Your friend mentions they’re starting HIV prevention medication. And you want to be supportive, but your knowledge stops somewhere around high school health class or whatever you heard about in the late 90s. Daily pills, right? But what else?
Here’s the thing: HIV prevention has changed dramatically in the past few years, and most of us missed the memo. That outdated knowledge affects real conversations with real people—the ones who matter to us—so let’s update what you know, and how you talk about it.
A Quick Look Back
1980s: The earliest hint of prevention came almost by accident. AZT, the first HIV treatment, was found to reduce mother-to-child transmission and protect healthcare workers after accidental exposure—though it was never officially approved for prevention.
2012: A major breakthrough. The FDA approved Truvada as the first medication for PrEP (pre-exposure prophylaxis), changing the game for people at higher risk.
Since then: More tools followed—PEP (post-exposure prophylaxis), Descovy, and in 2021, the first injectable PrEP (cabotegravir/Apretude), given every two months.
And now? 2025 marks another leap forward, with a twice-yearly injection that pushes HIV prevention into an entirely new era.
New Advances in HIV Prevention #1: The Twice-a-Year Injectable
This is the headline news: a new injectable PrEP, approved by the FDA, that you only need once every six months. That’s right—just two appointments a year, and you’re covered.
Think about what that means in practice. No pill bottles. No daily reminders. No awkward “Did I forget today?” spiral. You get an injection, and then you’re free to live your life for the next six months with strong protection against HIV.
The drug is called lenacapavir (brand name Yeztugo), and the effectiveness is stunning. In the PURPOSE 1 trial, not a single woman who received the twice-yearly shot contracted HIV. Zero infections. For a disease that has challenged scientists for decades, that result is nothing short of historic.
What this means beyond the medical breakthrough is simple: when someone you care about mentions they’re “on PrEP” now, they might not be taking a pill a day. They might get two shots a year and think about HIV prevention as often as they think about their tetanus vaccine. The conversation changes completely.
But You Have Even More HIV Prevention Options
What’s important to understand about HIV prevention is that it’s no longer about “the one right choice.” It’s about having a menu. That matters because your needs today might not be your needs next year, and it matters because different people need different solutions. Besides the twice-yearly injection, other HIV prevention advances include:
The once-every-two-months injection (cabotegravir): Shots every eight weeks that work as well as daily pills. Recent research shows it’s safe for people who are pregnant or breastfeeding—huge news that means you don’t have to choose between protecting yourself and protecting your baby.
Daily pills: Still 99% effective when taken consistently. Often the easiest to start with and perfect for people who like having control over their routine.
Monthly pills coming soon: MK-8527 is moving through final trials and could be approved within 2-3 years.
The dapivirine vaginal ring: Monthly prevention specifically designed for women.
What About HIV Vaccines?
Every generation asks, “When will there be a vaccine?” The honest answer is still “soon—maybe.” The timeline reality is that even optimistic projections put a widely available HIV vaccine several years out. But for the first time, researchers are doing more than just chasing hope—they’re building it systematically. Here’s why:
Scientists are using new tools, like mRNA technology (the same approach used for COVID-19 vaccines), to design more innovative strategies. In 2025, researchers successfully induced HIV-fighting antibodies in human volunteers, proving that the human immune system can be trained to recognize and attack HIV.
So we don’t have a preventive HIV vaccine you can get at CVS—yet.
If someone asks about HIV vaccines: “There’s exciting progress in trials, but right now we have incredibly effective prevention methods available today that work better than most vaccines.”
How These Real Advances Change Your Real Conversations
All of these medical breakthroughs are impressive, but here’s what really matters: they completely change how you should respond when HIV comes up in conversation. The old responses that made sense in 1995 can actually harm people now by reflecting outdated fears instead of current realities.
When Someone Mentions Starting PrEP
The old mindset: PrEP means daily pills and someone is “high risk.”
The new reality: PrEP comes in multiple forms and is smart prevention for anyone who wants it.
✅ Try: “That’s smart prevention. How’s the method working for your routine?”
❌ Avoid: “Are you remembering to take it every day?” (assumes daily pills and creates shame about adherence)
❌ Also avoid: “Do you really need that?” (questions their risk assessment)
Why this matters: Someone starting PrEP has thought carefully about their situation and talked with healthcare providers. Your job is to support, not second-guess their decision. And now that PrEP includes twice-yearly shots, your assumptions about what “being on PrEP” looks like need updating.
When Someone Discloses HIV+ Status
The old mindset: This is a crisis requiring immediate emotional support and transmission fears need addressing.
The new reality: This is someone trusting you with their health information about a manageable condition.
✅ Try: “Thank you for trusting me with this. What kind of support would be helpful?”
❌ Avoid:
- Medical questions (“How did this happen?”)
- Transmission fears (“Are you safe to be around?”)
- Immediate advice-giving (“You need to start treatment right away”)
Your first ten seconds matter most. After that initial response, follow their lead. They might need practical support like rides to appointments, someone to pick up prescriptions, or just someone who treats them normally. They probably don’t need you to process the emotional weight of their diagnosis – they’ve likely already done that work.
When Someone Mentions HIV Testing
The old mindset: HIV testing means something scary is happening.
The new reality: HIV testing should be as routine as any health screening.
✅ Try: “Good for you for staying on top of your health. Want company for the appointment?”
❌ Avoid: “Are you worried about something?” (This implies they should only test if scared)
Why this matters: Regular HIV testing is preventive healthcare, not crisis management. When you treat it as normal, you’re helping reduce the stigma that keeps people from testing regularly.
Addressing Your Own Discomfort
Here’s the honest truth: feeling awkward about HIV conversations doesn’t make you a bad person. These topics bring up sex, health, mortality, and decades of cultural baggage. It’s normal to feel unsure about how to respond.
But their HIV status or prevention choices aren’t about your comfort level. If you need to process your own feelings about HIV, do that on your own time with other people or resources. Don’t make the person who disclosed to you responsible for managing your emotional reaction.
Get educated separately. Learn about current HIV realities outside of conversations with people affected. This lets you show up as an informed supporter rather than someone who needs education and reassurance.
Supporting Treatment and Prevention Decisions
Listen more than you advise. People managing HIV prevention or treatment usually know more about their options than you do. They’ve talked with healthcare providers, read research, and considered their specific situation.
Practical support wins every time. Offering specific help – “Can I give you a ride to your appointment next Tuesday?” or “Want me to grab your prescription while I’m at the pharmacy?” – is more useful than general emotional support.
Respect their autonomy. Adults make their own medical decisions. Your role is support, not supervision. That means not asking, “Are you taking your medication?” or “Are you being safe?” unless they specifically ask for that kind of accountability.
Time for Our Language to Catch Up to the Science
HIV conversations in 2026 should sound like conversations about any other manageable health condition. When a friend mentions starting cholesterol medication or switching birth control, you probably don’t panic. HIV prevention and treatment deserve the same practical, supportive response.
There’s a growing gap between what HIV science can accomplish and how we talk about it in everyday life. Medical advances are outpacing social understanding, which means stigma persists even when the medical reality has changed completely.
These new scientific tools honor people’s real lives. They fit into unpredictable schedules, respect privacy, and offer personal choice. They are medical victories, sure, but they are conversation changers.
Your challenge: Let your language catch up with the science and help create spaces for people to discuss healthcare decisions that work for their lives.
Need other support documents? Need to find a counselor or support group?
We have you covered.
