We came together for AIDS 2026 against a tumultuous funding and geopolitical backdrop, which has utterly changed the global response to HIV. At the same time, scientific discoveries are bringing us the most powerful tools yet to end the pandemic as a threat to public health and individual well-being. For six days, delegates from across the response examined every aspect of this paradox and more. We did so through more than 150 sessions, 2,400 posters, 220 Global Village activities, countless conversations, and new networks and partnerships that we will take home as we continue to Rethink. Rebuild. Rise.
These are the key takeaways from AIDS 2026.
1. The real impact of funding cuts
Eighteen months since the Trump administration severely disrupted aid funding, study after study, conversation after conversation brought home the hard reality of what that means for communities, services and the HIV response. Among the evidence:
- The PEPFAR Pulse study of 166 implementing partners across 46 countries showed that US funding and policy changes resulted in more than 1,700 clinics and other service delivery sites being closed, mostly in eastern and southern Africa and affecting key populations.
- A systematic review of 21 studies and reports indicated more than 8,000 PEPFAR-supported health workers lost in South Africa and about 16,700 positions threatened in Zimbabwe. In central, eastern, southern and western Africa, PrEP initiations fell by 31-64%, voluntary medical male circumcision by 65-88%, and condom distribution by over 50%.
- In Nigeria, key population prevention services reached 50.5% fewer people and HIV self-testing dropped by 70.2% between the first and second quarter of 2025. PrEP initiation among key populations decreased by 83%.
Reports released at AIDS 2026 frame the funding picture: a KFF and UNAIDS report found donor government funding fell by 25%; and a UNAIDS report found domestic HIV financing rose 4% in 2025 – now nearly 60% of total HIV funding. “The era of relying on international aid is over,” Winnie Byanyima, UNAIDS Executive Director, said at the conference. She called for debt restructuring so governments “can invest in what matters most: the health, education and futures of their people”.
2. Political leadership and new models of partnership
The funding crisis exposed a structural weakness of the global HIV response: a governance model built around dependence on a single donor. AIDS 2026 heard growing consensus that progress will require political leadership and partnership models that diversify power and funding away from that reliance.
A qualitative review of international responses assessed six alternative paths, from Global South donor coalitions and solidarity taxes to integrating HIV into national health systems. Sustainability beyond 2026, it concluded, depends on cutting costs through telemedicine and local generic production, shifting toward diversified donor coalitions and South-South leadership.
That shift demands new leadership. A cross-regional review of sustainability efforts found that poor transition planning, weak community leadership and shrinking civic spaces were recurring threats to continuity of care. Priority actions for securing HIV services beyond 2030 include incorporating leadership of people living with HIV into national sustainability roadmaps and strengthening community capacity for budget and supply chain oversight.
Delegates heard how funders are shifting toward “catalytic capital” to mobilize public and private resources, with new funding models complementing, not replacing, governments’ core responsibility. We also heard that no single partnership model fits all contexts – culturally relevant communication, access by design and community engagement are essential for science to reach the people who need it.
3. Advances in long-acting prevention, access and the power of choice
Efficacy data for long-acting injectable HIV prevention, especially twice-yearly lenacapavir, have been impressive over the past two years, and studies spotlighted at AIDS 2026 brought it closer to real-world settings. In the PURPOSE 1 and PURPOSE 2 trials, 95% of participants across eight countries chose to continue lenacapavir, confirming a preference for long-acting options over daily pills – echoed in qualitative studies citing convenience and reduced stigma and pill burden.
Choice is expanding further: Modelling showed that Merck’s once-monthly oral MK-8527 could be mass produced for USD 15 per person per year; and the dapivirine vaginal ring offers a female-controlled monthly alternative.
Researchers shared some early rollout data for lenacapavir, showing it reaching PrEP-naïve clients, adolescent girls and key populations in Zambia and Eswatini. In Uganda’s Nakivale refugee settlement, the first humanitarian acceptability study of lenacapavir found it “life-changing” for displaced populations facing conflict and mobility restrictions. Sessions on PrEP delivery in eastern Europe and demedicalizing PrEP made it clear that expanding access is a matter of political will and delivery models, not just resources.
Yet access gaps persist even where the evidence was gathered. Brazil’s Minister of Health, Alexandre Padilha, announced a pending deal to integrate long-acting cabotegravir into the country’s health system and an agreement regarding development and production of a long-acting oral prophylaxis. He noted that questions remain over Brazil’s access to affordable lenacapavir – despite hosting the PURPOSE 2 trial. “Innovation without access is not an innovation,” he said. “It is an injustice.”
