Is PrEP more effective than a vaccine would be?

Twice-yearly lenacapavir showed 99.9–100% efficacy in trials — better than any licensed vaccine against any disease. The open questions are cost, access, and uptake: an injection program must reach people twice a year, forever. A vaccine, if one existed, would be a one-course tool.

Does PrEP work for everyone?

Trial efficacy was near-uniform across studied populations when the drug was present in the body. Effectiveness in practice depends on adherence and access — which is why long-acting formulations matter.

Where can I get PrEP?

Talk to a clinician or public health service; availability varies by country. This site is a history and data archive, not a medical service.

The prevention line: PrEP's record while the world waited

The parallel line

1994 → NOW · 4 PRODUCTS

This site keeps two ledgers. The vaccine line is the one people ask about. The prevention line is the one that quietly won: from a 1994 idea to a twice-yearly injection with near-perfect trial efficacy. Vaccines didn't arrive; prevention did.

INFECTIONS · PURPOSE 1 LENACAPAVIR ARM (N=2,134)

99.9%

EFFICACY · PURPOSE 2 (2024)

2×

INJECTIONS PER YEAR · YEZTUGO (2025)

2012

FIRST ORAL PREP APPROVED

YEAR	THE PREVENTION LINE	STATUS
1994	The idea Early trials of tenofovir for treatment suggest it might protect uninfected cells. The concept of pre-exposure prophylaxis — PrEP — enters the literature.	CONCEPT
2010	iPrEx: proof in humans Daily oral tenofovir/FTC cut infections by 44% in men who have sex with men — the first RCT proof PrEP works (NEJM).	PARTIAL
2012	FDA approves Truvada as PrEP The first prevention pill for HIV. The vaccine line had been waiting 28 years; the prevention line now had its first licensed product.	DELIVERED
2021	Long-acting injections FDA approves cabotegravir (Apretude) — one shot every two months, after HPTN 083/084 showed it beats the daily pill. Adherence problem, meet solution.	DELIVERED
2024	PURPOSE 1: 100% Twice-yearly lenacapavir: zero infections among 2,134 women in South Africa and Uganda — 100% efficacy (NEJM). Science names it Breakthrough of the Year.	DELIVERED
2024	PURPOSE 2: 99.9% The result generalizes — 99.9% protection across diverse populations including cisgender men and transgender partners.	DELIVERED
2025	Yeztugo reaches clinics FDA approves lenacapavir (Yeztugo) for PrEP: two injections a year. The most effective HIV prevention tool ever licensed.	DELIVERED
2026	The gap that remains Access, cost and uptake — not efficacy — are now the binding constraints. A vaccine would still be the only tool that scales without a clinic visit; that line is being rebuilt in Phase 1.	NOW

Straight answers

FAQ

Is PrEP more effective than a vaccine would be?: Twice-yearly lenacapavir showed 99.9–100% efficacy in trials — better than any licensed vaccine against any disease. The open questions are cost, access, and uptake: an injection program must reach people twice a year, forever. A vaccine, if one existed, would be a one-course tool.
Does PrEP work for everyone?: Trial efficacy was near-uniform across studied populations when the drug was present in the body. Effectiveness in practice depends on adherence and access — which is why long-acting formulations matter.
Where can I get PrEP?: Talk to a clinician or public health service; availability varies by country. This site is a history and data archive, not a medical service.

Why this page exists on a vaccine site. Because the honest answer to "where is the HIV vaccine?" has two halves, and the second half is the actionable one. The ledger's vaccine column is a record of the world's longest wait; the prevention column is what you can use today. Sources: NEJM 2024 (PURPOSE 1, doi:10.1056/NEJMoa2407001), FDA approval records, evidence grades.