Pre-Exposure Prophylaxis of HIV InfectionPhase 3PURPOSE 2NCT04925752
Pre-Exposure Prophylaxis Study of Lenacapavir in Cisgender Men, Transgender Women, Transgender Men, and Gender Nonbinary People at Risk for HIV Infection
A Phase 3 study testing Oral Lenacapavir (LEN), F/TDF and Sub-cutaneous (SC) Lenacapavir (LEN) in people with Pre-Exposure Prophylaxis of HIV Infection, run by Gilead Sciences at 93 sites in 8 countries.
Trial summary
The goal of this study is to evaluate the efficacy of the study drugs, lenacapavir (LEN) in preventing HIV infection, in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV-1 infection. Read more about this study
- Who is it for?
- Ages 16 years and olderHealthy volunteers can take part
- Conditions the study is for
- Pre-Exposure Prophylaxis of HIV Infection
- What is being tested?
- Oral Lenacapavir (LEN), F/TDF and Sub-cutaneous (SC) Lenacapavir (LEN)
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 3,292 participants
- Where
- 93 sitesin 8 countries
- Study dates
- 28 Jun 2021to Aug 2028
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Incidence Phase
- CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection.
- HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months.
- Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following:
- Condomless receptive anal sex with ≥ 2 partners in the last 12 weeks.
- History of syphilis, rectal gonorrhea, or rectal chlamydia in the last 24 weeks.
Show all 10Show fewer
- Self-reported use of stimulants with sex in the last 12 weeks.
- Randomized Phase
- Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT).
- Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr).
Who cannot join
- Incidence Phase
- Prior use of HIV PrEP (including F/TDF or F/TAF) or HIV postexposure prophylaxis (PEP) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir).
- Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation.
- Randomized Phase
- Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection.
- Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis.
- Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Trial locations and contacts
93 sites in 8 countries.
93 sites in 8 countries
United States60 sites
The Hope Clinic at Emory University
Atlanta, Georgia, 30030
Emory University
Atlanta, Georgia, 30303
Emory University Hospital Midtown Infectious Disease Clinic
Atlanta, Georgia, 30308
University of Colorado Clinical and Translational Research Centers (CTRC)
Aurora, Colorado, 80045
Central Texas Clinical Research
Austin, Texas, 78705
Johns Hopkins University School of Medicine
Baltimore, Maryland, 21287
Be Well Medical Center
Berkley, Michigan, 48072
UAB Sexual Health Research Clinic
Birmingham, Alabama, 35233
The Fenway Institute
Boston, Massachusetts, 02215
NC TraCS Institute - CTRC; University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27514
Medical University of South Carolina, Infectious Disease Clinic
Charleston, South Carolina, 29425
RMR Core Center
Chicago, Illinois, 60612
University of Illinois at Chicago, Department of Medicine, Division of Infectious Diseases, Project WISH
Chicago, Illinois, 60612
Howard Brown Health Center
Chicago, Illinois, 60613
University of Cincinnati
Cincinnati, Ohio, 45267
Prisma Health-Midlands Clinical Research Unit
Columbia, South Carolina, 29203
The Ohio State University Wexner Medical Center
Columbus, Ohio, 43210
Henry Ford Hospital
Detroit, Michigan, 48202
Centro San Vincente
El Paso, Texas, 79915
Therafirst Medical Center
Fort Lauderdale, Florida, 33308
Gary Richmond, MD, PA
Fort Lauderdale, Florida, 33316
Midway Immunology & Research Center, LLC
Ft. Pierce, Florida, 34982
Cone Health/Regional Center for Infectious Disease Research Center
Greensboro, North Carolina, 27401
Prisma Health Internal Medicine Clinic
Greenville, South Carolina, 29605
UT Health Science Center at Houston
Houston, Texas, 77009
The Crofoot Research Center, INC
Houston, Texas, 77098
Indiana University Infectious Diseases Research
Indianapolis, Indiana, 46202
Open Arms Healthcare Center
Jackson, Mississippi, 39202
CAN Community Health Clinic
Jacksonville, Florida, 32207
KC CARE Health Center
Kansas City, Missouri, 64111
Baptist Health Lexington
Lexington, Kentucky, 40503
Loma Linda University Clinical Trial Center Clinic
Loma Linda, California, 92354
Ruane Clinical Research Group Inc.
