Scientists Are Gaining Ground Against AIDS

Post-trial surveys found that 98 percent of the subjects preferred injections to pills.In poor countries, cabotegravir may be especially useful because it does not need to be refrigerated.The clinical trial involving Descovy, a new pill from Gilead Sciences containing a form of tenofovir known as TAF — instead of TDF, the form in Truvada — showed that it suppressed the virus just as well as Truvada did.People who take Truvada every day as PrEP, or pre-exposure prophylaxis, are almost 100 percent protected against getting H.I.V., whether from unprotected sex or drug injection.The trial, known as Discover, found that Descovy was slightly less likely than Truvada to harm kidneys or bone density, but other studies have suggested that Descovy is more likely to raise cholesterol.Gilead said it will soon ask the Food and Drug Administration to let it market Descovy as PrEP. Some AIDS activists worry that people at risk will be urged to switch to Descovy just as low-cost generic versions of Truvada become available.Truvada has been very safe for most patients, but its high price — now about $20,000 a year — and the red tape needed to help the uninsured pay for it have become major obstacles to ending the AIDS epidemic in the United States.Gilead has already sold $33 billion worth of tenofovir; it is now shifting its new H.I.V. drug cocktails to TAF, which will remain patented — and, presumably, expensive — for many more years.The trial in 21 neighborhoods in Zambia and South Africa — a region where H.I.V. infection rates are the world’s highest — was designed to see whether infection rates could be dramatically cut if teams of counselors went door-to-door, testing anyone who agreed and offering pills to anyone testing positive.