Ask AI
Back Back
Patient Advocate Insights for HIV Care
CROI 2026: A Patient Advocate's Perspective on Transformative Insights for HIV Care

Released: March 26, 2026

L. Lorenzo Williams
L. Lorenzo Williams
Activity Information

Activity

Progress
1
Course Completed
Continue
Key Takeaways
  • To truly harness the potential of the breakthroughs presented at CROI, healthcare professionals, policymakers, and patient advocates must prioritize scaling up the use of injectables, fostering transparent communication about treatment options, investing in community-led care models, and accelerating research into multipurpose technologies that meet the diverse needs of populations at risk.

The 33rd Conference on Retroviruses and Opportunistic Infections (CROI 2026), held from February 22-25 in Denver, was a pivotal moment in the ongoing fight against HIV. As a patient advocate, I was inspired by the groundbreaking data presented at this conference, which highlighted not only advancements in prevention and treatment but also the pressing need for equitable access to these innovations. The implications of these studies resonate deeply for individuals living with or at risk for HIV and underscore the importance of taking action to ensure these findings translate into improved patient care. 

Advances in Prevention and Treatment
One of the most compelling aspects of CROI 2026 was the focus on prevention strategies, particularly through the lens of pre-exposure prophylaxis (PrEP). The ANRS PREVENIR study showcased real-world effectiveness, revealing an HIV incidence of just 0.99 per 1000 person-years among 3209 users over a follow-up of 13,000 person-years.

This study affirms the effectiveness of flexible PrEP regimens: daily, on-demand, or mixed. However, only approximately 3.5 million people globally accessed PrEP in 2023, significantly below UNAIDS goals. The stark reality is that access to these life-saving medications remains a challenge, particularly in underserved regions. This disparity illustrates a critical gap in healthcare delivery and emphasizes the urgent need for advocacy and policy intervention to broaden access to PrEP.

Long-Acting Options
Long-acting (LA) injectable options like cabotegravir (CAB) and lenacapavir (LEN) emerged as potential game-changers that could address adherence barriers. The phase IV PILLAR study demonstrated 0 HIV infections among men who have sex with men and transgender men receiving bimonthly LA CAB injections, with high retention rates of 85% and 73% at 6 and 12 months, respectively.

However, despite these promising results, the uptake of injectable PrEP remains alarmingly low. This emphasizes the need for patient education and advocacy. Moreover, communication strategies must address the hesitancy that potential users may feel regarding these new PrEP agents, particularly given concerns about injection-site pain and the potential for missed doses.

Updated findings from the PURPOSE 1 and 2 trials of LEN were also particularly noteworthy, as they confirmed its efficacy despite some rare breakthrough infections. With the rarity of infections, among the lowest reported in HIV PrEP clinical trials, LEN presents an exciting opportunity for biannual or even annual dosing.

As advocates, we have a responsibility to ensure clear communication around the efficacy of these treatments to build trust among patients who may have concerns about breakthrough infections. It is essential to emphasize that, although no intervention is 100% effective, LEN represents a significant advancement in HIV prevention.

Advancements in treatment were also a major focus of the conference. The ARTISTRY-1 and ARTISTRY-2 trials highlighted the effectiveness of bictegravir/LEN regimens, which proved noninferior to more complex regimens, with over 90% maintenance of undetectable viral loads at 48 weeks in both studies. The reduced pill burden associated with antiretroviral therapy simplification improves quality of life, enhances patient comfort, and may also lead to better outcomes by improving adherence.

The Importance of Community Health Models
Equally important were the discussions around community health models, which demonstrated that science alone cannot eradicate HIV; effective delivery is paramount. Data from the SEARCH consortium illustrated a 70% reduction in HIV incidence through innovative community health worker interventions. These data reinforce the notion that localized, accessible care is vital for enhancing health outcomes.

The successful integration of pharmacy-based PrEP models in Kenya and Zimbabwe further showcases how community-driven initiatives can lead to increased initiation and continuation rates. These findings highlight the value of investing in community health infrastructure, where trained workers can provide culturally competent care, facilitate access to testing and treatment, and offer ongoing support to individuals at risk for HIV.

Furthermore, the conference shed light on the significance of multipurpose technologies, particularly for women and girls in high-burden areas. Early animal studies of a dolutegravir/levonorgestrel implant promise year-long HIV prevention and contraception. If successful, this implant could address dual needs for populations often neglected in traditional healthcare paradigms and revolutionize reproductive health for many, allowing women to take control of their health in ways that were previously unavailable.

The Ongoing Need for Equity
Although the advancements presented at CROI 2026 are promising, it is essential to remain vigilant about persistent barriers to access and equity that disproportionately affect marginalized communities, particularly women, youth, and underserved populations.

The fear of breakthrough infections and the stigma surrounding HIV can further complicate individuals' willingness to engage with HIV care and prevention. To truly harness the potential of these advances, we must prioritize scaling up the use of injectables, fostering transparent communication about treatment options, investing in community-led care models, and accelerating research into multipurpose technologies that meet the diverse needs of populations at risk.

CROI 2026 serves as a clarion call for advocates, healthcare professionals, and policymakers to unite in ensuring that the scientific advancements in HIV prevention and treatment reach those who need them most. The future of HIV care can be characterized by personalized, infrequent, and community-driven strategies, but only if we collectively commit to making this vision a reality.

The data are here, and now it is our responsibility to act. Only through collaboration and sustained advocacy can we dismantle the barriers that inhibit access and create a world where everyone, regardless of their circumstances, has the opportunity to live free from HIV.

Your Thoughts
How has the implementation of LA agents for HIV prevention and treatment fared in your area? How can you apply the lessons learned here to approaching equity in HIV care in your practice? Leave a comment to join the discussion!

Continue