[Correspondence] The promise and paradox of HIV self-testing in the era of twice-yearly PrEP

On July 12, WHO issued new guidelines recommending twice-yearly injectable lenacapavir as an additional option within combination HIV prevention—a pivotal moment in global prevention efforts.1 Relative to daily oral tenofovir disoproxil fumarate–emtricitabine, lenacapavir reduced HIV incidence by 100% in the PURPOSE 1 trial and by 89% in PURPOSE 2. Lenacapavir's high efficacy and biannual dosing could address adherence and access barriers hindering the scale-up of oral pre-exposure prophylaxis (PrEP).