 Global HIV prevention Access Framework aligned to the new recommended 2030 global HIV targets to support countries with scaling up proven existing HIV prevention interventions such as harm reduction, condom and lubricant use, oral PrEP and introduction of new long-acting prevention options to national prevention “options” kit. By 2030, at least 95% of the people in need of HIV prevention will have access to person-centered prevention programmes to ensure a 90% reduction in new HIV infections compared to 2010. The framework development process is aligned with the 2026-2031 Global AIDS Strategy development.

Country support to ensure sustainability for the HIV prevention response

Several GPC countries are highly dependent on international funding to effectively implement HIV prevention programmes – this is not sustainable in the long-term. UNAIDS and partners developed the HIV response sustainability primer – more than 20 focus countries including Indonesia, Thailand, South Africa, Malawi, Kenya, Democratic Republic of Congo, had been supported to develop Part A of the primer by the first quarter of 2025. Sustainability road maps developed by these countries focus on the current state HIV Response Sustainability Assessment Goal, impact targets and high-level outcomes.

In February 2025, the Government of Malawi hosted eleven countries in Sub-Saharan Africa and global partners including UNAIDS, AVAC, The Global Fund, BMGF, in a convening focused on facilitating strategic discussions on innovative approaches to sustainable HIV prevention across the African continent as well as contribute to drafts of the six sustainability papers to be published in Lancet – to be launched at 2025 International Conference for AIDS and STIs in Africa (ICASA) hosted in Accra, Ghana. These build on the Blantyre project – an initiative of – George Town University which focuses on utilizing a systems-based approach to sustainable HIV prevention. Countries require more sustainable models for implementing resilient and sustainable prevention programmes. South Africa for example has an integrated model from which service delivery of HIV prevention options is conducted mainly through the Primary Health Care system given that site-based prevention relies on existing human resources.

Strengthened support to countries remains a priority for the GPC to ensure adequate prevention systems exist for effective implementation of sustainable HIV prevention programmes.

Scaling up condom use in countries remains critical in advancing HIV prevention

According to the condom landscape analysis, declines in condom use range between 6-15% globally. Between 1990 and 2019, condom use averted an estimated 117 million new HIV infections worldwide. On International Condom Day, commemorated on 13 February 2025, UNAIDS and partners urged countries to strengthen HIV prevention efforts. In a press statement, UNAIDS highlighted condoms as one of the most effective (98%) when used correctly and consistently, low-cost HIV prevention tools available globally. However, there is no single option that would ensure notable incidence reduction towards global targets, therefore other existing options such as oral PrEP, voluntary medical male circumcision, harm reduction strategies such as needles, syringes Opioid Agonistic Therapy and new long-acting technologies should be available, affordable and accessible for all people in need of HIV prevention options.

Communities leading the HIV prevention response in countries

With the increased wide array of HIV prevention options, communities are key in ensuring people in need of HIV prevention can access it with ease – curbing the stigma and discrimination associated with use of the various prevention methods. Prevention method mix including biomedical, behavioural, and structural interventions requires that communities not only own but also lead and monitor evidence-based HIV Prevention programmes to ensure sustainable, well-prioritised, efficient and scaled implementation for impact. UNAIDS commemorated Zero Discrimination day on 1 March 2025, themed “We stand together” underscoring the role of communities in advancing and sustaining the HIV response.

GPC Upcoming Events

1. Global HIV Prevention Coalition High Level Leadership and Ministerial Forum Meeting, 20 May 2025

2. Global HIV prevention stakeholders group meeting, April 2025

3. HIV Multisector Leadership Forum meeting, May 2025

Publications in the first quarter of 2025

For any comments or questions on the above, please contact us at [email protected].

Kind regards,

Global HIV Prevention Coalition Secretariat | UNAIDS Joint United Nations Programme on HIV/AIDS | 20, Avenue Appia CH-1211 Geneva 27. Switzerland.

About the GPC

In 2017, a global coalition of United Nations Member States, donors, civil society organizations, and implementers was established to support global efforts to accelerate HIV prevention.  Membership includes 38 of the highest HIV-burden countries, UNAIDS Cosponsors, donors, civil society, and private sector organizations. The overarching goal of the Global HIV Prevention Coalition is to strengthen and sustain a political commitment to primary prevention by setting a common agenda among key policy-makers, funders, and programme implementers.