5 ms·

I'm a little wary with "100% effective". Not even 99.9% effective?

pkulak 1y ago
Not a great title, it would seem: > provides HIV-negative individuals around 99% protection from contracting the devastating virus through sex
- randcraw 1y ago
  Not a well written article in other ways too. What's the booster interval? What's the expected market coverage? How expensive is it, especially in poor countries where it's needed most? Are there challenges in transportation or storage that will limit its adoption? How does its efficacy as a preventative compare to its efficacy as a treatment (the reason it was approved in 2022)? Lots was left unsaid by this article. You'll note also, the sole source for the article is Gilead (mentioned at the end), the drug manufacturer.
  - freeone3000 1y ago
    These are better covered by Gilead’s actual press releases, of which this is a very poor summary. For pricing, Gilead will likely carry over its policy for Truvada, by charging fairly high rates to western countries (with vouchers available) to subsidize its operations in Africa, where it will be provided cheaply or freely. (Disclosure: I’m an investor. I truly believe that if any company can be morally good, Gilead qualifies.) https://www.gilead.com/news/news-details/2024/gileads-twice-yearly-lenacapavir-demonstrated-100-efficacy-and-superiority-to-daily-truvada-for-hiv-prevention https://www.gilead.com/news/news-details/2024/gileads-twice-... https://www.gilead.com/news/news-details/2025/gilead-finalizes-agreement-with-the-global-fund-to-accelerate-access-to-twice-yearly-lenacapavir-for-hiv-prevention-for-up-to-two-million-people-in-primarily-low--and-lower-middle-income-countries https://www.gilead.com/news/news-details/2025/gilead-finaliz... https://www.gilead.com/news/news-details/2025/gilead-receives-positive-chmp-opinions-under-accelerated-review-from-european-medicines-agency-for-twice-yearly-lenacapavir-for-hiv-prevention https://www.gilead.com/news/news-details/2025/gilead-receive...
    - haswell 1y ago
      > I truly believe that if any company can be morally good, Gilead qualifies. The primary reason Gilead exists in my memory is the headline years back about their exorbitantly high prices for a life saving hepatitis C drug and the resulting questions this was raising in congress ($84K for a 12 week supply) [0]. While it may be admirable that they are providing these drugs freely to countries in need, I’d be more hesitant to accept at face value the claim that US prices in particular are somehow reasonable on that basis. I also question the framing that those high prices are necessarily high. I’m less familiar with how they’ve priced things in recent years. - [0] https://news.ycombinator.com/item?id=7529435 https://news.ycombinator.com/item?id=7529435
      - wbl 1y ago
        Do you know how much a liver transplant is? That was the alternative.
      - freeone3000 1y ago
        They created a way to live with AIDS. They were the first. They did it in the 90s, where even working on this had significant stigma still. Friends are alive because of them.
- ksherlock 1y ago
  Wikipedia says: In 2024, lenacapavir was named the "2024 Breakthrough of the Year", citing its "astonishing 100% efficacy" in one large efficacy trial in women to prevent HIV and "99.9% efficacy in gender diverse people who have sex with men," https://en.wikipedia.org/wiki/Lenacapavir https://en.wikipedia.org/wiki/Lenacapavir It's curious that the article (and wikipedia) specifically refer to sexual acquisition.
  - deleted 1y ago
    [deleted]
  - aerostable_slug 1y ago
    Wouldn't sexually active people who have sex with men be the primary market? It makes sense this would be the focus of the drug's development. They may also have issues trying to conduct robust clinical trials with IV drug abusers. If a subject entered rehab or were incarcerated for a period of the trial, would that invalidate their data? I don't know enough about the subject but it intuitively feels like it could present a real challenge.
    - pitpatagain 1y ago
      Prep has been studied for IV drug users. It works, enough that it is recommended, but is much less effective. IV drug use is a massively more efficient transmission route than any type of sexual contact.
      - 42772827 1y ago
        >IV drug use is a massively more efficient transmission route than any type of sexual contact. Yes, and people who take IV drugs are much less likely than men who have sex with men in general to take a pill daily.
  - kstrauser 1y ago
    Asking here instead of searching, for conversational purposes: In the 90s, some STD training I took said it was highly unlikely for otherwise healthy bio women to contract HIV from a man (ie compared to sex trafficked women in poor health), with the claim that vaginal sex is less susceptible to micro tearing that allows easy transmission than anal sex is. I didn’t really question this at the time because it seemed plausible and I believed the people who were telling us this. (Note: this was in a medical context, not someone trying to scare us.) Is there any credibility to that idea now that we have more data, and hopefully leased biased science than we had in the 80s?
- deleted 1y ago
  [deleted]

