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Convenience and Choice Are Not Enough: Treatment Highlights From AIDS 2026

Conference Coverage Clinical Thought
Conference Coverage Clinical Thought
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Released: August 25, 2026

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New treatments are promising convenience and choice for people living with HIV. But in order to truly rethink, rebuild, and rise to tackle HIV—the theme from the AIDS 2026 conference—we need to ensure access to these treatments.

Tristan J. Barber
Tristan J. Barber, MA, MD, FRCP
Treatment Highlights AIDS 2026


After a conference like AIDS 2026 in Rio de Janeiro, Brazil, people often ask, “What did you learn that will change your practice?” As the dust settles, here are my highlights on how choice and convenience are important treatment advances and what they mean to practice.

ISLENDs in the Stream
Every community group I have spoken with in the last 2 years has been overwhelmingly positive and excited about the possibility of long-acting oral treatment. So to me, the big story for HIV treatment came in the ISLEND-1 and ISLEND-2 studies.

These studies give us phase III data on islatravir/lenacapavir as a single-tablet, once-weekly switch option. It was virologically noninferior to bictegravir/emtricitabine/tenofovir alafenamide at 48 weeks, with an excellent safety profile. Those receiving weekly medication also reported great treatment satisfaction.

Some healthcare professionals (HCPs) have wondered whether people would have difficulty remembering to take a weekly pill, but in these studies, adherence was great, demonstrating that people living with HIV can find solutions to problems that HCPs may worry about, sometimes needlessly.

In terms of other possible weekly oral options, data were also presented on islatravir and the nonnucleoside reverse transcriptase inhibitor (NNRTI) ulonivirine, also showing promise. It will be explored further in future studies.

People living with HIV have said that the psychological impact of a weekly pill is genuinely different from a daily one. That is why I think, with the right pricing and access, a once-weekly option could be a game changer. It could offer an important new choice, with agency and control, for people who want long-acting treatment with fewer pills but who may not want or like needles or regular injection appointments.

LATA: Tada!
Another treatment that is important for choice and convenience is long-acting injectable antiretroviral therapy (ART). Evidence keeps mounting that injectable long-acting cabotegravir and rilpivirine (LA CAB + RPV) can support not only those with an undetectable HIV-1 RNA, but also those struggling with adherence and detectable viremia. One might wonder if adherence would be an issue in adolescents, where the only previous trial with LA CAB + RPV was a single-arm study. Well, in the LATA study of adolescents with virologic suppression in Kenya, South Africa, Uganda, and Zimbabwe, a switch to LA CAB + RPV was effective and well tolerated. In this trial, adolescents were adherent and maintained viral suppression.

To me, these results show us that the people who stand to benefit the most from injectables may well be the ones who have historically found it hard to remain engaged in care. Sometimes our worry about drugs and safety or resistance can lead to paternalism, so it is good to see data that support wider rollout of medicines that can improve quality of life while safely supporting HIV suppression.

Come on, VOGUE
One study that I feel should have been done years ago is the VOGUE study, which examined starting HIV treatment with a 2-drug regimen—dolutegravir/lamivudine—instead of a standard 3-drug regimen of bictegravir/emtricitabine/tenofovir alafenamide. When used in a rapid start “test and treat” strategy, with no restrictions on CD4+ cell count or HIV-1 RNA before starting ART, both the 2-drug and 3-drug regimens were associated with comparable viral suppression. The conversations I had suggest that this might have a big impact in low-income and middle-income countries, particularly in Africa, where the standard first-line treatment is the 3-drug regimen of dolutegravir/lamivudine/tenofovir disoproxil fumarate.

Choice and Convenience, Without Access?
What nagged at me all week, though, was not a drug at all. It was the widening gap between what science can now offer vs what PEPFAR cuts and shrinking global funding mean for who gets any of it. Choice and convenience are great, but nearly 9 million people are still not on treatment at all. In the closing session, there were 2 quotes that hit home, the first from Edwin Bernard (“Science may advance, but justice does not”), and the second from the Minister of Health for Brazil, Alexandre Padilha (“Innovation without access is an injustice”). 

Truly a call to arms if we are to respond to the conference theme to “rethink, rebuild, and rise” together.

Your Thoughts
What developments from the AIDS 2026 conference were most intriguing to you, and why? Leave a comment to join the discussion!