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PxWire Vol 13, No 1

A Quarterly Update on HIV Prevention Research

February 2023: Volume 13, Number 1

PxWire Cover

PxWire is AVAC’s quarterly update covering the latest in the field of biomedical HIV prevention research and development, implementation and advocacy. Each issue includes updates, emerging issues and features upcoming events.

More than 40 years into this epidemic—and in the midst of multiple pandemics and persistent inequities—2022 brought a rare opportunity to fundamentally reshape and reimagine HIV prevention, if everyone does their part.

This issue offers data from Q4 of 2022, when South Africa became the fourth country in the world to approve injectable cabotegravir (CAB) for PrEP; the dapivirine vaginal ring (DVR) was approved in a growing number of countries; and oral PrEP use was on the rise, passing the mark of 3.8 million initiations. For the first time, the world has multiple biomedical interventions to offer choice, and it’s essential to develop the programs that bring the fruits of science to the communities facing public health threats, while continuing to invest in developing new options to meet diverse needs.

PrEP Tracker Data/Oral PrEP Progress

  • The world surpassed 3,800,000 PrEP initiations as of December 2022, an increase of about 530,000 (16 percent) from Q3.
  • 2022 saw the biggest cumulative increase in a calendar year of PrEP initiations (1,875,870).
  • South Africa continues to have the greatest number of PrEP initiations in the world with more than 790,000 at year-end.
  • Nigeria surpassed 400,000 initiations (an increase of 58,000 in Q4) and Uganda and Zambia each surpassed 350,000 initiations (increasing by more than 36,000 and 38,000 in Q4, respectively), continuing a trajectory of rapid scale-up.
  • In other regions, Haiti surpassed 20,000 initiations, and Ukraine surpassed 10,000 initiations—a testament that PrEP programs can operate in the midst of war and other infectious disease outbreaks.

bar chart of PrEP uptake

PrEP Introduction Country Planning Matrix

This chart shows the trajectory of regulatory approvals and implementation science studies for CAB for PrEP and the dapivirine vaginal ring (DVR), in the context of oral PrEP programs.

See our Global PrEP Tracker for more details about oral PrEP uptake. See Implementation Study Tracker for more details on implementation science studies of new PrEP products.

HIV Prevention & Cure Pipeline

Just as this issue was going to press, the Mosaico vaccine efficacy trial was stopped early for non-efficacy (see here for more information and here for a webinar recording to unpack the results). The remaining HIV preventive vaccine efficacy trial, PrEPVacc, is a large efficacy study that will contribute to evidence about both PrEP (TDF/FTC and TAF/FTC) and two different vaccine concepts, but it will not lead to licensure in either case. We’ve updated our infographics and materials on the HIV prevention pipeline, including this pipeline overview.

hiv prevention pipeline

Additional updated materials include:

Other important R&D updates:

  • Stakeholders from Kenya, South Africa and Zimbabwe came together to share feedback on the MATRIX pipeline of early phase and pre-clinical products. The country consultations are establishing a foundation for future engagement through the lifecycle of product development.
  • Results from a Phase 1 vaccine proof of concept study (IAVI G001), using a germline-targeting strategy supports further development of the approach, with the goal of inducing broadly neutralizing antibodies to prevent HIV acquisition.
  • Substudies of the HPTN 084 open label extension trial were extended by 48 weeks to allow for inclusion of adolescents and pregnant and lactating people and their infants. HPTN 084 is designed to test if an injection of CAB given once every two months works better than a Truvada pill taken every day for PrEP.

Prevention Playlist

The most effective advocacy is based on smart analysis and accurate information. AVAC develops a wide range of materials and resources to inform decision making and action. Be sure to read, join or listen to these essential resources for HIV prevention and global health equity.




About AVAC

Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of HIV prevention options as part of a comprehensive response to the pandemic. Follow AVAC on Twitter @HIVpxresearch and find more at and