What Older Adults Need to Know About a New HIV Medication

Thousands of adults age 50-plus are diagnosed with HIV every year, but an expanding menu of medications can help prevent these infections

Rachel Nania,

AARP

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Published July 17, 2025

pharmacist holds a vial of lenacapavir, an injectable HIV prevention drug

AARP (Nardus Engelbrecht/AP Photo)

There’s a new tool to help prevent HIV in people who are at risk of contracting the virus, and health experts say it has the potential to change the trajectory of the global epidemic and may be especially beneficial for some older adults.

In June, the U.S. Food and Drug Administration (FDA) approved the twice-yearly injection lenacapavir, marketed as Yeztugo, for use as pre-exposure prophylaxis (PrEP), a preventive treatment that helps stop HIV infection before it starts. Other forms of PrEP that are available include daily pills, like Truvada, or a shot that’s given every other month, known as Apretude.

In clinical trials, however, lenacapavir — which has been FDA-approved since 2022 to treat certain types of HIV infections — was found to be more effective at HIV prevention than a daily PrEP pill. Results from a phase 3 study, published in the New England Journal of Medicine, showed that nearly all (99.9 percent) of participants taking lenacapavir were protected against HIV.

“So it’s very, very effective,” says Joseph J. Eron, M.D., the Herman and Louise Smith Distinguished Professor of Medicine at UNC School of Medicine and director of the Clinical Core at the UNC Center for AIDS Research.

It’s also more convenient than other available options. Patients don’t need to make frequent trips to the clinic for the medication, and “it doesn’t require people to remember to take a pill,” which, if missed often, can affect how well it works, says Matthew Hamill, M.D., an HIV expert and an associate professor of medicine at Johns Hopkins Medicine.

Researchers leading the clinical trial found that adherence to lenacapavir was higher than that of the daily oral pill. “I think people underestimate how hard it is to take their medicine every day, especially if you’re not having symptoms,” Eron says.

Public health experts say a twice-yearly injection could support broader HIV prevention efforts, especially in areas of the U.S. and the world where access to routine medication and medical appointments is limited.

“It’s just better to have more options that more people can use,” says Katherine Promer, M.D., an infectious disease physician who specializes in caring for individuals with HIV at UC San Diego Health.

HIV trends in older adults

There’s a common misconception that HIV affects only younger populations; in fact, infections among older adults have increased in recent years.

In 2022, people age 50 and older accounted for approximately 16 percent of the nearly 39,000 new HIV diagnoses in the U.S., federal data shows. More than half of the nearly 1.1 million people living with HIV in the U.S. in 2022 were 50 or older.

There’s a “tendency to desexualize older individuals and imagine that sex isn’t important to them and that they’re not engaging in sexual activity, which, of course, is not true,” Hamill says. What’s more, postmenopausal women, who can have sex without worrying about pregnancy, may neglect using forms of protection, like condoms, “putting them at heightened risk for STIs [sexually transmitted infections], including HIV,” Hamill explains.

Federal data shows STIs among older adults have spiked in recent years, and that cases of syphilis, gonorrhea and chlamydia more than doubled among people 55 and older between 2012 and 2022.

Potential benefits for older adults

All currently available PrEP options have their benefits, but experts say lenacapavir — which works differently than other medications by blocking the virus from making copies of itself — has some qualities that could make it especially well suited for older adults.

One is that it doesn’t add to the pill burden that many people 50 and older experience, Promer says. According to the National Center for Health Statistics, roughly 20 percent of adults ages 40 to 79 take five or more prescription medications. That share jumps to 40 percent when considering adults 65 and older, additional research shows.

Promer says that “there are no major drug interactions” for lenacapavir, though Hamill says your doctor should still do a thorough review of your medications before prescribing it. And the side effects reported in the trials were minimal, with injection site reactions, headache and nausea among the most common.

What’s more, some people may feel less stigmatized receiving a twice-yearly injection compared with taking a daily medication, or they may be less fearful of someone else discovering they’re taking PrEP, Promer says.

However, one obstacle that could prevent eligible individuals from obtaining lenacapavir is its price: $28,000 per year. Experts say it’s unclear yet whether insurance companies will cover the costs.

“If a drug is not affordable, that really limits the utility,” Promer says.

Under the Affordable Care Act, some form of PrEP is free under almost all health insurance plans. The New York Times reports that 21,000 Americans take an Apretude injection every other month, while nearly 500,000 take daily PrEP pills.

Talk to your doctor about your risks

Hamill’s advice for adults age 50-plus is to make sure you’re talking to your doctor about your risks for STIs, including HIV, at your routine visits, just like you would about high blood pressure or heart disease. In 2022, only one-third of people in the U.S. who could benefit from PrEP had been prescribed it, according to the CDC.

When it comes to preventing and treating HIV, we’ve made “incredible progress” in the past several years, Hamill says. “And for older people who were witnesses to the ravages of AIDS in the ’80s and ’90s, I can imagine that this [latest drug approval] could be a really potent message of hope for those who may have lost friends and loved ones.”

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