The FDA has just greenlit Yeztugo, a groundbreaking HIV prevention shot you only need every six months. On paper, it’s a miracle: in clinical trials, it practically erased new HIV cases among gay and bisexual men, transgender people, and cisgender women in sub-Saharan Africa. The science? Solid. The delivery? Smooth. But here’s the rub—bureaucracy, politics, and cost could keep this medical marvel out of reach for the very people who need it most.
Yeztugo, also known by its generic name lenacapavir, doesn’t mess around. It’s a new class of drug that blocks HIV from hijacking immune cells. And unlike daily pills like Truvada or Descovy, which can be hard to stick with, this shot is in and out—twice a year and you’re good. In trials, it was up to 96% more effective than standard PrEP. It’s the kind of innovation the LGBTQ community has been waiting for since the start of the epidemic.
“This is the single best opportunity in 44 years of HIV prevention,” said Mitchell Warren, director of AVAC, an HIV advocacy group. And he’s not exaggerating. With PrEP use low among Black and Latino gay and bi men—who bear the brunt of new HIV infections—this injectable option could level the playing field, if we can actually get it into arms.
A Shot of Hope—and a Dose of Politics
Here’s where the celebration hits a snag. The Trump administration’s aggressive cuts to HIV funding—including plans to gut the CDC’s HIV-prevention division—could sabotage any hope of wide Yeztugo rollout. Research grants? Slashed. Staffing? Downsized. Public health infrastructure? Barely holding on. Even the NIH, once a steady hand in HIV research, is reeling from grant cancellations deemed “arbitrary and capricious” by a federal judge.
And then there’s the price tag: $14,109 per injection. That’s over $28,000 a year—unless insurance covers it. Which, spoiler alert, many don’t. While Gilead, the drug’s maker, has promised up to $7,200 in yearly out-of-pocket coverage and free access for uninsured low-income folks, the system remains a mess. Many insurers are still clinging to cheaper oral PrEP options like generic Truvada, which costs as little as $30 a month.
Experts worry that these financial and bureaucratic hurdles will disproportionately affect people of color and those already marginalized—again. “If there are barriers, like complicated prior authorizations or high copays… we could see disparities just get worse,” warned Dr. Susanne Doblecki-Lewis, who ran Yeztugo clinical trials at the University of Miami.
Community Clinics and Queer Innovation
There’s still hope on the horizon. Queer-led initiatives like Mistr, a PrEP-focused telehealth company, are already planning to roll out Yeztugo in seven major gayborhoods across the country. They’re working with community clinics to serve even the uninsured, keeping the community-first ethos alive in a healthcare landscape riddled with inequality.
And let’s be real: the LGBTQ community has never waited politely for access—we fight, we organize, and we look out for each other. Yeztugo is a medical revolution, but whether it delivers on its promise will depend on political will, insurance battles, and our own community’s ability to push the system to do better.
If we’ve learned anything from the last four decades of HIV activism, it’s this: science alone isn’t enough. Access matters. Equity matters. And no one should be left behind because their zip code, skin color, or insurance plan isn’t up to par.
Let’s make sure this isn’t another miracle lost in the red tape.