One of the biggest problems in HIV prevention is not starting PrEP. It is staying on it. New results from a randomized trial in the United Kingdom and France, released by drugmaker Gilead Sciences on November 6, 2026, suggest that a twice-yearly PrEP injection may help with that. In the PURPOSE 5 study, 85.6% of people who started twice-yearly lenacapavir were still on schedule a year later, compared with 46.3% of people who started daily PrEP pills.

The findings are early and come from a company announcement ahead of the HIV Glasgow 2026 conference (November 8 to 11), so the full data have not yet been presented or peer reviewed. Here is what the study found, what it did not test, and why it matters if you are dating, in a relationship with someone of a different HIV status, or deciding which prevention option fits your life.

The short version

• Who was studied: 267 people in the UK and France who could benefit from PrEP but were not taking it when they enrolled. They were randomly assigned, two to one, to twice-yearly lenacapavir injections or daily oral emtricitabine/tenofovir disoproxil fumarate (F/TDF) pills, and followed for 52 weeks.
• The main result: 85.6% (154 of 180) in the injection group stayed persistent through week 52, versus 46.3% (37 of 80) in the pill group, a difference of 39.3 percentage points, according to Gilead's announcement.
• HIV acquisitions: Zero in the injection group and one in the pill group. Gilead reports that drug levels in that participant were consistent with fewer than two pills a week.
• Side effects: Injection-site reactions were the most common, mostly mild or moderate. No one stopped the injections because of side effects.

What "persistence" meant in this study

Persistence means consistent, on-time use over time, and the study measured it differently for each option. For the injection, a participant counted as persistent if they got their first injection and their week-26 injection on time (within two weeks either way) and came to the week-52 visit on time. For the pills, a participant counted as persistent only if dried blood spot tests at weeks 13, 26, 39 and 52 all showed drug levels consistent with at least four doses a week.

That detail matters. An injection is either given on time or not, while pill-taking has to be measured indirectly, every quarter, against a set threshold. The study was built to answer one question: which option people kept using. According to its ClinicalTrials.gov registration, the primary outcome is persistence through 52 weeks. It was not designed to compare how well the two options prevent HIV, so the zero-versus-one acquisition count should not be read as an efficacy comparison.

Who was in the trial

According to Gilead, 72.3% of participants were cisgender men, 7.1% were cisgender women and 20.6% were gender-diverse. Everyone was not taking PrEP at enrollment, and 37.8% had never used PrEP before. Retention was high in both groups: 89.4% of the injection group and 83.9% of the pill group attended the week-52 visit. The study is a phase 2, open-label trial, which means participants and their clinicians knew which option they were getting, and it is still ongoing. ClinicalTrials.gov lists 14 sites across the two countries.

Chloe Orkin, a clinical professor of infection and inequities at Queen Mary University of London, said in the announcement: "While starting on PrEP is important, persisting on PrEP is critical to preventing HIV acquisition." She added that it was notable the study reached a high proportion of new PrEP users.

What about side effects?

Gilead reports that serious adverse events were uncommon in both groups, 3.9% with the injection and 3.4% with the pills, and that investigators judged none to be related to the study medicine. The most common treatment-related reactions with the injection were at the injection site: nodules, or small lumps under the skin (67.8%), pain (60.0%), hardening of the skin (20.6%) and redness (17.8%). If you are curious what those lumps are like in practice, our explainer on how long PrEP shot lumps last walks through what the prescribing information and studies say.

Twice-yearly lenacapavir is sold in the United States as Yeztugo and in Europe as Yeytuo. Its US prescribing information carries a boxed warning: people must test negative for HIV before starting and before each injection, because drug resistance has been seen in people who had undiagnosed HIV while using it. The label also notes that the medicine can stay in the body for 12 months or longer after the last injection, and that people who stop and remain at risk should start another form of PrEP within 28 weeks of their last shot. In other words, a long-acting option still depends on keeping appointments.