4. Treatment advances
Scientific efforts have been moving towards reducing the burden of daily treatment. Now, once-weekly oral HIV treatment is within sight. AIDS 2026 heard the first detailed results from the ISLEND-1 and ISLEND-2 trials of oral islatravir/lenacapavir, which has the potential to be the first complete once-weekly oral treatment for HIV. The studies enrolled a population of more than 1,200 people living with HIV in Asia, Australia, Europe, the Americas and South Africa. Phase 3 trials demonstrate that once-weekly oral islatravir/lenacapavir is efficacious and well tolerated in people with virologically suppressed HIV.
5. Progress towards cure
We heard about the 12th and 13th people to be “cured” of HIV – or more accurately, to be in sustained HIV remission. The “Kansas City patient” has been in remission for 14 months after a CCR5 delta32/delta32 stem-cell transplant without treatment. Delegates also heard expanded results from a previously reported instance of HIV remission after a stem cell transplant in a person in Essen, Germany.
The Children with Early Antiretroviral Therapy (CHER) trial in South Africa followed 79 adolescents for 16 years. They had acquired HIV at birth and started antiretroviral treatment in infancy. Almost one in five, mostly those with more frequent treatment interruption, showed signs of an HIV-specific immune activity in the central nervous system despite viral suppression in blood, with potential implications for plasma-only monitoring in HIV cure and analytic treatment interruption trials.
Researchers continue to explore the potential of broadly neutralizing antibodies (bNAbs), which differ from conventional antiretroviral therapy by engaging the immune system directly. The placebo-controlled RIO trial provided an opportunity to identify correlates of enhanced post-treatment control, highlighting the importance of stem-like CD8⁺ T-cell responses.
6. Vaccine promises
HIV vaccine research pointed to steady progress on how to steer the immune system toward the rare, broadly protective responses a vaccine needs to induce. One obstacle is that vaccines often provoke antibodies aimed at a non-protective site on HIV. New research found these antibody-producing cells can be redirected mid-course, through carefully sequenced doses, toward a genuinely protective target – suggesting they are raw material, not a dead end.
A second study removed a small segment of HIV’s outer protein from a vaccine. This shifted the immune response toward a calmer, less inflammatory pattern, cutting HIV acquisition risk in monkeys by more than 80% – enough to support the first human trial of this design. A third strategy used a lipid nanoparticle-formulated mRNA “prime” dose showing the immune system a multi-epitope immunogen, which contained four conserved regions of the HIV envelope protein. In mice, the combination triggered strong antibody and T-cell responses, setting up testing in non-human primates.
7. AI and digital tools
Use of AI and digital tools is taking the HIV response to new frontiers, and AIDS 2026 learnt of exciting innovations from around the world. In China, for example, where 40% of people diagnosed with HIV have historically been diagnosed late, an AI-powered self-testing device reads results optically and transmits them to the cloud, allowing partners of newly diagnosed people to test privately while connecting their results to care. Piloted across 17 provinces, the approach caught new HIV acquisitions markedly earlier – 31% of partners living with HIV had signs of late-stage disease, down from 40%. In Nigeria’s Niger Delta, riverine communities face intense logistical barriers to routine ART refills. Drones are delivering ART refills, test kits and medical consumables – and 30 children and adolescents living with HIV on stable ART are experiencing 100% successful delivery and pickup rates.
Sessions also discussed guardrails for responsible AI use and examined the political economy of AI in HIV programmes.
8. Focus on children
Children remain among the most vulnerable and overlooked in the HIV response. This year’s data showed both the scale of the issue and glimpses of progress.
Prevention remains fragile. An audit of 365 Ugandan infants who acquired HIV perinatally found gaps in retesting, viral load monitoring and partner engagement driving ongoing, preventable transmission.
There are scientific advances in treatment. A five-year study found a once-daily single-tablet regimen remained safe and effective in children. A larger trial went further: a long-acting injectable given every eight weeks outperformed daily oral treatment in 476 adolescents, and was strongly preferred. But funding cuts threaten this progress – a PEPFAR data analysis found 77,163 fewer children on treatment in FY2025, a 14% decline. And as this generation ages, a London study found over 70% of adults with perinatally acquired HIV now have a metabolic condition, pointing to the need for early screening.
