Gilead Sciences’ Strategic Expansion in HIV Prevention and Global Access: Assessing Long-Term Investment Potential

Gilead Sciences has emerged as a pivotal player in the HIV prevention landscape, leveraging innovative therapies and strategic global partnerships to solidify its long-term investment appeal. With a focus on pre-exposure prophylaxis (PrEP) and expanded access initiatives, the company is addressing both market demand and public health needs, positioning itself for sustained growth in a high-stakes sector.

Financial Momentum in PrEP Innovation

Gilead’s PrEP portfolio, anchored by Descovy and the newly launched Yeztugo, demonstrates robust financial performance and market potential. In Q2 2025, Descovy sales surged 35% year-over-year to $653 million, driven by increased demand and higher average realized prices [1]. This growth underscores Descovy’s dominance in the U.S. PrEP market, where it maintains over 40% market share [2]. Meanwhile, Yeztugo, the first twice-yearly injectable PrEP option, is poised to disrupt the market. Gilead aims for 75% coverage within six months of its launch and 90% within a year [3]. Analysts caution that Yeztugo may initially cannibalize Descovy sales but project it could contribute meaningfully to the PrEP segment by 2028 [3].

The HIV segment as a whole is a cornerstone of Gilead’s financial strategy, with total HIV product sales reaching $5.1 billion in Q2 2025—a 7% year-over-year increase. Biktarvy, a key HIV treatment, accounted for 51% of the U.S. treatment market share, with sales rising 9% to $3.5 billion [2]. These figures highlight Gilead’s ability to balance therapeutic and preventive HIV solutions, ensuring resilience against generic competition for older PrEP products like Truvada.

Global Partnerships and Access Initiatives

Gilead’s long-term investment potential is further bolstered by its commitment to expanding HIV prevention in low- and lower-middle-income countries (LLMICs). In 2025, the company partnered with PEPFAR and the U.S. State Department to deliver lenacapavir—a twice-yearly injectable PrEP option—to up to two million people in high-burden regions over three years [1]. This initiative is supported by royalty-free licensing agreements with six generic manufacturers, ensuring supply for 120 high-incidence countries [3].

A landmark agreement with the Global Fund in July 2025 allows Gilead to supply lenacapavir at no profit, enabling low- and middle-income countries to access the drug. The Global Fund aims to deliver lenacapavir to at least one African country by year-end 2025, with a target of reaching two million people by 2028 [4]. These partnerships align with Gilead’s broader strategy of accelerating regulatory approvals in priority regions, including South Africa and Brazil, to ensure rapid deployment [3].

Strategic Risks and Opportunities

While Gilead’s PrEP innovations and global access programs are promising, challenges remain. The introduction of Yeztugo may temporarily reduce Descovy sales, and generic competition for Truvada could pressure margins. However, the twice-yearly administration of Yeztugo and lenacapavir offers a unique value proposition, potentially attracting patients and payers seeking long-term adherence solutions.

Globally, Gilead’s partnerships mitigate supply chain risks by involving generic manufacturers and leveraging donor funding from entities like the Children’s Investment Fund Foundation (CIFF) [4]. Domestically, the company faces structural barriers to PrEP uptake in the U.S., such as cost and fragmented healthcare delivery [4]. Addressing these issues through policy advocacy or public-private partnerships could enhance its market position.

Investment Thesis

Gilead’s dual focus on innovation and equitable access positions it as a leader in the HIV prevention market. The company’s 2025 guidance of $28.3–28.7 billion in total product sales, with HIV contributing significantly, reflects strong near-term confidence [3]. Long-term, the global expansion of lenacapavir and Yeztugo—supported by strategic partnerships and regulatory milestones—could drive revenue growth beyond 2028. Investors should monitor market share dynamics, generic competition, and the success of international access programs as key indicators of Gilead’s ability to sustain its momentum.

**Source:[1] Gilead Sciences Announces Second Quarter 2025 Financial Results [https://www.gilead.com/news/news-details/2025/gilead-sciences-announces-second-quarter-2025-financial-results][2] Gilead Sciences (GILD) Q2 2025 Earnings Call Transcript [https://www.fool.com/earnings/call-transcripts/2025/08/08/gilead-sciences-gild-q2-2025-earnings-call-transcript/][3] Gilead Stock Surges, Flirting With A Breakout, As HIV PrEP Launch Gains Momentum [https://www.investors.com/news/technology/gilead-stock-gilead-earnings-q2-2025/][4] Global Fund Secures Access to Breakthrough HIV Prevention Drug Lenacapavir for LMICs [https://www.eatg.org/hiv-news/global-fund-secures-access-to-breakthrough-hiv-prevention-drug-lenacapavir-for-lmics/]