Grinsztejn Beatriz, Appay Victor, Bekker Linda-Gail, Beyrer Chris, Donnell Deborah, Sanchez Jorge, Canagasabey Davina, Coutinho Carolina, Ganor Yonatan, Muturi-Kioi Vincent, Ortblad Katrina F, Cooney Erin, Devisich Gastón, Ellenberg Paula, Ghiglione Yanina, K'Orimba Kevin, Ssemambo Phionah Kibalama, Ludwig-Barron Natasha Tatiana, Mielke Dieter Kenneth, Mullick Ranajoy, Muthui Michelle Kathini, Radusky Pablo D, Sendaula Emmanuel, Tirmizi Syed Raza Haider, Sanchez Akemi V Matsuno, Vega Julian, Pebody Roger
Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil.
Université de Bordeaux, Bordeaux, France.
J Int AIDS Soc. 2025 Jul;28(7):e70001. doi: 10.1002/jia2.70001.
INTRODUCTION: HIVR4P 2024, the 5th HIV Research for Prevention Conference, took place in Lima, Peru, 6-10 October 2024. The conference focused on new developments in HIV prevention from basic research to new product development and implementation science. METHODS: Sessions were assigned to one of five tracks: basic science; pre-exposure prophylaxis (PrEP) and antiretroviral (ARV)-based prevention; vaccines and broadly neutralizing antibodies (bNAbs); applied and implementation science; and other prevention modalities and cross-cutting issues. A team of rapporteurs covered each track and identified conference highlights. RESULTS: Strategies to elicit bNAb responses by vaccination are advancing to clinical trials, while combination bNAbs show promise as an alternative to ARV-based products. There is promising diversity in the PrEP product pipeline and twice-yearly lenacapavir has demonstrated exceptional efficacy, but barriers to widespread access and implementation remain, compounded by new challenges from the significant policy changes and funding reductions of the new US administration. Innovative ways of delivering PrEP to vulnerable communities that could benefit are being explored and, in some cases, have been successfully implemented. DISCUSSION: Choice in HIV prevention products and differentiated delivery models that enable clients to select options that meet their preferences and changing needs is essential. Additionally, the involvement of the community throughout the design, implementation and dissemination process is necessary to maximize the impact of HIV prevention. Ensuring equitable access in a rapidly changing context will involve policy changes, partnerships with local organizations and addressing social determinants that impact health outcomes. CONCLUSIONS: We are in an era with more tools than ever before to prevent HIV acquisition; now, we need to facilitate collaborations between diverse stakeholders, including researchers, community members, policymakers, healthcare providers and funders. The future of HIV prevention should lie in a holistic approach that respects individual choice, enhances service accessibility and is flexible to meet evolving challenges and opportunities. However, policy changes since the conference ended have profoundly altered the HIV prevention landscape and threaten the advances described in this report.
引言：2024年第五届预防艾滋病病毒研究会议（HIVR4P 2024）于2024年10月6日至10日在秘鲁利马举行。会议聚焦于从基础研究到新产品开发及实施科学等艾滋病病毒预防领域的新进展。 方法：会议场次被分配到五个主题领域之一：基础科学；暴露前预防（PrEP）及基于抗逆转录病毒药物（ARV）的预防；疫苗及广泛中和抗体（bNAb）；应用与实施科学；以及其他预防方式和交叉问题。一组报告员负责每个主题领域，并确定会议亮点。 结果：通过疫苗接种引发广泛中和抗体反应的策略正推进至临床试验阶段，而联合广泛中和抗体有望成为基于抗逆转录病毒药物产品的替代方案。暴露前预防产品研发线呈现出多样且有前景的态势，每年两次注射的来那卡韦已展现出卓越疗效，但广泛获取和实施仍存在障碍，新美国政府重大政策变化和资金削减带来的新挑战使情况更加复杂。正在探索并在某些情况下已成功实施向可能受益的弱势群体提供暴露前预防的创新方式。 讨论：在艾滋病病毒预防产品方面做出选择以及采用差异化的交付模式，使客户能够选择符合其偏好和不断变化需求的选项至关重要。此外，社区参与整个设计、实施和传播过程对于最大化艾滋病病毒预防的影响是必要的。在快速变化的背景下确保公平获取将涉及政策变革、与当地组织的伙伴关系以及解决影响健康结果的社会决定因素。 结论：我们正处于一个预防艾滋病病毒感染的工具比以往任何时候都更多的时代；现在，我们需要促进包括研究人员、社区成员、政策制定者、医疗保健提供者和资助者在内的不同利益相关者之间的合作。艾滋病病毒预防的未来应在于一种尊重个人选择、提高服务可及性并灵活应对不断演变的挑战和机遇的整体方法。然而，会议结束后的政策变化已深刻改变了艾滋病病毒预防格局，并威胁到本报告所述的进展。
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