Recent research on a new long-acting HIV prevention medication is providing reassurance for transgender and gender-diverse people who rely on gender-affirming hormone therapy. Studies show that the injectable PrEP medication lenacapavir does not interfere with feminizing or masculinizing hormone regimens.
Lenacapavir, marketed under the brand name Yeztugo, was approved by the U.S. Food and Drug Administration in 2025 as a pre-exposure prophylaxis option to prevent HIV. Unlike daily oral PrEP pills or injections that require dosing every two months, lenacapavir is administered just twice a year, making it the longest-acting PrEP option currently available.
New data presented at IDWeek 2025 examined hormone levels in transgender participants receiving gender-affirming care while using lenacapavir. Researchers found that hormone levels remained stable after receiving the injectable medication, with no clinically significant drug interactions identified.
The findings address a longstanding concern within trans communities that HIV prevention medications might compromise hormone therapy effectiveness. Previous studies of oral PrEP have shown similar results, but uncertainty has continued to impact PrEP uptake among transgender people, particularly trans women and trans feminine individuals who face elevated HIV risk.
According to researchers, lenacapavir can be safely used alongside estrogen, testosterone, and other hormone regimens without requiring dose changes or additional monitoring beyond standard care. Over a 26-week observation period, no meaningful changes were observed in hormone concentrations that would affect gender-affirming outcomes.
Public health experts say the findings are significant because they remove a perceived barrier to HIV prevention. Transgender and gender-diverse people experience disproportionately high HIV rates due to a combination of systemic discrimination, healthcare access gaps, and social vulnerability. Ensuring that prevention tools are both effective and affirming is considered essential to addressing these disparities.
Lenacapavir is not the first injectable PrEP option. Another medication, cabotegravir, sold under the brand name Apretude, has been available in many regions and requires injections every two months. However, advocates note that lenacapavir’s six-month dosing schedule may be especially beneficial for people who struggle with daily medication adherence or frequent clinic visits.
Healthcare providers and community advocates emphasize that PrEP remains one of the most effective methods of HIV prevention when taken as prescribed. They also note that misinformation about hormone interference has discouraged some trans people from seeking protection, despite consistent evidence showing PrEP does not undermine gender-affirming care.
With growing data supporting the safety of long-acting PrEP options like lenacapavir, experts hope more transgender and gender-diverse individuals will feel confident accessing HIV prevention without fear of compromising their transition-related healthcare.
