Top 10 HIV Clinical Developments of 2024

Speaking as an HIV clinician, I think one word best sums up the year in HIV: “wait.” No, not “weight,” which continues to be an outsized topic of some discussion, but its homophonic (and patient-focused) sibling, which highlights the extent to which the HIV medical field is currently stuck in standby mode.

If good things really do come to those who wait, we should be golden in 2025.

Next year, we can expect to have an every-six-month option for HIV pre-exposure prophylaxis (PrEP). “Game-changer,” “unprecedented,” “epic”—supply your own over-used hyperbolic cliché: Lenacapavir will fundamentally alter how we approach HIV prevention, and lead to a major shift in the PrEP prescription trends of the past several years.

Other remarkable innovations are also teetering on the cusp of reality, including the routine transplantation of kidneys from HIV-positive donors to HIV-positive recipients and weekly oral HIV therapy.

Still other advances are, well, advancing. That includes broader use of semaglutide and its ilk among people with HIV for its weight-reducing and metabolic benefits. It also includes DoxyPEP, which is slowly gaining traction and seems to be turning the tide on years of soaring rates of sexually transmitted infections.

Meanwhile, long-acting injectable HIV therapy just might start to make its way into the glutei medii of people in low- and middle-income nations—but the rise of resistance to integrase inhibitors in some of these regions is a worrying pain in the butt.

How will these all play out—and at what monetary cost—is the question. It’s a question that is even more fraught following the U.S. presidential and legislative elections, as the very foundations of the institutions supporting our nation’s health are rattled.

For all the answers, we will just have to—you guessed it—wait. But in the meantime, there are many details to analyze regarding this year’s HIV highlights.

Here is my analysis of the top 10 HIV-related clinical developments of 2024: