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Working Together: Australian Perspectives From AIDS 2026

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Released: August 31, 2026

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New data on HIV cure and long-acting HIV prevention and treatment were hot topics of discussion at the AIDS 2026 conference, with Australia maintaining strong contributions to global research and HIV response efforts. Read on to learn more about how collaboration between Australia and Fiji to end an outbreak of HIV demonstrates that nations must work together on a global scale to bring equity to HIV prevention and management.

Sharon R. Lewin
Sharon R. Lewin, AO, FRACP, PhD
AIDS 2026 Australia

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AIDS 2026 had all the color, music, activism, and impact that one might expect of a conference held in Rio de Janeiro, Brazil, home to several landmark HIV prevention studies. Of the many abstracts presented, I found several notable trials to be important internationally as well as specifically to the Australian region.

Global HIV Response
Fiji was in the spotlight at AIDS 2026, and I had the great honor to chair a media roundtable as part of the conference. Against a global decline in new HIV acquisition rates, Asia and the Pacific Islands are 1 of 3 regions in the world where case numbers actually increased between 2010 and 2024. Fiji has seen a tenfold increase in new HIV acquisitions since 2014, largely driven by injection drug use, with Fiji’s Ministry of Health and Medical Services (MOHMS) declaring a national HIV outbreak in early 2025. UNAIDS estimates that Fiji currently has 1.6% HIV prevalence amongst adults. Fiji’s MOHMS launched a multisectoral response to manage the outbreak, with HIV prevention as a central part of the response.

To aid Fiji’s domestic efforts, the Australian government recently announced an investment of $48 million for programming in Fiji and the Pacific to address HIV and other communicable diseases. In addition, many groups from across Australia are sharing their expertise in HIV diagnostics, treatment, and prevention. There is still a long way to go to stop this outbreak, but the collaborative efforts to stem new HIV acquisitions in Fiji demonstrate how nations must work together on a global scale to bring equity to HIV prevention and management.

Long-Acting HIV Prevention
Access to long-acting antivirals for HIV prevention remains a major global issue. To date, Australia has chosen not to subsidize these medicines through the Pharmaceutical Benefits Scheme. However, there is growing evidence that long-acting antivirals, such as lenacapavir, are the preferred prevention tool for many people.

In the PURPOSE 1 and PURPOSE 2 trials, 95% of participants across 8 countries chose to continue lenacapavir, confirming a preference for long-acting options over daily pills in those clinical trials.

Another exciting HIV prevention tool in the development pipeline is the once-monthly oral nucleoside reverse transcriptase translocation inhibitor, MK-8527, now called alimatravir. Access to this medication was a hot topic of discussion, particularly for low- and middle-income countries, with estimates that it could be mass produced for about USD $15 per person per year.

However, not all news in HIV prevention was positive. CAPRISA 012C was a phase II, randomized, placebo-controlled trial from South Africa that evaluated a combination of 2 broadly neutralizing antibodies (bNAbs) for HIV prevention: CAP256-V2LS plus VRC07-523LS, administered subcutaneously every 6 months.

The combination was reported to be safe but did not reduce overall HIV incidence. According to investigators, the main problem was the high frequency of viruses circulating in South Africa that were resistant to both antibodies. This was also the Achilles heel of prior bNAb prevention studies, such as the Antibody-Mediated Prevention trials with VRC01.

Results from CAPRISA 012C will certainly trigger a reexamination of whether bNAbs really can play a role in HIV prevention, or whether our focus should remain on long-acting small molecule antivirals and developing an effective vaccine.

bNAbs in Treatment and Cure
Australia’s James McMahon presented the phase II results for a twice-yearly long-acting HIV treatment regimen combining lenacapavir and 2 bNAbs, teropavimab and zinlirvimab, compared to continuing an existing antiretroviral therapy (ART) regimen. Results at Week 104 demonstrated high rates of viral suppression: 98% (40/41) and 100% (19/19) in continuous vs late-switch arms, respectively. 

Separately, a large, randomized trial of bNAbs for cure, coincidentally titled RIO, showed that approximately a third of participants could successfully control HIV without ART after receiving 2 long-acting bNAbs. In his fantastic plenary talk, Michel Nussenzweig further explored the role that bNAbs are playing in cure trials, dissecting the immunologic predictors of who could and couldn’t control HIV after receiving a bNAb. This work is hugely important as it will give us new clues on who to enroll in cure trials that use bNAbs, as well as other new targets for cure strategies.

For Australia, this research highlights the importance of maintaining investment in HIV cure science alongside prevention and treatment programs. Australian researchers are already contributing to global cure efforts, and advances in bNAb-based approaches could create future opportunities for local participation in studies aimed at achieving long-term ART-free remission.

Your Thoughts
Between long-acting HIV treatment and prevention, new data on HIV cure, and collaborative international responses to end HIV, what do you think will be the most impactful for managing HIV in your country? Leave a comment to join the discussion!

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