Thrilled that lenacapavir, which is injected twice yearly, was highly effective in both gay men and women in clinical trials, HIV advocates worry it will prove too expensive for insurers.

The hotly anticipated results are in from a landmark pair of major clinical trials of a long-acting, injectable HIV-prevention drug that only requires dosing every six months.

They are sensational.

Thrilled over the news Thursday that lenacapavir was 89% more effective at preventing HIV than daily oral preventive medication among gay, bisexual and transgender people, plus previous news that the injectable drug was 100% effective in cisgender women, HIV advocates are looking to the future. They hope that if rolled out broadly and equitably, lenacapavir could be the game changer the nation badly needs.