9. The case for integrated care
Across several sessions, a consistent message emerged: HIV outcomes improve when services are integrated into existing points of care, rather than delivered in isolation.
Two studies underscored the ongoing burden of TB in people living with HIV. A South African cohort of nearly 186,000 adults starting ART found that treatment interruptions and unsuppressed viral loads markedly raise vulnerability to TB. A Mumbai study found that TB relapse after completing treatment was a strong, independent predictor of death, arguing that TB treatment completion should be seen as a transition point requiring continued monitoring, not an endpoint.
Elsewhere, integration showed clear practical gains. In Mozambique, folding HIV testing into cervical cancer screening accounted for 7.3% of all new national ART initiations in 2025. In Botswana, integrating hypertension care into HIV clinics improved clients’ trust in providers and how well their healthcare needs were met. A session on integrated testing models across Africa and Asia – from same-day cervical screening in Zimbabwe to triple HIV/hepatitis B/syphilis testing for pregnant women in The Gambia – showed combined HIV, STI, cervical cancer and hepatitis testing improving uptake and case finding.
10. Communities at the centre
Across sessions, the evidence showed that community-led responses produce measurably better outcomes, yet remain among the most precarious for HIV funding.
We heard how communities in Brazil, Nigeria, Indonesia and Lesotho are shifting their role from recipients of services to leaders who challenge patent barriers, monitor quality and document rights violations, improving accountability and reducing stigma. Delegates also heard that community-led monitoring (CLM) in restrictive environments should be treated as an investment in accountability, not a cost. In Lesotho, CLM implementation across six districts was linked to reduced stigma, shorter waiting times and fewer commodity stock-outs.
Community-led models also reached populations conventional services often miss. In Colombia, a peer-led programme for Venezuelan migrants combined testing, peer navigation and legal support, improving early diagnosis and viral suppression despite migration status and exclusion from health insurance. In Tanzania, a community-led STI self-testing project for adolescent girls and young women lifted uptake of HIV prevention services, with 72% of those seeking follow-up care also completing HIV testing.
11. The compounding harm of stigma and criminalization
In the context of an anti-rights backlash and rising conservatism, stigma and criminalization are structural forces that actively undermine health outcomes. A symposium on structural stigma, spanning LGBTQ+ communities, sex workers and climate-affected populations, showed stigma sustained by unequal power relations and deficit-based narratives that blame people for their health conditions.
The HIV Justice Network presented evidence that HIV criminalization deters testing and delays treatment. A similar pattern emerged around drug use. A regional study across Latin America found that punitive drug policing disrupted HIV care – 52% of participants reported arbitrary detention that interrupted their treatment – with non-binary and trans people being most harassed.
Overlapping shocks quickly escalate harm. In Uganda, following the 2023 Anti-Homosexuality Act, a study found 31% of men who have sex with men screened positive for moderate-to-severe depression; after 2025’s HIV donor funding freeze, that rose to 44%, with suicidal ideation rising from 15% to 24%.
12. Conflict, disruption and resilience
Studies focused on two very different conflict settings. In Sudan, civil war, starting in April 2023, devastated HIV testing and prevention services – an analysis showed HIV testing dropped by up to 78% and positivity rates rising sharply among those still testing. ART coverage collapsed by 59% and then recovered to 94% of pre-conflict levels by the end of 2024 thanks to prioritization and redistribution to more stable areas. Testing and prevention services remained weakened, underscoring the need for more decentralized, conflict-resilient models of care. Ukraine’s experience demonstrated what makes that resilience possible. Well before Russia’s full-scale invasion in 2022, Ukraine had begun shifting HIV support services from donor-funded pilots into national public financing – during the war, 97.5% of nearly 18,000 people newly enrolled in the national HIV programme in 2024 were still on treatment in early 2026.
Meanwhile, a session on structural drivers of HIV, drawing on studies from Uganda, Kenya, East Africa, Nigeria and Fiji, reinforced the point that violence, food and water insecurity, and funding disruptions shape HIV outcomes as powerfully as war – evidence that these outcomes stem from intersecting social and economic conditions, not individual behaviour alone.
A session on Ebola reflected on the 2026 Bundibugyo virus outbreak in the Democratic Republic of the Congo – 2,905 confirmed cases and a 43.7% case fatality ratio by 22 July. The outbreak underscored a lesson familiar from HIV: diagnostics and vaccines alone are insufficient without trust, access, security and functioning health systems.