A twice-yearly shot could be the catalyst for stopping a recent spike in new HIV diagnoses that’s disproportionately hitting young men of color, but the challenge is creating awareness among people who will benefit from it.
The drug lenacapavir, which goes by the brand name Yeztugo, was developed by California-based Gilead Sciences. Clinical trials on twice-yearly shots of Yeztugo for HIV prevention showed remarkable results: It provided 100% protection from HIV in one study of 2,134 adolescent girls and young women in sub-Saharan Africa that was published July 24, 2024, in the New England Journal of Medicine.
Yeztugo was first approved by the U.S. Food and Drug Administration in June 2025 and recommended by the U.S. Centers for Disease Control and Prevention Sept. 18. Traction with patients and insurers has been growing since early October, said Mark Moeremans, who is the CEO of Phoenix-based Spectrum Medical Care Center and who received his first dose of Yeztugo at Spectrum Medical on March 13.
Moeremans and other HIV prevention advocates see Yeztugo as a potential gamechanger for preventing new HIV (human immunodeficiency virus) infections. HIV is no longer the near-certain death sentence it once was, but it still exacts a high emotional, physical and financial toll, which is why prevention is so important.
Yeztugo is a long-acting form of PrEP — pre-exposure prophylaxis to prevent HIV infections — in people who are at risk and are HIV negative. Other PrEP options include a daily oral pill and a bi-monthly intramuscular shot called Apretude (cabotegravir).
Officials at Spectrum Medical have given the Yeztugo injection to 185 patients since late 2025 and as of March 13, another 100 patients were either waiting to receive it or were in the screening process to receive it. If everyone at risk of contracting HIV was taking either Yeztugo or another form of PrEP to prevent HIV, “we could eliminate HIV in one generation,” Moeremans said as he held ice packs on his abdominal area to prepare for his first dose of Yeztugo.
Before Yeztugo, Moeremans had spent approximately a decade on a daily PrEP pill. He views Yeztugo as both easier and better for peace of mind in providing protection from HIV infection.
“This is really a huge breakthrough for us medically,” said Dr. Howard Grossman, who is the chief medical officer for Spectrum Medical. “It really increases patient convenience. It’s going to hopefully increase their adherence, their ability to take
these medications … If you could stop transmission, you end the epidemic.”
Health leader: Outreach needs to go ‘so much further’ than gay bars
Spectrum Medical does outreach at LGBTQ+ bars, gay sports leagues, Roller Derby and events like Phoenix Pride and the regular RuPaul’s Drag Race watch parties it sponsors at Kobalt Bar in central Phoenix. But not everyone at risk of HIV frequents those venues.
A key part of getting the word out about Yeztugo will be finding the people who will benefit from it, Moeremans said.
“HIV and sexual health prevention and even LGBTQ primary care goes so much further beyond the community of people that’s going to bars,” Moeremans said.
Yeztugo is subcutaneous and reportedly less painful than Apretude, and it’s also needed twice a year versus every other month for the Apretude injection or every day for the PrEP oral pills, which first became available in 2012.
“This is huge. Everyone in HIV prevention has been really excited for this to come out,” said Casey Simon, chief clinical programs officer for the nonprofit Prisma Community Care in Phoenix, which has 40 to 50 patients receiving Yeztugo. “We are still in an early adoption phase where clinicians are learning more about it and insurance companies are starting to cover it. I think it’s just going to continue to grow.”
The most up-to-date available data for Arizona shows that 964 people received new diagnoses of HIV in 2024, which is 30% higher than the number of new diagnoses a decade prior. A majority of those newly diagnosed in 2024 in Arizona were men, and 45% of them were Hispanic, state data shows.
The most recently available national data, from 2023, shows 39,201 individuals in the United States (including its five territories and the Republic of Palau) received new diagnoses of HIV, data from the U.S. Centers for Disease Control and Prevention says. Eighty-one percent of those diagnoses were among men, and more than one-third were in Black and Hispanic individuals, the CDC data shows.
Globally, 1.3 million people became newly-infected with HIV in 2024, according to the Joint United Nations Program on HIV/AIDS.
People who have already tested positive for HIV are not eligible for Yeztugo, and ascertaining that HIV negative status is part of the process when someone gets their Yeztugo injection, providers say.
