Groundbreaking developments from the International AIDS Society Conference on HIV Science in Kigali, Rwanda
Imagine an HIV prevention method so effective it requires just two injections per year and proves 100% effective in clinical trials. Or a laboratory breakthrough that could finally force hidden HIV reservoirs out of their dormant state, potentially paving the way for a cure. These aren't speculative fantasies—they were the groundbreaking developments presented at the 2025 International AIDS Society Conference on HIV Science in Kigali, Rwanda.
This gathering of the world's leading HIV researchers occurred at a paradoxical time: unprecedented scientific innovation coincides with a global funding crisis that threatens to reverse decades of progress. As one advocate starkly noted at the conference, "You can't end the AIDS pandemic while African nations must choose between paying creditors and saving lives" 1 .
This article explores the most significant revelations from IAS 2025, where science and equity intersect in the global fight against HIV. We will journey through the expanding arsenal of long-acting prevention tools, examine breathtaking advances in cure research that are turning HIV's mechanisms against itself, and spotlight a pivotal experiment that could reshape future treatment strategies.
The paradigm of HIV prevention is undergoing its most dramatic transformation since the introduction of daily PrEP pills. The conference spotlight shone brightly on long-acting options that liberate users from daily dosing schedules, addressing adherence challenges and stigma that can accompany visible medication use.
The undisputed star of the conference was lenacapavir, a revolutionary drug that represents the first in a new class of capsid inhibitors 6 .
This innovative approach makes it exceptionally potent, requiring administration just twice yearly 1 .
The effectiveness data presented was striking: Phase 3 PURPOSE trial data demonstrated lenacapavir was nearly 100% effective in preventing HIV acquisition across a broad range of populations 1 .
| Option | Dosing Frequency | Stage of Development | Key Advantages |
|---|---|---|---|
| Lenacapavir | Twice yearly | Approved & Implementation | Highest efficacy, infrequent dosing |
| Cabotegravir-LA | Every 2 months | Approved & Implementation | Discreet, few side effects |
| MK-8527 | Once monthly | Phase 3 Trials | Oral rather than injectable |
The elusive goal of an HIV cure saw remarkable advances at the conference, with researchers reporting progress on multiple fronts against the virus's ability to establish hidden reservoirs that evade current treatments.
A groundbreaking study introduced an elegant refinement to the "shock and kill" approach for eliminating HIV reservoirs .
The researchers devised a clever solution using four different compounds that work in concert:
This approach specifically targets the estimated 3% of reservoir viruses that are intact and capable of causing rebound infection .
Researchers demonstrated how mRNA technology—pioneered in COVID-19 vaccines—could be harnessed to reveal hidden HIV 2 .
The team developed a novel lipid nanoparticle (LNP X) capable of delivering mRNA into the specific white blood cells where HIV hides 2 .
"We were overwhelmed by how much of a night and day difference it was—from not working before, and then all of a sudden it was working. And all of us were just sitting gasping like, 'wow'" 2 .
First person cured of HIV through CCR5-delta32 stem cell transplantation
Second confirmed HIV cure using similar stem cell approach
First woman cured using umbilical cord blood stem cells
Houston Methodist study demonstrates targeted reservoir elimination
The Houston Methodist study on eliminating HIV reservoirs represents such a significant methodological advance that it warrants closer examination. This experiment provides a potential missing piece in the cure puzzle by specifically targeting only the HIV reservoirs that matter.
| Experimental Group | Rate of Viral Rebound | Intact Virus Detected After Treatment |
|---|---|---|
| ART alone | 100% rebounded | Yes |
| ART + experimental cocktail | 31% rebounded | Only in mice that rebounded |
| ART + experimental cocktail (no rebound subgroup) | No rebound (69% of group) | No intact virus detected |
Unlike approaches that would eliminate all reservoir cells, this method specifically targets the small fraction (approximately 3%) capable of reigniting infection .
By sparing cells with defective viruses, the approach potentially avoids massive cell die-off that could trigger dangerous immune responses.
Modern HIV research relies on sophisticated tools and reagents that enable scientists to probe the virus's vulnerabilities. Here are some essential components of the contemporary HIV research toolkit:
| Research Reagent | Function in HIV Research | Application in Featured Studies |
|---|---|---|
| Lipid Nanoparticles (LNPs) | Deliver genetic material into specific cell types | Novel LNP X formulation targets HIV reservoir cells 2 |
| Broadly Neutralizing Antibodies (bNAbs) | Bind to and neutralize multiple HIV strains | Used in combination with lenacapavir and as standalone therapy 1 |
| Latency Reversing Agents | Activate dormant HIV in reservoir cells | Essential component of "shock and kill" approach |
| Apoptosis Modulators | Regulate programmed cell death pathways | ABT-263 makes HIV-infected cells more prone to death upon activation |
| Autophagy Inhibitors | Block cellular recycling processes that promote survival | SAR405 prevents infected cells from avoiding death signals |
| CRISPR-Cas9 Systems | Precisely edit DNA to excise HIV from infected cells | EBT-101 therapy currently in clinical trials |
The scientific advances unveiled at IAS 2025 represent extraordinary achievements in the four-decade fight against HIV. We now have prevention tools of unprecedented effectiveness and convenience, and cure research has progressed from theoretical concepts to tangible strategies with demonstrated efficacy in animal models. The message from Kigali was clear: the scientific building blocks to end the HIV epidemic increasingly exist.
However, these promising developments face a formidable obstacle—a global funding crisis that threatens to reverse progress. The impact of recent cuts was quantified in stark terms at the conference: in Mozambique, adult ART initiations fell by 25%; in Johannesburg, HIV testing declined by 8.5%, diagnoses by 31%, and ART initiations by 30%; across Latin America and the Caribbean, an estimated 156,164 beneficiaries lost access to HIV services 1 .
"We cannot stretch people to the brink and then praise their strength while denying them support" 1 .
The path forward requires dual commitment: continued investment in the implementation science that translates laboratory breakthroughs into accessible community services, and sustained funding to ensure these innovations reach everyone who would benefit. The tools to end HIV are increasingly within our grasp—whether we collectively choose to pick them up remains the decisive question.
Continue advancing long-acting prevention and cure research
Ensure new technologies reach all communities in need
Maintain and increase global commitment to HIV response