Why this matters for people who date

PrEP only works when there is enough medicine in the body. The CDC's PrEP page puts it plainly: you must take PrEP as prescribed for it to work. Daily pills ask for a daily decision, through busy weeks, travel, breakups and new relationships. A study showing that more people stayed on schedule with an injection every six months speaks directly to that real-life challenge.

A few grounded points for daters and couples:

• U=U still applies. People living with HIV who take treatment as prescribed and keep a sustained undetectable viral load have effectively no risk of transmitting HIV through sex. PrEP is one additional tool for partners without HIV, not a replacement for treatment. Our guide to undetectable viral load and U=U explains how that works in a relationship.
• Mixed-status couples have choices. Some couples rely on U=U, some add PrEP, some use condoms too. Our piece on serodiscordant couples covers how partners talk through those decisions together.
• PrEP is HIV-only. The CDC notes that PrEP does not prevent other STIs or pregnancy. Our explainer on what PrEP and DoxyPEP do not protect against covers testing, vaccines and condoms.
• Access is still uneven. Results like these strengthen the case for long-acting options, but cost and supply decide who can get them. See our coverage of the first generic twice-yearly PrEP shot and the global push to reach 3 million people.

Whether a pill, an injection or another approach fits you is a decision to make with a licensed clinician who knows your health history. The CDC also advises talking with your provider before stopping PrEP, so they can explain how to stop safely and what other options may work better.

What to keep in mind

• The results come from a company press release. Full data are scheduled for HIV Glasgow 2026 and have not yet been published in a peer-reviewed journal.
• It is a relatively small, open-label, phase 2 study in two Western European countries, and it is still ongoing.
• Persistence was defined differently for each option, and the study was not designed to compare effectiveness against HIV.
• Daily oral PrEP remains highly effective when taken as prescribed. These findings are about how easy each option was to keep using, not about pills failing.

Quick FAQ

Does this mean the shot works better than PrEP pills?
Not exactly. PURPOSE 5 measured how many people kept using each option on time for a year. It was not designed to compare how well they prevent HIV. Both are approved PrEP options when used as prescribed.

Can I get the twice-yearly shot in the US?
Lenacapavir for PrEP is sold in the US as Yeztugo. Coverage, cost and clinic availability vary, so a health care provider or local sexual health clinic is the best place to ask. The CDC notes that most insurance plans and state Medicaid programs cover some form of PrEP.

What happens if I miss an injection?
The prescribing information includes steps for delayed or missed injections, and the right steps depend on timing. Talk with your provider rather than guessing.

Does PrEP change anything for my partner who is undetectable?
U=U is about the partner living with HIV keeping an undetectable viral load through treatment. PrEP is an option the partner without HIV can choose for added protection or peace of mind. Many couples decide together.

The bottom line

PURPOSE 5 is the first randomized trial designed specifically to compare whether people stay on a long-acting PrEP option versus daily pills, and in this group, far more people stayed on the twice-yearly shot. The full data at HIV Glasgow will tell us more. For now, the takeaway for daters is simple: the best prevention plan is the one you can actually keep, alongside testing, honest conversations and U=U. If you are looking for a community that understands life with HIV or another STI, explore HIV dating on MeetPositives.

Sources

• Gilead Sciences. "New Data Show Twice-Yearly Lenacapavir Achieved Nearly Twice the One-Year Persistence of Daily Oral F/TDF in HIV Prevention." Press release, November 6, 2026.
• ClinicalTrials.gov. "Study of Lenacapavir Taken Twice a Year for HIV Pre-Exposure Prophylaxis (PrEP)" (PURPOSE 5), NCT06513312.
• Centers for Disease Control and Prevention. "Preventing HIV with PrEP." Updated September 15, 2026.

This article is for general information only and is not medical advice. It does not create a doctor-patient relationship. Talk with a licensed health care provider about your own situation. This article does not recommend or promote any product.