IAS 2025 Showcases Pivotal Advancements in HIV Prevention and Global Health Equity

In July 2025, the IAS (International AIDS Society) Conference on HIV Science convened in Kigali, Rwanda, amidst a shifting global landscape marked by scientific breakthroughs. IAS 2025 provided a crucial platform to assess the state of the HIV response, spotlight African leadership in science, and explore emerging prevention and treatment tools. The conference emphasized an urgent need for sustainable financing, equitable access to innovation, and strengthening health systems. This article outlines critical insights, new data, and policy directions discussed during the conference.

HIV in 2024: 1.3 million Newly Infected, 630,000 Deaths Worldwide

According to the World Health Organization (WHO), in 2024, approximately 1.3 million people globally acquired HIV, including nearly 120,000 children aged 0-14 years and around 1.2 million adults aged 15 and older. The global incidence rate was close to 0.16 per 1,000 uninfected individuals. Furthermore, HIV-related illnesses were responsible for an estimated 630,000 deaths worldwide. These figures highlight the persistent global health challenge posed by HIV and emphasize the critical need for sustained efforts in prevention, early diagnosis, treatment, and long-term care.

Global HIV Funding Crisis: A Landmark in HIV Prevention

Severe funding disruption caused by a sudden reduction in international financial support, particularly from the United States was amongst the most pressing concerns addressed at IAS 2025. In early 2025, a cut of USD 400 million to the United States President’s Emergency Plan for AIDS Relief (PEPFAR) had far-reaching consequences. This funding disruption raised alarms about the sustainability of HIV programs and their ability to reach those in need.

In Mozambique, the reduction in funding resulted in a 25% decrease in adult Antiretroviral Therapy (ART) initiations in February 2025 compared to the previous year. In Johannesburg, South Africa, the end of PEPFAR funding led to a decline in key metrics: HIV testing dropped by 8.5%, diagnoses decreased by 31%, and ART initiations fell by 30% in the first quarter of 2025 compared to the same period in 2024.

The effects of these funding cuts were also felt in Latin America and the Caribbean, where the suspension of U.S. funding to NGOs impacted 87% of the 40 organizations surveyed, affecting approximately 156,164 beneficiaries.

On a positive note, as per to UNAIDS’ Global AIDS Update 2025 reports, 25 of 60 low- and middle-income countries have increased domestic HIV spending, and the global solidarity remains essential. High national debt continues to restrict many African countries’ capacity to deliver comprehensive HIV services. During the conference, Zackie Achmat, founder of South Africa’s Treatment Action Campaign, stated that, “You cannot end the AIDS pandemic while African nations must choose between paying creditors and saving lives.”

Africa at the Center of Scientific and Public Health Leadership

IAS 2025 emphasized Africa's growing role not only as a region heavily impacted by HIV, but also as a center of scientific innovation. The host country, Rwanda, was praised for its swift containment of a Marburg virus outbreak within three months, an achievement that demonstrated the value of regional leadership and global health partnerships. The conference highlighted African-led initiatives such as the Africa Cure Consortium, which is advancing HIV cure research infrastructure and clinical trials across the continent. African scientists and institutions are increasingly influencing global policy, vaccine development, and therapeutic strategies.

Leading Industry Contributions to HIV Innovation at IAS 2025

At IAS 2025, leading pharmaceutical companies presented significant innovations in HIV diagnostics and treatment.

Lenacapavir: A Landmark in HIV Prevention

Lenacapavir (LEN), a twice-yearly injectable developed by Gilead Sciences, took center stage in HIV prevention discussions at IAS 2025. As a capsid inhibitor, LEN demonstrated nearly 100% efficacy in preventing HIV acquisition across diverse populations in the Phase 3 PURPOSE 1 and PURPOSE 2 trials. These trials also revealed high levels of adherence and user preference for this long-acting pre-exposure prophylaxis (PrEP). In July 2025, the World Health Organization (WHO) officially recommended twice-yearly Lenacapavir as a new PrEP option, representing a major milestone in HIV prevention and highlighting the growing role of long-acting injectables in public health.

