FDA has approved Yeztugo, a drug that provides protection against HIV infection

Headline & Efficacy Claims

• Many commenters object to the “100% effective” framing as unscientific and clickbait.
• Even the linked article internally walks back to “almost 100%” and “around 99% protection,” causing distrust.
• People distinguish between trial results with zero infections and the statistical reality: using the “rule of 3,” 0 infections in a finite sample still means a non‑zero upper bound on risk.

Clinical Performance & Adherence

• Trial data discussed: one large study in young African women saw 0 HIV infections on lenacapavir vs 16 on Truvada; another showed ~89% relative risk reduction vs existing PrEP.
• Commenters stress the key advantage is not necessarily higher biological efficacy vs daily PrEP, but far better effectiveness because it’s much easier to adhere to two injections/year than daily pills.
• Existing PrEP is already highly effective when taken correctly; real‑world failures are mostly adherence problems.

Mechanism and Virology Questions

• Lenacapavir is a capsid inhibitor; several comments correct an early claim that it only works after integration and merely suppresses replication.
• Shared sources describe multi‑stage action: interfering with capsid function before nuclear import and reverse transcription, and also with later assembly/release.
• Some raise theoretical concerns about “occult” infections masked by a long‑acting antiviral and ask how trials rule this out; others argue prior experience with PrEP and FDA review make that unlikely.
• There’s debate about viral evolution: consensus is that targeting a fundamental, structurally constrained part of the virus makes resistance harder but not impossible.

Intended Use & Target Populations

• The drug is positioned as twice‑yearly PrEP, not a one‑off vaccine.
• High‑risk groups cited: men who have sex with men, sex workers, people who inject drugs, and young women in parts of Southern Africa with very high incidence.
• Some doubt it will ever be used broadly in low‑risk populations given already low baseline risk and cost.

Pricing, Access, and Pharma Economics

• US list price cited around $28k/year; speculation that, as with earlier Gilead drugs, rich countries subsidize cheap or free access in low‑income regions via tiered pricing and licensing deals.
• Strong disagreement over whether this makes Gilead “morally good” or just highly exploitative domestically. Past hepatitis C pricing is invoked both as evidence of predation and as cost‑effective versus liver transplantation.
• Several argue high US prices are driven less by R&D and more by marketing, PBMs, and profit extraction (dividends/buybacks), with Americans effectively subsidizing global access. Others counter that high US profits incentivize innovation worldwide.

Quality of Coverage and Data Transparency

• The New Atlas article is widely criticized as a shallow rewrite of Gilead PR: poor sourcing, confusing numbers, lack of detail on side effects, booster intervals, and global rollout.
• Commenters prefer going directly to Gilead’s press releases or mainstream medical reporting, which clearly state ~99–99.9% risk reduction rather than absolute 100%.

Broader Public Health & Social Context

• The twice‑yearly injectable form is seen as transformative for marginalized populations (unhoused people, rural patients, women facing stigma for daily PrEP, people where visible HIV meds are dangerous).
• Some discuss social barriers (e.g., women in South Africa being judged for PrEP use), stressing that discreet, infrequent injections may overcome these.
• There is speculative talk about modeling whether near‑universal, long‑acting PrEP could drive HIV toward eradication, balanced by concerns about risk compensation and anti‑medication attitudes.
• A side thread notes that decades of HIV research have massively advanced antiviral science more generally, with hopes this groundwork will aid future pandemics.