Lenacapavir, Twice-a-Year HIV Prevention

 What is lenacapavir?

Lenacapavir (LEN) is a long-acting antiretroviral drug that blocks HIV from entering human immune cells. It’s part of a class of drugs called capsid inhibitors, which work differently from most HIV meds by targeting the protective shell of the virus.

Here’s the kicker: instead of taking pills every day like with oral PrEP (e.g. Truvada or Descovy), you get just two injections a year.

 

Why it matters

The problem with daily PrEP has always been this: it works great if you take it consistently. But life happens. People forget. Stigma gets in the way. Access isn't equal.

LEN changes the game by removing the need for daily adherence. Just show up every six months for your shot, and you’re covered.

That’s a huge deal for:

• Adolescents and young adults
• Women in high-risk communities
• People who experience stigma in clinics
• Key populations like sex workers, MSM, and transgender individuals

 

What the research says

WHO’s recommendation is based on strong evidence from clinical trials, especially CAPELLA and CALIBRATE, which showed:

• High levels of protection against HIV
• Minimal side effects
• Excellent adherence (since there’s almost nothing to remember)

As of July 2024, lenacapavir is approved for HIV prevention in some countries, and the WHO is pushing for more widespread access, especially in places where HIV is still a major threat.

 

What does this mean for Africa and for Nigeria

In countries like Nigeria, where HIV prevalence is still high among certain populations, long-acting injectables could help close the prevention gap. Especially for young women and girls who often face barriers to consistent daily pill use.

It also opens the door to community-based delivery, think: mobile outreach, drop-in centers, or youth-friendly clinics doing biannual “prevention days.”

But rollout won't be automatic. It will need:

• Local approval and procurement
• Trained providers
• Public awareness campaigns
• Community buy-in

 

 What’s next?

WHO has included lenacapavir in its updated HIV prevention guidelines, alongside other options like:

• Oral PrEP
• Dapivirine vaginal ring
• CAB-LA (long-acting injectable cabotegravir)

The key message: people should have choices. And now, there’s a new one on the table.

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