Los Angeles, California, 90036
UCLA CBAM Vine Street Clinic
Los Angeles, California, 90038
Charles R. Drew University of Medicine and Science (CDU) - Clinical Translational Research Center (CTRC)
Los Angeles, California, 90059
Mills Clinical Research
Los Angeles, California, 90069
The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Los Angeles, California, 90502
Norton Infectious Disease Specialists
Louisville, Kentucky, 40241
Methodist University Hospital/University of Tennessee Health Science Center, Clinical Research Center
Memphis, Tennessee, 38103
St Jude Children's Research Hospital
Memphis, Tennessee, 38105
University of Miami Miller School of Medicine Division of Infectious Disease Research - Converge Miami
Miami, Florida, 33136
CAN Community Health
Miami Gardens, Florida, 33055
Meharry Medical College Clinical and Transitional Research Center
Nashville, Tennessee, 37208
Yale University, School of Medicine
New Haven, Connecticut, 06510
LSU-CrescentCare Sexual Health Center- New Orleans Community Health Center
New Orleans, Louisiana, 70119
Icahn School of Medicine at Mount Sinai- Mount Sinai Downtown
New York, New York, 10029
St. Michael's Medical Center
Newark, New Jersey, 07102
Orlando Immunology Center
Orlando, Florida, 32803
BIOS Clinical Research
Palm Springs, California, 92262
Penn Prevention Unit
Philadelphia, Pennsylvania, 19104
Philadelphia FIGHT Community Health Centers, Jonathan Lax Treatment Center
Philadelphia, Pennsylvania, 19107
UCSD Anti Viral Research Center
San Diego, California, 92103
Bridge HIV at the San Francisco Department of Public Health
San Francisco, California, 94102
Optimus Medical Group
San Francisco, California, 94102
CAN Community Health
Sarasota, Florida, 34237
Ofiice of Dr. Peter Shalit, MD
Seattle, Washington, 98104
South Jersey Infectious Disease
Somers Point, New Jersey, 08244
Whitman-Walker Institute Inc.
Washington D.C., District of Columbia, 20009
Washington Health Institute
Washington D.C., District of Columbia, 20017
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27103
Brazil9 sites
Unidade de Pesquisa Clinica em Vacinas (UPqVac) da Faculdade de Medicina da Universidade
Belo Horizonte - MG, 30130-100
Fundação Bahiana de Infectologia
Canela-Salvador, 40110-060
Fundação de Medicina Tropical Doutor Heitor Vieira Dourado / Fundação Medicina Tropical do Amazonas - FMT/IMT/AM
Manauas, 69040-000
Hospital General de Nova Iguaçu - HGNI
Nova Iguaçu, 26030-380
Grupo Hospitalar Conceição/ Hospital Nossa Senhora da Conceição S.A.
