CATHERINE MUROMBEDZI
HEALTH CORRESPONDENT

The fight against HIV/AIDS has reached a pivotal moment. After decades of reliance on condoms and antiretroviral therapy, a new wave of prevention options is revolutionizing the landscape. From oral pre-exposure prophylaxis (PrEP) tablets to long-acting injectables like Lenacapavir and Cabotegravir, the choice basket for HIV prevention is expanding rapidly But with 1.3 million new infections in 2023, the urgency for accessible and affordable prevention measures has never been greater.
In this article, we explore the latest developments in HIV prevention and the voices of reason driving change.
Lenacapavir will do just that with two pricks a year.
While choice has been the limiting factor to HIV prevention options, science has been miles ahead with novel prevention tools. What advocates now demand is a downward price review, a thousand times lower.
With lenacapavir costing US$40 000 a year, activists, advocates, and participants at the recently ended 25th AIDS Conference in Munich, Germany called for Gilead, the manufacturers to be people-centred.

In a vox pop, with voices ranging from joy to action demands, the media was called to amplify science.
Talking of pill fatigue, which often leads to missed doses, Dr Bernard Madzima, the National AIDS Council Chief Executive Officer, said lenacapavir is a game-changer
“Lenacapavir and CAB-LA, being injectables, unlike oral pre-exposure prophylaxis (PrEP) tablets taken daily, injectable will see compliance peaking because there is no pill burden. These are HIV negative clients who can easily get tired of taking a pill for prevention every day. They want to remain negative, but the motivation to take a pill every day wanes. So, these new injectables are game changers, and they decrease the risk of acquiring HIV. It is very welcome as the choice basket widens. We now advocate for the cost to come down,” said Dr Madzima.
Dr Angela Mushavi, the HIV prevention from mother-to-child-transmission National PMTCT and Pediatric HIV Care and Treatment Coordinator in the Ministry of Health and Child Care, was pleased with the long-acting prevention injectable.

“It was great news to hear about the recent approval of the long-acting Lenacapavir for use as HIV Pre-Exposure Prophylaxis (PrEP). In the prevention-of-mother-to-child transmission of HIV program, we see that 50% of pregnant women are below the age of 30 years, encompassing the adolescent girls and young women between the ages of 10-24 years and up to 30 years, who are at high risk of getting HIV from their partners if they are in a discordant relationship.

“HIV pregnant adolescent girls and young women or those who are breastfeeding who are HIV negative should be encouraged to remain HIV negative. The use of Lenacapavir for PrEP, given as a twice yearly injection, offers a unique opportunity to prevent women from getting an HIV infection. This is important to prevent the HIV virus from getting to the baby either during pregnancy or during the breastfeeding period. PrEP can also be given as a daily pill taken every day or as an injection of long-acting Cabotegravir (CAB-LA) given every 2 months. In the case of CAB-LA, this would be 6 injections a year. For the novel drug, lenacapavir, this would only be two injections per year. This really would be a game-changer in the program to keep young girls and women HIV negative; before pregnancy; during the pregnancy and even during the breastfeeding period as the country moves to eliminate mother-to-child transmission of HIV,” said Dr. Angela Mushavi.
Dr Mushavi also provides technical leadership and guidance for the expansion of PMTCT and Pediatric HIV and AIDS care and treatment programs in Zimbabwe. She is involved in policy and guideline development at national and international levels and is a member of the WHO ARV Guideline Development Group.
Phyllis Mavushe, a young advocate for sexual reproductive health and rights, said the prevention injection was empowering.
“I feel the HIV prevention injectable is empowering for women who had difficulty in taking PrEP pills. Some feared being seen by a partner who would raise the card, ‘So you don’t trust me?’ Some partners would become abusive upon finding out that their wife is taking prevention pills. The twice a year injection is a breakthrough. But still, this prevents HIV not other STIs, so young people, young women, should be empowered to negotiate for safer sex and protect themselves,” said Mavushe.
“And for those who may have missed the opportunity to protect themselves, there’s still hope. Post-Exposure Prophylaxis (PEP) is an emergency medication that can prevent HIV infection if taken within 72 hours of exposure. It is equivalent to the morning after pill. It’s a 28-day course of antiretroviral oral medication in pill form. It can be obtained from healthcare providers or emergency rooms. Remember, it’s never too late to take control of your HIV status. Even in the midst of an “oh gosh, I should have used protection” moment, PEP can still be a reality. In all tgis, we rely on the mass media to get the prevention message out. We also have foot soldiers, they never tire, these are the community health workers who educate communities in public health issues,” said Mavusha.
Sipho Mpofu, who is a champion for girls’ rights with Shamwari Yemwanasikana, welcomed the new drug.
“The coming on board of the lenacapavir HIV injectable drug to the market towards ending new HIV infections is a hugely welcome move. It will see more youths protected from HIV infections. The long-acting period of the drug is commandable compared to other PrEP methods. Clients will now visit health institutions twice a year. It is given at a facility, so that is measurable. Given that the health seeking behavior of Zimbabweans, particularly youths and adolescents, is very low, the twice injectable is welcome. It will also overcome adherence issues where clients miss taking the oral pills every day. However, in as much as the lenacapivir has high efficacy we encourage young people to protect themselves with other available means particularly girls if they engage in sexual relations as teen pregnancies may arise as well as other STIs which are not prevented by the lenacapavir,” said Sipho Mpofu of Shamwari Yemwanasikana, Monitoring, Evaluation, Research and Learning Officer.
In 2023, 1.3 million people were infected with HIV. (UNAIDS). Zimbabwe recorded 15,312 new HIV infections in the same year. (NAC)
Don’t hesitate to seek help and take action to protect your health.
As science strives for a cure, let’s take the precautionary measures. Prevention is better than cure.

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