Bulawayo rolls out twice-yearly HIV experiment

Bulawayo has marked a major milestone in Zimbabwe's fight against HIV following the launch of Lenacapavir, a long-acting injectable pre-exposure prophylaxis (PrEP) administered just twice a year.

Scores of people from key vulnerable groups, including sex workers, gathered at the "Sisters Clinic" run by CeSHHAR Zimbabwe at Khami Clinic to access the new long-acting HIV prevention option.

Lenacapavir, recently recommended by the World Health Organization as an additional HIV prevention method, is being hailed as a potential game-changer in a country that continues to face one of the highest HIV burdens in southern Africa.

Unlike daily oral PrEP pills, Lenacapavir provides protection for six months per injection, easing adherence challenges for individuals who struggle to take medication consistently. Health authorities say the innovation strengthens Zimbabwe's combination HIV prevention strategy, complementing condom use, regular testing, treatment and behavioural interventions.

The initial rollout will prioritise populations at higher risk of HIV infection, including adolescent girls and young women, sex workers and their clients, men who have sex with men, and pregnant and breastfeeding women in high-incidence settings.

Bulawayo, one of the country's major urban centres with significant HIV incidence, is part of the phased introduction.

Beneficiaries who spoke at the launch said the twice-yearly injection addresses real-life challenges.

"We sometimes travel for our work, and it becomes difficult to take a pill every day at the same time. With an injection that lasts six months, I feel more protected and less stressed," said one beneficiary.

Others cited stigma associated with daily PrEP pills as a barrier, saying the injectable option allows for greater privacy and empowerment.

CeSHHAR Technical Director Dr Byron Chingombe said Lenacapavir adds another layer of protection rather than replacing existing methods.

"This is an additional tool in our HIV prevention toolkit. Scientific evidence shows very high effectiveness when administered correctly. Our priority now is ensuring equitable access, proper follow-up and sustained supply," he said.

The Medicines Control Authority of Zimbabwe approved the drug following an expedited review process, highlighting its public health importance. Health workers are currently undergoing training to administer the injection and manage follow-up care.

The programme is being supported by partners including the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the The Global Fund to Fight AIDS, Tuberculosis and Malaria to help ensure sustainable supply and technical assistance.

City of Bulawayo Director of Health Services Dr Edwin Sibanda described the development as a breakthrough in provincial HIV prevention efforts.

"The introduction of Lenacapavir marks a significant milestone in our provincial HIV prevention efforts. A twice-yearly injectable option improves adherence, expands choice and strengthens our ability to reduce new infections, particularly among high-risk populations," he said.

Health experts emphasised that Lenacapavir must be used as part of comprehensive prevention, including regular HIV testing, condom use and risk-reduction counselling.

As the rollout begins, attention now turns to community awareness, uptake and sustained funding  -  key factors that will determine how transformative the intervention becomes in Zimbabwe's ongoing fight against HIV.