Long-acting therapies continue to gain momentum in HIV, says GlobalData

The next phase of competition in the HIV market will be defined not only by achieving viral suppression, but by improving treatment adherence, reducing medication burden and delivering more convenient treatment options, with long-acting therapies at the forefront, according to GlobalData, a leading intelligence and productivity platform.

GlobalData forecasts that the HIV market across the seven major markets (7MM: the US, France, Germany, Italy, Spain, the UK and Japan) will grow from $26.4 billion in 2023 to $30.6 billion by 2033, with increased uptake of long-acting therapies representing a key driver of growth.

Findings presented at the 26th International AIDS Conference (AIDS 2026) included positive new data for ViiV Healthcare’s Cabenuva (cabotegravir/rilpivirine) among adolescents living with HIV.

Cabenuva was the first complete long-acting injectable treatment regimen to reach the HIV market and is now approved in regions including the US, the EU, Japan, and Canada, among others. In terms of virologic suppression, Cabenuva administered every other month demonstrated superiority compared with daily oral antiretroviral therapy in adolescents living with HIV. These results further support the role of long-acting injectable therapies in addressing adherence challenges and reducing the burden associated with lifelong daily medication.

Once-weekly oral therapy

In addition, new Phase III data was presented for the investigational once-weekly oral combination of islatravir and lenacapavir (ISL/LEN), which is under development by Gilead and Merck, is on track to become the first once-weekly oral therapy. ISL/LEN demonstrated non-inferiority in terms of maintaining virologic suppression compared with daily oral regimens in people living with HIV who switched from standard-of-care daily oral regimens. Growing interest in extended-interval treatment approaches such as ISL/LEN could offer patients greater flexibility while maintaining effective viral control.

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Abigail Harris, Infectious Disease Analyst at GlobalData, comments: “Long-acting HIV therapies are becoming an increasingly competitive treatment category. While efficacy remains essential, differentiation is now shifting towards factors such as dosing convenience, adherence benefits and the ability to improve the overall treatment experience for patients.”

Although daily oral antiretroviral therapies remain highly effective and continue to represent the standard of care for many patients, long-acting approaches may help address some of the persistent challenges associated with lifelong HIV treatment.

Priorities for patients

The key opinion leaders (KOL) previously interviewed by GlobalData have indicated that reducing pill burden and treatment visibility are important priorities for many people living with HIV, particularly those who experience stigma associated with taking daily medication. Long-acting therapies have the potential to improve adherence by reducing dosing frequency while also helping patients maintain discretion around their condition.

However, KOLs have also highlighted that affordability, reimbursement and healthcare infrastructure may represent significant barriers to broader adoption. Compared with oral therapies, injectable products require additional manufacturing, storage and administration requirements. Strong uptake will depend on continued investment in healthcare infrastructure, pricing strategies and access initiatives to ensure these therapies reach the patients who could benefit most.

Next steps

Harris concludes: “Once-weekly oral therapies offer manufacturing and delivery advantages compared with injectable products. However, their commercial success will depend on balancing affordability with the premium associated with improved convenience and reduced dosing frequency. The future competitive landscape will be shaped by products that can combine strong clinical performance with improved convenience, and equitable access.”