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Experts urge caution over HIV prevention injection

Kampala, Uganda | URN | Experts have urged those who already received their first injection of the twice-yearly HIV preventing drug Lenacapavir to consider using combination prevention options, warning that the game changer injection is not a vaccine.

The initial recipients of the drug that has since had a lot of demand countrywide are set to receive their second dose in October and Dr Vincent Bagambe, the Policy Planning and Strategic Manager at the Uganda AIDS Commission says for those who access it, they should be keen on receiving their next dose on the prescribed dates if they are to maintain optimal drug levels in their blood.

Bagambe says that with the injection now part of the prevention tools in the country, they hope to cut the 37,000 new infections recorded yearly to less than 10,000 by 2030, which will all depend on how compliant people be to maintain the required drug levels in their blood to guarantee protection.

At the launch of the prevention option in April, Uganda had received 19,200 doses supplied across 103 health facilities across the country. The main clients targeted for the drug include people at highest risk of infection such as sex workers, couples in discordant relationships, fisherfolk and pregnant women engaging in risky behavior among others. But reports by the Ministry of Health show that the drug was accessed by those not listed as high risk as demand surpassed available supplies.

Asked about supplies for those who will soon need the second dose, Dr Herbert Kadama who coordinates Pre-Exposure Prophylaxis (PrEP) at the Ministry of Health said sixty – percent of the facilities that received the first batch have now received second batches.

Kadama explains that the facilities received the second batches earlier than scheduled because the doses were running out in two to three weeks and yet at the beginning, they had thought they would be supplying every two months.

Meanwhile, the country expects a top-up consignment of another 19,200 doses donation.

In an earlier interview with URN, Dr Peter Mudiope who heads HIV Prevention in the ministry this consignment was initially expected to arrive in the country in June only to be informed by the manufacturer Gilead Sciences that this couldn’t happen due to shortages of a tablet that complements the injection, also called the loading dose.

Mudiope says that as calls for more doses continue and the valid need for people to comply on the prevention treatment, government cannot do much to avail the game changer drug for now. He says the current price of Lenacapivir is still too high to be afforded by the government. At 28,000 dollars per dose, the official says Uganda can for now only count on more donations expected from Global Fund and the American government to guarantee availability.

With supplies not yet guaranteed, Mudiope says the public should continue relying on other prevention options such as condoms, Pre and Post Exposure Prophylaxis tablets and being faithful as they are equally scientifically tested and confirmed to prevent HIV infection.

However, a study conducted by Makerere University School of Public Health in which they assessed access to HIV prevention services found use of key prevention options low.

According to results of this study which were released on Wednesday, researchers found only 24 percent of female sex workers and injection drug users, who are also a high at-risk group used PEP in the last three months. Seventy-six percent reported to have not used the prevention option despite knowledge of where to access it.

In terms prevalence, while national prevalence currently stands at 4.9 percent, among sex workers and injection drug users, HIV prevalence is high at 30 percent and 17 percent respectively.

Ideally, Kadama says such groups are the ones targeted as a top priority for Lenacapavir.

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