Not a great title, it would seem: > provides HIV-negative individuals around 99% protection from contracting the devastating virus through sex

randcraw 1y ago
Not a well written article in other ways too. What's the booster interval? What's the expected market coverage? How expensive is it, especially in poor countries where it's needed most? Are there challenges in transportation or storage that will limit its adoption? How does its efficacy as a preventative compare to its efficacy as a treatment (the reason it was approved in 2022)? Lots was left unsaid by this article. You'll note also, the sole source for the article is Gilead (mentioned at the end), the drug manufacturer.
- freeone3000 1y ago
  These are better covered by Gilead’s actual press releases, of which this is a very poor summary. For pricing, Gilead will likely carry over its policy for Truvada, by charging fairly high rates to western countries (with vouchers available) to subsidize its operations in Africa, where it will be provided cheaply or freely. (Disclosure: I’m an investor. I truly believe that if any company can be morally good, Gilead qualifies.) https://www.gilead.com/news/news-details/2024/gileads-twice-yearly-lenacapavir-demonstrated-100-efficacy-and-superiority-to-daily-truvada-for-hiv-prevention https://www.gilead.com/news/news-details/2024/gileads-twice-... https://www.gilead.com/news/news-details/2025/gilead-finalizes-agreement-with-the-global-fund-to-accelerate-access-to-twice-yearly-lenacapavir-for-hiv-prevention-for-up-to-two-million-people-in-primarily-low--and-lower-middle-income-countries https://www.gilead.com/news/news-details/2025/gilead-finaliz... https://www.gilead.com/news/news-details/2025/gilead-receives-positive-chmp-opinions-under-accelerated-review-from-european-medicines-agency-for-twice-yearly-lenacapavir-for-hiv-prevention https://www.gilead.com/news/news-details/2025/gilead-receive...
  - haswell 1y ago
    > I truly believe that if any company can be morally good, Gilead qualifies. The primary reason Gilead exists in my memory is the headline years back about their exorbitantly high prices for a life saving hepatitis C drug and the resulting questions this was raising in congress ($84K for a 12 week supply) [0]. While it may be admirable that they are providing these drugs freely to countries in need, I’d be more hesitant to accept at face value the claim that US prices in particular are somehow reasonable on that basis. I also question the framing that those high prices are necessarily high. I’m less familiar with how they’ve priced things in recent years. - [0] https://news.ycombinator.com/item?id=7529435 https://news.ycombinator.com/item?id=7529435
    - wbl 1y ago
      Do you know how much a liver transplant is? That was the alternative.
    - freeone3000 1y ago
      They created a way to live with AIDS. They were the first. They did it in the 90s, where even working on this had significant stigma still. Friends are alive because of them.
ksherlock 1y ago
Wikipedia says: In 2024, lenacapavir was named the "2024 Breakthrough of the Year", citing its "astonishing 100% efficacy" in one large efficacy trial in women to prevent HIV and "99.9% efficacy in gender diverse people who have sex with men," https://en.wikipedia.org/wiki/Lenacapavir https://en.wikipedia.org/wiki/Lenacapavir It's curious that the article (and wikipedia) specifically refer to sexual acquisition.
- deleted 1y ago
  [deleted]
- aerostable_slug 1y ago
  Wouldn't sexually active people who have sex with men be the primary market? It makes sense this would be the focus of the drug's development. They may also have issues trying to conduct robust clinical trials with IV drug abusers. If a subject entered rehab or were incarcerated for a period of the trial, would that invalidate their data? I don't know enough about the subject but it intuitively feels like it could present a real challenge.
  - pitpatagain 1y ago
    Prep has been studied for IV drug users. It works, enough that it is recommended, but is much less effective. IV drug use is a massively more efficient transmission route than any type of sexual contact.
    - 42772827 1y ago
      >IV drug use is a massively more efficient transmission route than any type of sexual contact. Yes, and people who take IV drugs are much less likely than men who have sex with men in general to take a pill daily.
- kstrauser 1y ago
  Asking here instead of searching, for conversational purposes: In the 90s, some STD training I took said it was highly unlikely for otherwise healthy bio women to contract HIV from a man (ie compared to sex trafficked women in poor health), with the claim that vaginal sex is less susceptible to micro tearing that allows easy transmission than anal sex is. I didn’t really question this at the time because it seemed plausible and I believed the people who were telling us this. (Note: this was in a medical context, not someone trying to scare us.) Is there any credibility to that idea now that we have more data, and hopefully leased biased science than we had in the 80s?
deleted 1y ago
[deleted]