Nigeria Introduces Revolutionary Long-Acting Injectable for HIV Prevention
Nigeria is poised to significantly advance its HIV prevention strategy with the introduction of Lenacapavir, a groundbreaking long-acting injectable drug. This innovative treatment offers a new layer of protection against HIV infection, particularly for individuals at higher risk. The rollout is set to commence in eight key states: Anambra, Ebonyi, Gombe, Kwara, Akwa Ibom, Cross River, Benue, and the Federal Capital Territory (FCT). This initiative is a crucial step in expanding access to cutting-edge HIV prevention options across the nation.
The introduction of Lenacapavir is a collaborative effort, bolstered by the support of international partners including the Global Fund and the World Health Organisation. The WHO globally recommended the drug in July 2025, recognizing its potential to transform HIV prevention landscapes.
Adebobola Bashorun, National Coordinator of the National HIV, Viral Hepatitis and STDs Control Programme (NASCP), highlighted that the rollout plan was meticulously developed, informed by robust programme data and extensive stakeholder collaboration. He emphasized that Lenacapavir is not a cure for HIV but a vital complementary tool. It will work alongside existing prevention methods such as daily oral pre-exposure prophylaxis (PrEP) and the long-acting injectable drug, cabotegravir.
Temitope Ilori, Director-General of the National Agency for the Control of AIDS (NACA), noted that while global studies indicate Lenacapavir’s high safety profile, there is currently insufficient evidence to recommend its use during pregnancy. “Even though LenPrEP is considered very safe based on global studies, it is not recommended for pregnant women. It is important to emphasise that this is a preventive intervention, not a treatment,” she stated.
Health authorities view this rollout as a pivotal moment in Nigeria’s fight against HIV, marking a significant shift in prevention strategies, especially for those most vulnerable to infection.
Understanding Lenacapavir: A New Era in HIV Prevention
Lenacapavir is an advanced long-acting injectable antiretroviral medication specifically designed for pre-exposure prophylaxis (PrEP). Its primary function is to prevent HIV infection in individuals who are HIV-negative but face a substantial risk of exposure.
A key advantage of Lenacapavir over traditional daily oral PrEP pills is its extended duration of action. Instead of daily adherence, it is administered as an injection only once every six months. This significantly reduces the burden of consistent medication intake, a long-standing challenge in HIV prevention programs. Factors like stigma, forgetfulness, or difficulties in accessing healthcare can often impede adherence to daily regimens. By requiring just two injections per year, Lenacapavir aims to enhance protection rates and contribute to the global goal of ending HIV and AIDS as a public health threat by 2030.
Phased Rollout and Target Populations
Nigeria was selected as one of nine early adopter countries by the Global Fund to implement Lenacapavir. This selection followed Nigeria’s formal expression of interest in March 2025. Approximately 52,000 doses have been secured to support the initial introduction of the drug, with the first consignment already delivered. Preparations are actively underway for both national and facility-level distribution.
The Minister of State for Health and Social Welfare, Iziaq Salako, outlined that Lenacapavir is intended for HIV-negative individuals at substantial risk of acquiring HIV. This includes:
- Individuals with HIV-positive partners.
- People with multiple sexual partners.
- Sex workers.
- Men who have sex with men (MSM).
- People who inject drugs.
The government is adopting a strategic phased approach to ensure thorough monitoring of the drug’s safety and effectiveness within Nigerian populations before a nationwide expansion. This phased rollout will involve:
- A national launch event to officially inaugurate the program.
- Extensive media engagement to raise public awareness.
- Facility-level flag-off ceremonies at key healthcare sites.
These activities will be guided by the National Pre-Exposure Prophylaxis Implementation Plan (2025-2028), which encompasses critical aspects of service delivery, supply chain management, financing, and community engagement.
How Lenacapavir Works and Its Limitations
Lenacapavir operates by disrupting crucial stages in the HIV life cycle. By blocking these processes, it prevents the virus from establishing an infection in the body should an exposure occur. Once administered via injection, the drug is released slowly over several months, providing continuous protection.
To date, clinical trials have not reported any major adverse effects. The most commonly observed side effect is mild pain at the injection site. The phased rollout in Nigeria will allow for close observation and documentation of its safety and efficacy in the local context.
However, it is important to acknowledge the limitations of Lenacapavir. The drug does not offer protection against other sexually transmitted infections (STIs) or unintended pregnancies. Furthermore, as previously mentioned, it is not recommended for use by pregnant women due to a lack of sufficient safety data in this population. Health experts also stress that Lenacapavir should not be perceived as a license to engage in risky sexual behaviors; it is a powerful tool that works best when used in conjunction with other protective measures and informed decision-making.
Integrating Lenacapavir into Nigeria’s Comprehensive HIV Response
Lenacapavir is designed to complement, not replace, the existing array of HIV prevention methods available in Nigeria. These include daily oral PrEP, the long-acting injectable cabotegravir, consistent condom use, and various behavioural interventions. The availability of multiple prevention options is crucial, enabling individuals to select the method that best aligns with their personal circumstances, lifestyle, and preferences. This personalized approach is expected to boost uptake and ultimately enhance the overall effectiveness of HIV prevention efforts.
While the introduction of Lenacapavir represents a significant leap forward, ongoing challenges must be addressed to ensure its successful implementation. These include:
- Awareness and Education: Ensuring that at-risk populations are fully informed about the availability, benefits, and proper use of Lenacapavir.
- Stigma Reduction: Continuing efforts to combat the stigma associated with HIV and its prevention, which can deter individuals from seeking services.
- Health System Capacity: Strengthening the capacity of healthcare facilities and personnel to deliver the injectable service effectively and efficiently.
- Equitable Access: Working to ensure that Lenacapavir is accessible to all individuals who could benefit from it, regardless of their geographic location or socioeconomic status.
As Nigeria moves forward with this promising new intervention, a sustained commitment to these areas will be vital for maximizing its impact and moving closer to achieving an AIDS-free future.