About 20,000 Arizonans are living with HIV, a majority in Maricopa County, and about 13% of the people who are positive don’t know they have it, state and federal data shows.
Arizona’s Medicaid program requires prior authorization for Yeztugo
Since the FDA approval, there’s approximately 90% insurance coverage for Yeztugo, including with major payers and pharmacy benefit managers such as UnitedHealth, Express Scripts, CVS and Medicaid and Medicare, according to Gilead Sciences.
“Most private insurance, Medicaid expansion, and Medicare plans are required to cover PrEP medicines and related ancillary services with no cost-sharing,” Gilead Sciences wrote in an email to The Arizona Republic.
Medicaid programs in three states are not covering Yeztugo — South Dakota, Kansas and Wyoming, the company says. Medicaid programs in all other states, including Arizona, are covering the drug, although specific plan requirements may vary, officials wrote.
Arizona’s Medicaid program, known as the Arizona Health Care Cost Containment System, or AHCCCS, may cover the cost of Yeztugo after a prior authorization process that requires preapproval from AHCCCS health plans, agency spokesperson
Johnny Cordoba said.
“AHCCCS health plans review requests based on clinical criteria and medical necessity standards,” Cordoba wrote.
Other insurers have been adding Yeztugo to their list of covered drugs, and Gilead Sciences is providing manufacturer discounts for people who are uninsured or whose insurance won’t pay for it. Insurance or discounts are a must-have for Yeztugo since its wholesale acquisition cost is about $14,000 per injection.
Gilead Sciences says that list price “does not typically reflect the out-of-pocket cost a patient will pay because it does not account for health plan benefit designs or assistance programs.”
Gilead Sciences has also committed to making Yeztugo available in lower- and middle-income countries. In addition to the United States, it’s available in several countries in Africa, including Eswatini, Kenya, Zambia and Zimbabwe, Gilead officials wrote in an email.
Health plans typically require proof that a patient is at risk for HIV and that they are HIV negative, said Grossman, the chief medical officer for Spectrum Medical. He emphasized that it’s not just men who have sex with men who are at risk of HIV infection. Women having sex without using condoms are at risk, too, he said.
“We have to get this message out that there is a way to prevent HIV,” Grossman said. “We hope the message gets out to women and we hope that this message gets to the young men who are most at risk — young men of color.”
In 2024, 56% of the new HIV infections reported to the Arizona Department of Health Services fell into the transmission category of men who have sex with men; 7% were injection drug users; 7% had high-risk heterosexual activity; 5% were men who both have sex with men and are injection drug users; and in nearly one-quarter of the cases, the transmission manner was unknown or not reported.
‘Unfortunately awareness is still limited’
In addition to Prisma and Spectrum Medical, El Rio Community Health Care Center in Tucson is offering Yeztugo. And the nonprofit group Chicanos Por La Causa, which advocates for underserved communities, is doing outreach to connect people at risk who want the shot with other clinics around the state that will administer it.
Spectrum Medical has navigators that will help patients figure out whether they qualify, whether Yeztugo is the best option for their health needs, and how they will transition off the drug if it isn’t what they want.
Yeztugo stays in the system for up to a year, but its effectiveness will wane after six months unless the patient gets another shot. And if the patient does not get another shot, it’s important they use another method of protection because acquiring an HIV infection during that waning phase could leave them vulnerable to a drug-resistant strain of HIV, Grossman, the Spectrum Medical chief medical officer, said.
Yeztugo isn’t a vaccine, but it’s the closest thing to an HIV vaccine that’s available, which is why it’s important to get the word out, especially to people of color who are at high risk, said Erasmily Baca Garcia, Chicanos Por La Causa HIV educator and psychosocial specialist.
“We let them know we are a safe space for them, whenever they are able to talk more freely,” she said. “There’s still stigma, but there aren’t any questions that are too taboo.”
Spanish-speaking media outlets have begun airing advertisements for the injection, “but there is definitely more that needs to be done,” she said.
Chicanos Por La Causa is doing education outreach about Yeztugo at local events and works with domestic violence shelters, some school-based programs, faith-based groups and other community organizations, too. The organization works with anyone, according to Baca Garcia, no matter their health insurance status, to try to connect them with affordable care and answers they need.
“Our biggest barrier is letting our community know that they are at higher risk and finding that accessibility for them,” Baca Garcia said. “Unfortunately, awareness is still limited.”
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