New advances in long-acting HIV prevention and treatment are offering fresh hope in the global fight against AIDS.
However, researchers warn that disruptions to the US President's Emergency Plan for AIDS Relief (PEPFAR) are undermining progress.
The disruptions have forced the closure of thousands of HIV service sites and made it more difficult for children to access lifesaving treatment.
The findings were shared on Tuesday at a press conference ahead of the 26th International AIDS Conference (AIDS 2026), which will be held in Rio de Janeiro and online from July 26 to 31.
During a press conference, researchers offered a preview of new studies examining the impact of PEPFAR disruptions, advances in long-acting HIV prevention and treatment, and the latest developments in HIV cure research.
Organised by the International AIDS Society (IAS), the conference comes at a critical time for the global HIV response.
Organizers say funding cuts now threaten years of progress, even as science moves forward quickly.
Organisers warned that funding cuts are threatening to reverse years of progress, even as scientific breakthroughs continue to accelerate.
“Science is moving fast, giving us more powerful HIV prevention and treatment tools. But these advances cannot save lives if they never reach the people who need them. That requires robust, stable financing and steadfast political commitment,” said Beatriz Grinsztejn, IAS President, AIDS 2026 Co-Chair and Director of the HIV/AIDS Clinical Research Unit at the Evandro Chagas National Institute of Infectious Diseases–Fiocruz in Rio de Janeiro.
Concerns grow over PEPFAR disruptions
The conference highlighted how recent problems with PEPFAR, the US global HIV program, are affecting progress.
Since its launch in 2003, PEPFAR has saved more than 26 million lives and helped bring the world closer to achieving the 95-95-95 HIV targets.
The PEPFAR Pulse Study, the first comprehensive assessment of its kind, surveyed 166 partner organisations across 46 countries.
More than half (52%) of respondents reported losing at least one funding award, while 77% said they had been instructed to scale back activities to comply with new US policy requirements.
The disruptions led to the closure of 1,714 HIV service sites, including 1,010 public health facilities, 325 access points, and 126 drop-in centres, with local organisations bearing the brunt of the impact.
Among treatment providers, 21% said they had permanently discontinued at least one HIV clinical care service.
Researchers also reported shortages of condoms (23%), laboratory commodities (23%), pre-exposure prophylaxis (PrEP) (22%), and antiretroviral medicines (20%).
Even organisations whose funding remained intact reported modifying their programmes to retain support. Around 61% said they censored programme language, 61% discontinued at least one service, and 44% ended services for specific populations.
A separate analysis of PEPFAR data found that 77,163 fewer children living with HIV received PEPFAR-supported treatment in 2025 compared with the previous year, marking a 14.2% global decline.
South Africa recorded the steepest drop, with 30,880 fewer children receiving treatment. Uganda, Haiti, Zambia and Kenya also reported declines that deviated from historical trends.
“These studies provide compelling new evidence that PEPFAR disruptions have had negative, far-reaching consequences, particularly for those most vulnerable people,” said Kenneth Ngure, IAS President-Elect and Associate Professor of Global Health at Jomo Kenyatta University of Agriculture and Technology in Kenya.
New progress in HIV prevention
Despite funding concerns, researchers reported encouraging results from the PURPOSE 1 and PURPOSE 2 studies evaluating twice-yearly injectable lenacapavir for HIV prevention.
Lenacapavir is already approved in several countries, and it is now being rolled out worldwide.
In PURPOSE 1, which included cisgender women in South Africa and Uganda, 95.2% of eligible participants chose the injectable lenacapavir during the extension phase.
No new HIV infections were reported in the first 52 weeks of follow-up, and 96% of participants stuck to the injection schedule with no new safety issues.
In PURPOSE 2, which included cisgender men and gender-diverse people from seven countries, 95% chose the injectable treatment.
Over more than 5,295 person-years of follow-up, researchers found only four HIV infections, and 92% of participants kept up with their injections.
“If we deliver it where it is needed most, lenacapavir for HIV prevention has the potential to help curb the global pandemic,” Grinsztejn said.
“In Latin America, where many countries are excluded from generic licensing and lack PEPFAR support, access hinges on reaching affordable price agreements. We must resolve these pricing barriers now to ensure the region is not left behind.”
Weekly pill and new cure research
Researchers also shared good Phase 3 results from the ISLEND-1 and ISLEND-2 trials, which tested a once-weekly oral HIV treatment that combines islatravir and lenacapavir.
This treatment was well tolerated and worked as well as standard daily therapies.
It could become the first complete once-weekly oral HIV treatment for people with suppressed HIV.
“Treatment needs to fit into people’s lives, not the other way around,” Ngure said.
“People living with HIV need new treatment options that offer flexibility, and a weekly pill could broaden the choices available for adults with virological suppression. We are excited to share these results at AIDS 2026.”
Another study looked at 79 South African teenagers who were born with HIV. It found that 19% still had HIV-specific immune activity in their spinal fluid, even though their blood tests showed the virus was under control.
This suggests that blood tests alone may not show all ongoing HIV-related immune activity and points to a new direction for HIV cure research.
As delegates get ready to meet in Rio, Brazil, under the theme “Rethink. Rebuild. Rise.”, researchers say the message is clear that the science is moving forward quickly, but without steady political support and funding, millions of people may not benefit from these advances.
