Kenya rolls out six- month HIV injection, easing daily pill pain

When 23-year-old Lawrence Peace Ochieng’ first started taking oral Pre-Exposure Prophylaxis (PrEP) in 2021, he was determined to stay HIV negative.

At the time, the daily pill felt like a small price to pay for protection. But four years later, the routine had become exhausting.

“Since 2021, I have been taking the oral PrEP.  Over time, I’ve had many partners, and sometimes when I don’t, I feel there’s no need to keep taking it because it’s preventive,” Lawrence explains.

Lawrence, a man living in Nairobi, considers himself at high risk of HIV infection. He also engages in sex work, a reality that often makes negotiating condom use complicated.

On Thursday, he became one of the first Kenyans to receive Lenacapavir, a new long-acting injectable HIV prevention drug recently launched in the country.

Administered at Riruta Health Centre, the injection is designed to be taken once every six months, a significant shift from the daily oral regimen that many users have struggled to maintain.

“I volunteered to receive the injection today because the daily PrEP pill burden is really tiresome,” Lawrence says. “I am HIV negative and I want to keep it that way. I don’t want to ease off protection.”

Unlike oral PrEP, which must be taken every day to remain effective, Lenacapavir is administered as two injections around the abdomen, about four centimetres apart.

After the first injection, users are required to take oral tablets within 24 hours, as directed by a clinician, before continuing with the six-month injectable schedule.

Nursing Officer Argwings Mawira, who has been administering the injections at Riruta Health Centre, says the innovation could ease the burden for many Kenyans who have struggled with adherence.

“This injectable lasts six months and is administered around the navel, about four centimetres apart,” Mawira explains.

“It is ideal for those at high risk, such as sex workers and for people who were taking daily PrEP but found it difficult to take a pill every day.”

On the day of the launch, five clients received the injection within hours, with dozens more waiting outside the clinic. “This move will reduce the burden for Kenyans who sometimes forget to take their medication,” Mawira adds.

“But people must understand that Lenacapavir prevents HIV only. It does not protect against other Sexually Transmitted Infections (STIs), so other forms of protection, including condoms, rem-ain important.”

For Lawrence, the injectable offers a sense of relief but not a solution to every risk.

“It is really hard,” he says when asked about condom use with clients. “You never know what the client will want. Sometimes it’s a mind game. You have to explain the benefits of protection and weigh the reasons.”

He acknowledges that while the injection will shield him from HIV, it does not protect against STIs. “For STIs, that’s a different case. This one is just HIV,” he says.

“I will still need to use condoms.” After receiving the two injections, Lawrence reported mild pain at the injection site but said he felt optimistic. “It’s easier to prevent something than to cure it,” he says. “It’s easier to come and take this medicine than to go to a doctor for treatment later.”

Daisy Oside, 28, shares a similar story.

She received her first Lenacapavir injection at Riruta Health Centre, citing her involvement in high-risk sexual behaviour and difficulty maintaining daily oral PrEP.

“I have had multiple partners. Taking the daily pill was challenging,” Daisy says. “Sometimes I would forget. And my boyfriend once found the PrEP medication and thought I was HIV positive, even though I am negative.”

The misunderstanding strained her relationship. For Daisy, the injectable offers not just medical convenience but also discretion.

“I hope this will give me more consistent protection without the daily stress,” she says.

Kenya has officially launched Lenacapavir as part of its national HIV prevention strategy, marking a major step in strengthening the country’s response to the epidemic.

Health Cabinet Secretary Aden Duale presided over the launch at Riruta Health Centre in Nairobi, describing the rollout as a milestone bringing renewed hope to millions of Kenyans.

“This milestone brings hope to Kenyan families. Prevention remains central to our national response,” Duale said. Kenya currently has 1.4 million people living with HIV, with thousands of new infections recorded annually.

While the country has made great progress over the past decade, officials say prevention innovations are essential to ending the epidemic.

Acting Chief Executive Officer of the National Syndemic Diseases Control Council (NSDCC) Douglas Bosire highlighted the gains made since 2013.

“In 2013, the country recorded 110,000 new HIV infections. In 2024, the number of new cases reduced to 15,000. Deaths reduced from 110,000 to 21,000. That is significant and tremendous progress,” Bosire said. However, he cautioned that HIV prevention cannot be isolated from broader social challenges.

Dr Andrew Mulwa, Head of the National AIDS and STI Control Programme (NASCOP), described the launch as a landmark moment for Kenya’s HIV response. 

“We have been talking about this from June (last year) or thereabouts, and a lot of work has gone into making this day a success.”

He said months of planning, coordination and preparation preceded the rollout, involving multiple stakeholders within and outside government.

The rollout will begin in 15 counties identified as having the highest number of new HIV infections, before expanding in phases.

According to Dr Mulwa, the phased approach ensures that counties selected are ready in terms of trained personnel, commodity management and systems to monitor clients effectively.

He clarified that the drug will be offered free of charge to eligible clients in public facilities.