To end AIDS as a public health threat by 2030, we must leverage both the impactful message of U=U (undetectable equals untransmittable) and viral suppression to improve the wellbeing of individuals living with HIV, increase engagement with HIV services, and reduce barriers such as stigma, discrimination, and criminalisation. This message requires clear and unambiguous evidence-based narratives that emphasise the message that there is zero risk of sexual transmission when an undetectable viral load is maintained and negligible risk when viral suppression (as defined by 200–1000 copies per mL) is maintained.

Just 2 months ago, our Editorial covered the announcement of the PURPOSE 1 study results at the 25th International AIDS Conference (Munich, Germany; July 22–26): the study showed 100% efficacy for lenacapavir pre-exposure prophylaxis (PrEP) when given as injections every 6 months in cisgender women. Results of PURPOSE 2, reported at the HIVR4P conference in Lima, Peru, Oct 6–10, extend the proof of efficacy to cisgender men and gender-diverse populations who have sex with men. With this second large phase 3 trial showing efficacy of this long-acting injectable PrEP approach, regulatory approval is a formality.