Porto Alegre, RS 91350 200
Instituto Nacional de Infectologia Evandro Chagas / Fundação Oswaldo Cruz - INI FIOCRUZ
Rio de Janeiro, 21040-360
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
São Paulo, 01246-903
Centro de Referência e Treinamento DST/AIDS
São Paulo, 04121-000
Center for Management and Research. SPDM-Paulista Association for the Development of Medicine-Hospital São Paulo/Federal
São Paulo, 06519-332
Thailand7 sites
Institute of HIV Research and Innovation
Bangkok, 10330
King Chulalongkorn Memorial Hospital
Bangkok, 10330
The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS research Centre
Bangkok, 10330
Ramathibodi Hospital, Mahidol University
Bangkok, 10400
Research Institute for Health Sciences, Chiang Mai University
Chiang Mai, 50200
Srinagarind Hospital, Khon Kaen University
Khon Kaen, 40002
Bamrasnaradura Infectious Disease Institute
Nonthaburi, 11000
South Africa6 sites
Desmond Tutu Health Foundation
Cape Town, 7925
Wits Reproductive Health and HIV Institute (Wits RHI)
Johannesburg, 2038
The Aurum Institute: Pretoria Clinical Research Centre
Pretoria, 87
Setshaba Research Centre
Soshanguvhe, 0152
The Aurum Institute Tembisa CRC, Clinic 4
Tembisa, 1632
FPD-DTHF Ndevana Commuity Research Site
Vincent, 5217
Peru5 sites
Asociacion Civil Impacta Salud y Educacion - Sede Barranco
Barranco, 15063
Instituto de Medicina Tropical "Daniel Alcides Carrion", Facultad de Medicina Humana, UNMSM
Callao, 7006
Asociacion Civil Selva Amazonica
Iquitos
Via Libre
Lima, 15001
Asociacion Civil Impacta Salud y Educacion - Sede San Miguel
Lima, 15088
Argentina3 sites
Hospital General de Agudos JM Ramos Mejia
Buenos Aires, 1072
Fundacion Huesped
Buenos Aires, 1202
Instituto de Investigaciones Clinicas Mar del Plata
Buenos Aires, B7600
Puerto Rico2 sites
Ararat Research Center
San Juan, PR, 00717
Centro Ararat- San Juan
San Juan, PR, 00909
Mexico1 site
Centro de Investigacion Farmaceutica Especializada de Occidente S.C.
Guadalajara C.P., 44160
About this study
Official title: A Phase 3, Double-Blind, Multicenter, Randomized Study to Evaluate the Efficacy and Safety of Subcutaneous Twice Yearly Long-Acting Lenacapavir for HIV Pre-Exposure Prophylaxis in Cisgender Men, Transgender Women, Transgender Men, and Gender Nonbinary People ≥ 16 Years of Age Who Have Sex With Male Partners and Are at Risk for HIV Infection
The goal of this study is to evaluate the efficacy of the study drugs, lenacapavir (LEN) in preventing HIV infection, in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV-1 infection.
The primary objective of this study is to evaluate the efficacy of LEN for HIV-1 pre-exposure prophylaxis (PrEP) in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth at risk of HIV-1 infection.
- Being tested
- Oral Lenacapavir (LEN), F/TDF, Sub-cutaneous (SC) Lenacapavir (LEN), Placebo SC LEN, PTM F/TDF
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Oral Lenacapavir (LEN)Drug
Also called GS-6207
Tablets administered orally without regard to food
F/TDFDrug
Also called Truvada®
Tablets administered orally
Sub-cutaneous (SC) Lenacapavir (LEN)Drug
Also called GS-6207; Yeztugo
Administered via SC injections
Placebo SC LENDrug
Administered via SC injections
PTM F/TDFDrug
Tablets administered orally
PTM Oral LENDrug
Tablets administered orally
F/TAF (for US participants only)Drug
Also called Descovy
F/TAF tablets administered orally once daily
| Study group | Role | What they receive |
|---|---|---|
| Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF | Experimental | Participants will receive the following for up to approximately 52 weeks:
* Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks
* Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily
* Oral LEN 600 mg on Days 1 and 2
Participants will receive oral LEN if SC injections are not available. Receives: Drug: Oral Lenacapavir (LEN); Drug: Sub-cutaneous (SC) Lenacapavir (LEN); Drug: PTM F/TDF |
| Randomized Blinded Phase: Placebo LEN + F/TDF | Experimental | Participants will receive the following for up to approximately 52 weeks:
* SC LEN placebo every 26 weeks
* Oral F/TDF 200/300 mg once daily
* PTM Oral LEN on Days 1 and 2
Participants will receive oral LEN placebo if SC injections are not available. Receives: Drug: F/TDF; Drug: Placebo SC LEN; Drug: PTM Oral LEN |
| LEN Open-Label Extension (OLE) Phase | Experimental | Participants will be offered entry into LEN OLE Phase, following completion of primary analysis, if LEN demonstrates acceptable safety and efficacy in the Randomized Blinded Phase.
