New HIV jab offers relief from daily pills

For 27 years, Esther Shiyayo and her husband have navigated life in a discordant marriage. Esther is HIV‑positive while he remains HIV‑negative. To maintain his status, he faithfully took a daily dose of pre‑exposure prophylaxis (PrEP).

“It hasn’t been easy. Some days he feels exhausted and wants to quit, but I keep encouraging him,” says Esther. Despite the physical toll of the pill regimen, the couple have raised six HIV‑negative children, thanks to strict adherence to PrEP and Esther’s suppressed viral load.

“When I first introduced him to PrEP, he had so many questions. He didn’t like the idea of taking pills every day for the rest of his life. But with time, he accepted it was the only way to protect himself,” she says.

Now, Esther is among the many discordant relationships who are celebrating the introduction of Lenacapavir, an injectable HIV prevention drug taken just twice a year.

“The injectable will ease the stress of taking pills every day and reduce the pressure of monthly clinic visits. It’s a huge relief for couples like us,” she said.

Thousands of Kenyans are set to benefit from the roll-out of Lenacapavir injectable HIV preventive drug.

The drug is the first long-acting injectable form of PrEP, offering an alternative to the daily oral pills currently used for HIV prevention.

The Ministry of Health, through the National AIDS and STI Control Programme (NASCOP), announced the approval of the injectable recently. The country will begin receiving the drugs by January 2026.

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Clinical data shows the drug has up to 99 per cent efficacy in preventing HIV transmission.

The injection is administered under the skin in the abdominal area (stomach) by a healthcare provider and is designed to be discreet, convenient and stigma-free.

Trials found little to no differences in rates of adverse effects, apart from mild and moderate severity at the injection site.

Also, it has no adverse side effects in pregnancy and birth outcome as compared to oral PrEP.

Kenya is expected to receive the drug with procurement supported by the Global Fund and other partners.

The rollout will be coordinated by the Ministry of Health through NASCOP, in collaboration with partner organisations.

NASCOP Chief Executive Dr Andrew Mulwa says approval of the medicine for use is a big milestone in the prevention of HIV infections. It will also be easy to monitor uptake and adherence. “Approval of the injectable means we are making a leap in prevention services with the long-acting pre-exposure prophylaxis medicine, which will be easy to administer and monitor adherence,” said Mulwa.

Not a vaccine

Lenacapavir, a new long-acting injectable drug for HIV prevention, is being hailed as a game-changer by both medical experts and members of key populations, particularly sex workers. Unlike traditional oral PrEP (pre-exposure prophylaxis) that must be taken daily, Lenacapavir requires just two injections per year, offering a more convenient and discreet alternative in the ongoing fight against HIV.

Professor Omu Anzala, a leading virologist at the University of Nairobi, explained that Lenacapavir is an antiviral drug that directly targets the HIV virus, much like current antiretroviral medications. “It is purely antiviral, not a vaccine. It targets the virus itself,” Prof Anzala clarified.

He described the injectable as revolutionary in its ability to serve both as a treatment and a preventive measure. “This PrEP is safe, highly effective, and has been used in the United States for the past two years,” he added.

However, Prof Anzala pointed out a major challenge: the cost. “The injection itself is not the problem. The real issue is affordability; it’s extremely expensive,” he said.

“Approval is a good first step, but ensuring consistent access for those who need it most will be a true test,” he adds.

The long-acting nature of Lenacapavir is expected to greatly improve medication adherence, particularly among individuals who struggle with taking pills daily.

“If someone is asked to take a pill every day versus an injection every six months, adherence becomes far easier with the injectable,” Prof Anzala noted.

Sex workers, a group particularly vulnerable to HIV due to the nature of their work, have embraced the news with cautious optimism.

Everly Nabwire, who heads the key population programme at Nkoko Iju Africa, a sex worker-led organisation based in Mombasa, said that Lenacapavir has the potential to transform HIV prevention for women in the trade.

“Sex work comes with inherent risk, including condom breakages, which expose us to HIV,” Nabwire said.

She explained that the burden of taking pills every day adds another layer of difficulty to an already precarious lifestyle.

“Taking medication daily is stressful. Sometimes you forget — especially after a long night — and missing a dose increases your risk. On top of that, the stigma is heavy. Some women even confuse PrEP with ARVs and think they’re already sick,” she said.

For many of her peers, the injectable represents freedom from stigma, from daily reminders, and from the fear of forgetting.

“An injectable PrEP taken just twice a year will boost adherence, reduce stigma, and significantly improve health outcomes for sex workers,” she said.

Nkoko Iju Africa, supported by USAID through the Stawisha Project, works with 1,080 sex workers across Bamburi, Kisauni and Nyali in Mombasa. Of those, 580 are on oral PrEP while 100 are living with HIV and receiving treatment. The organisation distributes PrEP and condoms from Bamburi Dispensary.

Yet, Nabwire warned that erratic supplies remain a concern. “We often face stock-outs, especially when there are delays in foreign aid. That’s why we do community outreach every three months — to keep awareness and demand alive,” she explained.

A more manageable solution

In Nakuru, Daisy Achieng, Chairperson of Smart Ladies, another sex worker collective, echoed the sentiment, praising the injectable for its potential to improve their lives.

“Injectables will make our work smoother and less stressful. Daily pills are difficult to manage,” she said.

Achieng added that many women stop taking oral PrEP due to side effects such as vomiting, drowsiness, and diarrhoea — side effects that can cost them clients.

“Imagine taking a pill to stay safe, then getting sick and losing a client — that’s a direct financial loss. It’s a tough choice,” she said.

With the arrival of Lenacapavir expected in early 2026, and procurement support from the Global Fund and other partners, Kenya now has an opportunity to lead in the adoption of next-generation HIV prevention methods.

For women like Nabwire and Achieng, and the thousands of others they represent, it could mark the beginning of a safer, more manageable future.