Expanding the Toolbox: Long-Acting Prevention Options

IAS 2025 showcased emerging long-acting HIV prevention tools. Among them, MK-8527, an investigational once-monthly oral agent for HIV prevention, showed favorable tolerability and is now progressing to Phase 3 clinical trials in Africa. Meanwhile, the DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe) CAB-LA implementation study in Zambia demonstrated 100% adherence to the second dose of long-acting injectable cabotegravir (CAB-LA) among adolescent girls and young women. Participants reported high levels of satisfaction due to the discreet nature and low side effects of the injectable. In a parallel development, a licensing agreement between the Medicines Patent Pool (MPP) and ViiV Healthcare will enable generic production of CAB-LA for HIV treatment, in combination with rilpivirine, across 133 countries.

bNAb Breakthroughs: Toward HIV Control and Cure

Broadly neutralizing antibodies are increasingly recognized as a cornerstone of future HIV cure strategies. At IAS 2025, data showed that combining long-acting bNAbs with immune modulators such as N-803 (an interleukin-15 superagonist) modified viral rebound patterns after treatment interruption. Studies also introduced novel bNAb pairings that targeted distinct HIV envelope sites, offering insights into antibody synergy. Furthermore, chimeric antigen receptor T cells (CAR-T cells) engineered to secrete bNAbs significantly reduced viral load in humanized mice and facilitated Fc-mediated immune functions. The combination of lenacapavir with dual bNAbs preserved HIV-specific T-cell responses, although without increased antigen expression. These advancements reinforce the strategic role of bNAbs in long-term immune-based HIV control.

Harnessing Digital Technology to Strengthen HIV Services

Innovative digital solutions were a recurring theme at IAS 2025. In Nigeria, mobile vans equipped with artificial intelligence-powered chest X-ray scanners are enhancing tuberculosis screening and integrating HIV/TB services at the primary healthcare level. In South Africa, an artificial intelligence-based digital toolkit is being used by clinicians to improve HIV prevention outreach among adolescent girls and young women. In Kenya, blockchain-based systems are helping monitor treatment adherence, while in Ghana and Malawi, similar technologies are improving pharmaceutical logistics and supply chain integrity. In Canada, a digital chatbot named MARVIN is assisting people living with HIV in managing their health through real-time information and adherence support.

Pediatric and Adolescent HIV: Progress and Challenges

New findings at IAS 2025 illuminated both progress and persistent challenges in pediatric and adolescent HIV care. Data from the ODYSSEY trial identified key predictors of ART failure in children, such as low CD4 cell percentages, advanced WHO staging, and lower body weight at initiation. Pharmacokinetic modeling supported WHO-aligned dosing for a new pediatric formulation of darunavir/ritonavir, expanding child-appropriate treatment options. Early-life administration of two broadly neutralizing antibodies (bNAbs), CAP256V2LS and VRC07-523LS, was found to be safe in infants, supporting further development of antibody-based strategies to prevent mother-to-child transmission.

However, psychosocial challenges remain acute. In Zambia, nearly one-third of adolescents living with HIV exhibited suicidal behaviors, highlighting the need for integrated mental health services. In Zimbabwe, adherence monitoring using electronic devices improved viral suppression among youth at risk of treatment failure. The BREATHER Plus trial, conducted among 12-19-year-olds using tenofovir/lamivudine/dolutegravir (TLD), revealed inferior virologic outcomes in those on short-cycle ART compared to continuous ART.

IAS 2025 underscored the complex and evolving nature of the global HIV response. While groundbreaking scientific advances, particularly in long-acting prevention tools and immunotherapy, offer renewed hope, persistent challenges such as funding instability, inequitable access, and health system constraints continue to threaten progress. The conference reinforced the urgency of sustained global solidarity, African leadership, and integrated innovations to ensure that the end of the HIV pandemic remains an achievable global goal.