Participants randomized to LEN will continue to receive SC LEN 927 mg, every 26 weeks (± 7 days), and have study visits every 13 weeks (± 7 days).
Participants randomized to F/TDF will switch to SC LEN 927 mg on OLE Day 1, Week 26 and every 26 weeks thereafter. Participants will also receive oral LEN 600 mg on OLE Days 1 and 2.
All participants in LEN OLE Phase will complete the phase, once LEN becomes available or the sponsor decides to discontinue the study, whichever happens first.
After completing LEN OLE Phase or study discontinuation, participants will transition to local PrEP, including LEN or other options. If a participant exits early, they will complete an early study drug discontinuation (ESDD), be referred to local PrEP services if needed, and have a 30-day follow-up visit. Receives: Drug: Oral Lenacapavir (LEN); Drug: Sub-cutaneous (SC) Lenacapavir (LEN) |
| Pharmacokinetic (PK) Tail Phase | Experimental | Participants who prematurely discontinue study drug during the Randomized Blinded Phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase will transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks to cover the PK tail and complete visits every 13 weeks (+/- 7 days).
Upon unblinding, participants who were randomized to F/TDF in the Randomized Blinded Phase who decline to participate in the LEN OLE Phase will complete the ESDD visit, transition to local HIV prevention services, and return for a 30-day follow-up visit. Receives: Drug: F/TDF; Drug: F/TAF (for US participants only) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence Phase: Recent Infection Testing Algorithm (RITA) Estimate of the Background Human Immunodeficiency-1 Virus Infection Incidence Rate (bHIV) Per 100 Person Years (PY)
bHIV per 100 PY in the Incidence Phase was calculated using RITA. The RITA incorporated HIV-1 testing results and recency assay testing results to estimate the bHIV. Recency assay testing was performed for participants in the All Screened Set found to have HIV-1 infection at the Incidence Phase Screening Visit as defined below. Participants were considered to have recent HIV-1 infection if the normalized optical density (ODn) was below 1.5 threshold using the Sedia limiting antigen avidity enzyme immunoassay (LAg-EIA) and the HIV-1 RNA (viral load) was > 75 copies/mL of blood.
HIV-1 infection was defined as participants having at least one of the following central lab results at the Incidence Phase screening visit:
- Positive HIV-1/2 differentiation Ab, OR
- Positive HIV-1 ribonucleic acid (RNA) qualitative test, OR
- HIV-1 RNA quantitative test ≥200 copies/mL.
Measured: Incidence Phase Screening Visit (Day 1)
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to Background HIV (bHIV, Participants in All Screened Set)
HIV-1 incidence per 100 PY for LEN was calculated as the number of participants who acquired HIV-1 divided by the total of a) for participants not diagnosed with HIV-1, sum of all duration of follow-up time in years, while at risk of HIV-1 infection (where a year is 365.25 days) and b) for participants diagnosed with HIV-1, sum of all duration of follow-up time up to confirmed HIV-1 diagnoses. HIV-1 diagnosis was determined by an HIV adjudication committee who reviewed potential HIV-1 infection events in the randomized participants. The committee, in a blinded, consistent, and unbiased manner, determined whether HIV test results confirmed HIV-1 infection and determined the date of diagnosis for each case, defined as the date of the earliest study visit with evidence of HIV infection considering both prospective HIV testing and back-testing of archived samples. bHIV incidence per 100 PY in All Screened Set was estimated as described in outcome measure#1.
Measured: Up to 149 weeks
Secondary outcomes (4)
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to F/TDF
HIV-1 incidence per 100 PY was calculated as the number of participants who acquired HIV-1 divided by the total of a) for participants not diagnosed with HIV-1, sum of all duration of follow-up time in years, while at risk of HIV-1 infection (where a year is 365.25 days) and b) for participants diagnosed with HIV-1, sum of all duration of follow-up time up to confirmed HIV-1 diagnoses. HIV-1 diagnosis was determined by an HIV adjudication committee who reviewed potential HIV-1 infection events in the randomized participants. The committee, in a blinded, consistent, and unbiased manner, determined whether HIV test results confirmed HIV-1 infection and determined the date of diagnosis for each case, defined as the date of the earliest study visit with evidence of HIV infection considering both prospective HIV testing and back-testing of archived samples.
