On October 29, 2026, Gilead Sciences reported third-quarter results showing that HIV prevention sales nearly doubled year over year. Yeztugo (twice-yearly injectable lenacapavir for PrEP) brought in $305 million in the quarter, up from $39M a year earlier and up 31% sequentially. U.S. sales were $294M and the rest of the world contributed $10M. Year-to-date Yeztugo sales reached $702M, and Gilead reaffirmed its target of about $1 billion for the full year. Management cautioned that fourth-quarter growth will be more modest because of holiday seasonality. Descovy sales rose 49% to $1.0 billion, and Gilead says about 80% of that is PrEP use. Total HIV product sales grew 18% to $6.2 billion, and Gilead raised full-year product-sales guidance to $31.0–31.3 billion.

Why It Matters

This is the clearest commercial evidence yet that long-acting HIV prevention has gone mainstream in sexual health. A $1B first-year launch tells telehealth PrEP providers, sexual-health clinics and dating platforms (Grindr has pledged [PrEP information access for 10 million people](/stories/grindr-edge-tier-gayborhood-strategy)) where demand is going. It also sharpens the access story: this week's data showed [4 in 10 patients prescribed an injectable never got the shot](/stories/injectable-prep-insurance-barriers-idweek), so Yeztugo's growth is happening despite insurance friction. A once-weekly oral option in February 2027 would add a third format (daily pill, weekly pill, twice-yearly shot), and the PrEP market starts to look like contraception, with choice of method driving uptake. For investors, watch the PrEP-naive share. That number shows whether the market is growing or patients are just switching from Descovy.

On the earnings call, management said Yeztugo is now the leading long-acting injectable PrEP regimen in the U.S. and that more than 70% of users returned for their second injection, which gives up to a full year of protection. Yeztugo and Descovy for PrEP together hold about 50% PrEP market share, which management described as a $4 billion annual run rate. Most new Yeztugo starts are still people switching from other PrEP regimens, but the share of PrEP-naive patients rose during the quarter. Pharmacy-benefit access is about 70%. Gilead also said its application for once-weekly oral lenacapavir for PrEP is under FDA review with a decision expected in early February 2027, and that results from the Phase 3 PURPOSE-365 study of a once-yearly injection are expected in 2027. The company has extended its royalty-free voluntary licences to cover the once-yearly version in 120 high-incidence countries, if it is approved.

Sources

Update — 2026-10-30

Initial entry — story first created.