Experts explain new anti-HIV jabs ahead of rollout tomorrow

Kenyans eligible for the injectable HIV Pre-Exposure Prophylaxis (PrEP) will receive at least four jabs in a year.

The long-acting injection, Lenacapavir, is administered twice a year, once every six months, but during the first visit, a client receives two injections to complete the initial dose.

Individuals qualified for the jab shall be required to take oral PrEP tablets during initiation of the first jab to ensure rapid protection against HIV disease.

Further, after 24 hours, they will take two tablets of oral PrEP to complete the starting dose.

Thereafter, the persons will only return for their two injections after six months.

Experts shared details on the Lenacapavir set to be officially launched on Thursday during the media sensitisation forum.

“During an initial initiation, a client shall be injected twice with Lenacapavir. Tablets boost your protection very fast,” said Dr Elizabeth Irungu, an official at JHPIEGO.

Fine details further revealed that during initiation, two injections are given, each containing 1.5ml.

“The injection forms nodules because it is not a small amount. That is why it is split into two injections,” explained Irungu.

However, no major side effects are expected with the administration of Lenacapavir, apart from a mild nodule on the site of injection, which gradually fades.

It is also worth noting that Lenacapavir does not prevent other sexually transmitted diseases and infections.

According to Ruth Kamau, Programme Officer at the National AIDS and STI Control Programme (NASCOP), eligible people will be counselled before receiving the injectable to ensure they understand how it works.

“As long as a client is counselled properly, they should understand the side effects of the jab and its initiation process,” said Kamau.

To qualify for the jab, an individual must test HIV negative and should not have had any potential exposure to the virus within the past 72 hours.

HIV testing is conducted at the facility where the injection is administered by a healthcare worker.

Individuals shall also be required to disclose their medical history, including use of sexual enhancement drugs and tuberculosis (TB) treatment, to prevent possible harmful drug interactions.

"Nobody shall give you lenacapavir unless you test HIV. Only HIV-negative individuals shall be given," says Irungu.

Someone who is infected with HIV, or someone living with HIV, shall not be eligible for the injectable.

According to Irungu, the injectable is a strong medicine, and therefore administering it to someone already with the virus weakens them.

“The injectable is meant to boost immunity of the body's immunity against acquiring the virus, and placing it already in a body with it, weakens it more- someone will be shaken and weakened,” warned the expert.

Other health services shall also be provided alongside initiation of the drug, like screening for non-communicable diseases like cancer, diabetes and hypertension for care.

Irungu maintained that lenacapavir is effective in the prevention of HIV and is not a treatment.

Two studies for the product were conducted, with the first one done in South Africa and Uganda, with women participants. No participant acquired HIV during the trial.

The second study was done among men and transgender individuals in America, South America, South Africa and Asia.

The studies placed the efficacy of the drug at 96 per cent.

“Lenacapavir is over 96 per cent effective. This is already established,” said Irungu.

She added, "It'll not affect infertility, it won't do away with breast milk. It won't interfere with pregnancy. A breastfeeding woman has a high risk of acquiring HIV. This is the woman we want to come and receive HIV prevention.”

The expert maintained that "It's important to prevent HIV. It'll be given to breastfeeding and pregnant women because it helps prevent HIV to newborn.”

The drugs are also safe for pregnant women, said Irungu, emphasising it is an additional form of long-lasting PrEP and shall be given as an additional prevention option alongside existing methods, namely Cabotegravir and Oral PrEP.

The national roll-out shall be held at Rituta Health Center in Nairobi, as the country gears up efforts to end new HIV infections by 2030.

Lenacapavir shall be rolled out alongside cabotegravir, two months injectable.

There are at least 18, 000 doses of cabotegravir. Kenya received at least 21, 000 doses of lenacapavir. For a start, the rollout shall be conducted in phases.

The first phase shall be in 15 counties, namely Kisumu, Mombasa, Nairobi, Migori, Homa Bay, Siaya, Kisii, Kajiado, Busia, Machakos, Kiambu, Uasin Gishu, Kakamega, Nakuru and Kisii.

Only 10 facilities in each of the counties have been identified to issue the injectables, balancing demand and supply.

Available drugs shall be given free of charge at MoH hospitals, faith-based hospitals and drop-ups. No private facility shall administer the drug.

“Lenacapavir shall be available free of charge. We shall go to facilities that are reporting high HIV burden and must be offering oral pills as PrEP,” said Kamau.

“We received limited product, therefore not able to do a national scale-up. As our policies provide, we shall prioritise geographies with high HIV disease burden and infections,” said Kamau.

Some of the counties given priority have also participated in previous PrEP studies.

Second phase shall be rolled out in Wajir, Samburu, Kwale, Turkana, Nandi, Kericho, Garissa, Nyandarua, Isiolo, Murang’a, Tana River, Makueni and Meri.

The third phase will include counties of Nyamira, Lamu, West Pokot, Nyeri, Trans Nzoia, Narok, Mandera, Kirinyaga, Bomet, Kitui, Laikipia, Taita Taveta, Vihiga, Ugenya, Marakwet, Tharaka Nithi, Baringo and Bungoma.

The data on individuals receiving the jab shall be keyed to Kenya’s Electronic Medical Record (EMR) at the hospital level.

“Issuance of the injectable shall be monitored at the facility level, and in case of any concern, the national technical working group shall be deployed to find out challenges, for a swift solution. This includes laxity in uptake, finding out solutions,” added Kamau.

Cabotegravir PrEp injection taken every two months is injected deep in the muscle (buttocks).

But uptake of PrEP in the country has remained low, according to experts.

For example, at least 12,000 people are started on PrEP every month, but data on continuing use has only 60,000 annually.

“People are always initiated in PrEP, but very few continue with the medicine,” regretted Kamau.

Lenacapavir is expected to cure pill fatigue, according to users and experts.

Kenya becomes the fourth country to adopt the use of lenacapavir, alongside Zambia, Zimbabwe and South Africa.

Kenya is among the countries with high rates of HIV burden globally.

Data by the National Syndemic Disease Control Council (NSDCC) shows that 19,991 new infections were recorded in 2024, representing a 19 per cent increase from 16,752 cases in 2023.

Of the new infections, 4,349 were children aged zero to 14 years, while 32 per cent of all new HIV infections occurred among adolescents and young people aged 10 to 24 years.

AIDS-related deaths in Kenya have also slightly increased over the last five years.

In 2019, at least 20,997 people died of AIDS-related complications, a number that increased to 21,007 in 2024.

Cases of mothers infecting babies with HIV remain high at 9.3 per cent, up from seven per cent in 2022. This is against WHO targets of below five per cent.

According to the data, the rise in mother-to-child transmission reflects persistent gaps in prevention, including missed antenatal care visits, poor antiretroviral therapy adherence, and retention.

Nevertheless, counties in arid and semi-arid areas are recording mother-to-child transmission rates above 20 per cent.