Measured: Up to 149 weeks
Randomized Blinded Phase: HIV-1 Incidence Among Participants Adherent to LEN
A participant was defined as adherent to LEN if they have received all per-protocol administrations of LEN within 28 weeks since the previous administration. The incidence of HIV-1 infection per 100 PY calculation is defined in outcome measure #2.
Measured: Up to 149 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a study drug that did not necessarily have a causal relationship with the treatment. TEAEs were defined as 1 or both of the following: Any AEs leading to premature discontinuation of study drug, or any AEs with an onset date on or after the study drug start date and no later than the last exposure date after permanent discontinuation of the study drug.
Measured: First dose date up to 184 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Grade 3 or Higher Laboratory Abnormalities
Treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any post-baseline visit, up to and including the last exposure date for participants who permanently discontinued study drug, or the last available date in the database snapshot for participants who were still on treatment at the time of an analysis. The division of acquired immunodeficiency syndrome toxicity grading scale, Version 2.1 was used to assign toxicity grades (0 to 4) to laboratory results for analysis. Grade 0 included all values that do not meet the criteria for an abnormality of at least Grade 1. Grade 1 mild, Grade 2 moderate, Grade 3 severe, and Grade 4 potentially life-threatening. Percentages were rounded off.
Measured: First dose date up to 184 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jun 2021
- Study start28 Jun 2021
- Primary completion21 Aug 2024
- Study completionAug 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Pre-Exposure Prophylaxis of HIV InfectionStudies of the same condition, open and under way.
- More trials run by Gilead SciencesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 3,292 participants (actual)
Sponsor and investigators
- Lead sponsor
- Gilead Sciences
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Gilead Study Director, Study director, Gilead Sciences
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04925752
- Sponsor's protocol ID
- GS-US-528-9023
- Other IDs
- DOH-27-102021-6681, 2023-001025-23, 2023
- Acronym
- PURPOSE 2
- Status last verified
- Sep 2026
- First submitted
- 28 May 2021
- Last updated
- 6 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kelley CF, Acevedo-Quiñones M, Agwu AL, et al. Twice-yearly lenacapavir PrEP in cisgender gay men, transgender women and men, and gender-diverse people (PURPOSE 2). Presented at: HIV Drug Therapy Glasgow; November 10-13, 2024; Glasgow, United Kingdom.
Kelley CF, Acevedo-Quinones M, Agwu AL, Avihingsanon A, Benson P, Blumenthal J, Brinson C, Brites C, Cahn P, Cantos VD, Clark J, Clement M, Creticos C, Crofoot G, Diaz RS, Doblecki-Lewis S, Gallardo-Cartagena JA, Gaur A, Grinsztejn B, Hassler S, Hinojosa JC, Hodge T, Kaplan R, Lacerda M, LaMarca A, Losso MH, Valdez Madruga J, Mayer KH, Mills A, Mounzer K, Ndlovu N, Novak RM, Perez Rios A, Phanuphak N, Ramgopal M, Ruane PJ, Sanchez J, Santos B, Schine P, Schreibman T, Spencer LY, Van Gerwen OT, Vasconcelos R, Vasquez JG, Zwane Z, Cox S, Deaton C, Ebrahimi R, Wong P, Singh R, Brown LB, Carter CC, Das M, Baeten JM, Ogbuagu O; PURPOSE 2 Study Team. Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons. N Engl J Med. 2025 Apr 3;392(13):1261-1276. doi: 10.1056/NEJMoa2411858. Epub 2024 Nov 27.
PubMed 39602624Cespedes M, Das M, Hojilla JC, Blumenthal J, Mounzer K, Ramgopal M, Hodge T, Torres TS, Peterson C, Shibase S, Elliott A, Demidont AC, Callaghan L, Watson CC, Carter C, Kintu A, Baeten JM, Ogbuagu O. Proactive strategies to optimize engagement of Black, Hispanic/Latinx, transgender, and nonbinary individuals in a trial of a novel agent for HIV pre-exposure prophylaxis (PrEP). PLoS One. 2022 Jun 3;17(6):e0267780. doi: 10.1371/journal.pone.0267780. eCollection 2022.
PubMed 35657826Cantos Lucio VD, Mngadi K, Supparatpinyo K, et al. From Breakthroughs to Backbones: The Evolving Landscape of HIV PrEP. Presented at: Conference on Retroviruses and Opportunistic Infections (CROI 2026); February 22-25, 2026; Denver, CO. Abstract 129.
Kwan TH, Chan DPC, Lee SS. Utilisation of HIV pre-exposure prophylaxis and preferences of alternative long-acting modalities among men who have sex with men in Hong kong: a cross-sectional study. BMC Public Health. 2025 Dec 26;26(1):361. doi: 10.1186/s12889-025-26025-5.
PubMed 41449429
Study at a glance
From the registry record, last updated by the sponsor on 6 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Double-Blind, Multicenter, Randomized Study to Evaluate the Efficacy and Safety of Subcutaneous Twice Yearly Long-Acting Lenacapavir for HIV Pre-Exposure Prophylaxis in Cisgender Men, Transgender Women, Transgender Men, and Gender Nonbinary People ≥ 16 Years of Age Who Have Sex With Male Partners and Are at Risk for HIV Infection
- ClinicalTrials.gov ID
- NCT04925752
- Acronym / sponsor ID
- PURPOSE 2 / GS-US-528-9023
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 3,292 participants (actual)
- Lead sponsor
- Gilead SciencesIndustry (pharma, biotech, devices)
- Study start
- 28 Jun 2021 (actual)
- Primary completion
- 21 Aug 2024 (actual)
- Study completion
- Aug 2028 (estimated)
- First posted
- 14 Jun 2021 (actual)
- Results
- Posted 17 Sep 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to evaluate the efficacy of the study drugs, lenacapavir (LEN) in preventing HIV infection, in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV-1 infection.
The primary objective of this study is to evaluate the efficacy of LEN for HIV-1 pre-exposure prophylaxis (PrEP) in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth at risk of HIV-1 infection.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF | Experimental | Drug: Oral Lenacapavir (LEN), Drug: Sub-cutaneous (SC) Lenacapavir (LEN), Drug: PTM F/TDFParticipants will receive the following for up to approximately 52 weeks: * Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks * Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily * Oral LEN 600 mg on Days 1 and 2 Participants will receive oral LEN if SC injections are not available. |
| Randomized Blinded Phase: Placebo LEN + F/TDF | Experimental | Drug: F/TDF, Drug: Placebo SC LEN, Drug: PTM Oral LENParticipants will receive the following for up to approximately 52 weeks: * SC LEN placebo every 26 weeks * Oral F/TDF 200/300 mg once daily * PTM Oral LEN on Days 1 and 2 Participants will receive oral LEN placebo if SC injections are not available. |
| LEN Open-Label Extension (OLE) Phase | Experimental | Drug: Oral Lenacapavir (LEN), Drug: Sub-cutaneous (SC) Lenacapavir (LEN)Participants will be offered entry into LEN OLE Phase, following completion of primary analysis, if LEN demonstrates acceptable safety and efficacy in the Randomized Blinded Phase. Participants randomized to LEN will continue to receive SC LEN 927 mg, every 26 weeks (± 7 days), and have study visits every 13 weeks (± 7 days). Participants randomized to F/TDF will switch to SC LEN 927 mg on OLE Day 1, Week 26 and every 26 weeks thereafter. Participants will also receive oral LEN 600 mg on OLE Days 1 and 2. All participants in LEN OLE Phase will complete the phase, once LEN becomes available or the sponsor decides to discontinue the study, whichever happens first. After completing LEN OLE Phase or study discontinuation, participants will transition to local PrEP, including LEN or other options. If a participant exits early, they will complete an early study drug discontinuation (ESDD), be referred to local PrEP services if needed, and have a 30-day follow-up visit. |
| Pharmacokinetic (PK) Tail Phase | Experimental | Drug: F/TDF, Drug: F/TAF (for US participants only)Participants who prematurely discontinue study drug during the Randomized Blinded Phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase will transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks to cover the PK tail and complete visits every 13 weeks (+/- 7 days). Upon unblinding, participants who were randomized to F/TDF in the Randomized Blinded Phase who decline to participate in the LEN OLE Phase will complete the ESDD visit, transition to local HIV prevention services, and return for a 30-day follow-up visit. |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (10 listed)
- Incidence Phase
- CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection.
- HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months.
- Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following:
- Randomized Phase
Key exclusion criteria (7 listed)
- Incidence Phase
- Prior use of HIV PrEP (including F/TDF or F/TAF) or HIV postexposure prophylaxis (PEP) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir).
- Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation.
- Randomized Phase
- Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Oral Lenacapavir (LEN)Also: GS-6207Tablets administered orally without regard to food | Drug | LEN Open-Label Extension (OLE) Phase, Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF |
| F/TDFAlso: Truvada®Tablets administered orally | Drug | Pharmacokinetic (PK) Tail Phase, Randomized Blinded Phase: Placebo LEN + F/TDF |
| Sub-cutaneous (SC) Lenacapavir (LEN)Also: GS-6207; YeztugoAdministered via SC injections | Drug | LEN Open-Label Extension (OLE) Phase, Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF |
| Placebo SC LENAdministered via SC injections | Drug | Randomized Blinded Phase: Placebo LEN + F/TDF |
| PTM F/TDFTablets administered orally | Drug | Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF |
| PTM Oral LENTablets administered orally | Drug | Randomized Blinded Phase: Placebo LEN + F/TDF |
| F/TAF (for US participants only)Also: DescovyF/TAF tablets administered orally once daily | Drug | Pharmacokinetic (PK) Tail Phase |
Primary outcome
Incidence Phase: Recent Infection Testing Algorithm (RITA) Estimate of the Background Human Immunodeficiency-1 Virus Infection Incidence Rate (bHIV) Per 100 Person Years (PY)
Time frame: Incidence Phase Screening Visit (Day 1)
bHIV per 100 PY in the Incidence Phase was calculated using RITA. The RITA incorporated HIV-1 testing results and recency assay testing results to estimate the bHIV. Recency assay testing was performed for participants in the All Screened Set found to have HIV-1 infection at the Incidence Phase Screening Visit as defined below. Participants were considered to have recent HIV-1 infection if the normalized optical density (ODn) was below 1.5 threshold using the Sedia limiting antigen avidity enzyme immunoassay (LAg-EIA) and the HIV-1 RNA (viral load) was > 75 copies/mL of blood. HIV-1 infection was defined as participants having at least one of the following central lab results at the Incidence Phase screening visit: * Positive HIV-1/2 differentiation Ab, OR * Positive HIV-1 ribonucleic acid (RNA) qualitative test, OR * HIV-1 RNA quantitative test ≥200 copies/mL.
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to Background HIV (bHIV, Participants in All Screened Set)
Time frame: Up to 149 weeks
HIV-1 incidence per 100 PY for LEN was calculated as the number of participants who acquired HIV-1 divided by the total of a) for participants not diagnosed with HIV-1, sum of all duration of follow-up time in years, while at risk of HIV-1 infection (where a year is 365.25 days) and b) for participants diagnosed with HIV-1, sum of all duration of follow-up time up to confirmed HIV-1 diagnoses. HIV-1 diagnosis was determined by an HIV adjudication committee who reviewed potential HIV-1 infection events in the randomized participants. The committee, in a blinded, consistent, and unbiased manner, determined whether HIV test results confirmed HIV-1 infection and determined the date of diagnosis for each case, defined as the date of the earliest study visit with evidence of HIV infection considering both prospective HIV testing and back-testing of archived samples. bHIV incidence per 100 PY in All Screened Set was estimated as described in outcome measure#1.
4 secondary outcomes
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to F/TDF
Time frame: Up to 149 weeks
Randomized Blinded Phase: HIV-1 Incidence Among Participants Adherent to LEN
Time frame: Up to 149 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
Time frame: First dose date up to 184 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Grade 3 or Higher Laboratory Abnormalities
Time frame: First dose date up to 184 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Oct 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- BackgroundKelley CF, Acevedo-Quiñones M, Agwu AL, et al. Twice-yearly lenacapavir PrEP in cisgender gay men, transgender women and men, and gender-diverse people (PURPOSE 2). Presented at: HIV Drug Therapy Glasgow; November 10-13, 2024; Glasgow, United Kingdom.
- Background: PubMed 39602624Kelley CF, Acevedo-Quinones M, Agwu AL, Avihingsanon A, Benson P, Blumenthal J, Brinson C, Brites C, Cahn P, Cantos VD, Clark J, Clement M, Creticos C, Crofoot G, Diaz RS, Doblecki-Lewis S, Gallardo-Cartagena JA, Gaur A, Grinsztejn B, Hassler S, Hinojosa JC, Hodge T, Kaplan R, Lacerda M, LaMarca A, Losso MH, Valdez Madruga J, Mayer KH, Mills A, Mounzer K, Ndlovu N, Novak RM, Perez Rios A, Phanuphak N, Ramgopal M, Ruane PJ, Sanchez J, Santos B, Schine P, Schreibman T, Spencer LY, Van Gerwen OT, Vasconcelos R, Vasquez JG, Zwane Z, Cox S, Deaton C, Ebrahimi R, Wong P, Singh R, Brown LB, Carter CC, Das M, Baeten JM, Ogbuagu O; PURPOSE 2 Study Team. Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons. N Engl J Med. 2025 Apr 3;392(13):1261-1276. doi: 10.1056/NEJMoa2411858. Epub 2024 Nov 27.
- Background: PubMed 35657826Cespedes M, Das M, Hojilla JC, Blumenthal J, Mounzer K, Ramgopal M, Hodge T, Torres TS, Peterson C, Shibase S, Elliott A, Demidont AC, Callaghan L, Watson CC, Carter C, Kintu A, Baeten JM, Ogbuagu O. Proactive strategies to optimize engagement of Black, Hispanic/Latinx, transgender, and nonbinary individuals in a trial of a novel agent for HIV pre-exposure prophylaxis (PrEP). PLoS One. 2022 Jun 3;17(6):e0267780. doi: 10.1371/journal.pone.0267780. eCollection 2022.
- BackgroundCantos Lucio VD, Mngadi K, Supparatpinyo K, et al. From Breakthroughs to Backbones: The Evolving Landscape of HIV PrEP. Presented at: Conference on Retroviruses and Opportunistic Infections (CROI 2026); February 22-25, 2026; Denver, CO. Abstract 129.
- Derived from this study: PubMed 41449429Kwan TH, Chan DPC, Lee SS. Utilisation of HIV pre-exposure prophylaxis and preferences of alternative long-acting modalities among men who have sex with men in Hong kong: a cross-sectional study. BMC Public Health. 2025 Dec 26;26(1):361. doi: 10.1186/s12889-025-26025-5.
- Gilead Clinical Trials WebsiteLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gilead Study Director study director
Gilead Sciences
93 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Oral Lenacapavir (LEN), F/TDF and Sub-cutaneous (SC) Lenacapavir (LEN) in people with Pre-Exposure Prophylaxis of HIV Infection, run by Gilead Sciences at 93 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 6 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 93 sites in United States, Brazil, Thailand, South Africa, Peru and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 17 Sep 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence Phase: Recent Infection Testing Algorithm (RITA) Estimate of the Background Human Immunodeficiency-1 Virus Infection Incidence Rate (bHIV) Per 100 Person Years (PY) (time frame: Incidence Phase Screening Visit (Day 1)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04925752, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2026.