By Eumu Emmanuel
The Ministry of Health has announced plans to introduce a long-acting injectable drug for HIV prevention, known as Cabotegravir (CAB-LA), starting in September. Dr. Herbert Kadama, the Ministry’s Pre-Exposure Prophylaxis (PrEP) Coordinator, revealed that the country expects to receive approximately 10,000 doses of CAB-LA through support from the United States Agency for International Development (USAID).
“We plan to begin CAB-LA implementation at seven PEPFAR USAID-supported facilities in September this year. By February 2025, we will expand to four additional sites, thanks to support from the Global Fund,” Dr. Kadama stated.
CAB-LA, administered every two months, is designed to prevent HIV from all forms of exposure. Dr. Kadama explained that when injected into the buttocks, the drug is slowly released from the muscle into the bloodstream, where it builds up in the body’s cells, preventing HIV infection. He attributed the slow release to the special components within the drug.
Speaking at a media orientation on new PrEP technologies and Lenacapavir research in Kampala, Dr. Kadama emphasized the importance of assessing each individual’s HIV risk before initiating treatment. “If you are HIV-negative and at risk, you will receive the injection every two months as long as the risk persists,” he added.
Currently, Uganda offers two HIV PrEP options: oral PrEP and the vaginal ring. Since the introduction of oral PrEP in 2017, the number of users has grown from 800 to over 700,000. Meanwhile, 279 women have used the vaginal ring at seven facilities across the country, including those in Mbarara, the Eastern region, and the Northern region. The vaginal ring, which is effective after one day of insertion, needs to be replaced every 28 days. With Global Fund support, the ring will soon be available in more facilities.
Dr. Kadama highlighted that existing PrEP options are currently offered at seven public health facilities under the PEPFAR USAID-MOSAIC Funded Project. These facilities include Mbarara Health Center IV, Bufunda Health Center II, Gulu Regional Hospital, Kitgum Hospital, Namakwekwe Bison Health Center III, and Malana Health Center IV. However, he noted that nationwide expansion is contingent on resource availability.
In addition to CAB-LA, research at Johns Hopkins University (JHU) is exploring other injectable PrEP drugs, including Lenacapavir and F/TAF. Lenacapavir has already been approved for preventing HIV in men who have sex with men and transgender women in Western countries. “Lenacapavir has proven to be highly effective, as it remains in the body for six months,” noted Dr. Matovu, a researcher at JHU. “We tested Lenacapavir for HIV prevention in young women, and it was found to be 100% effective in preventing HIV. Unlike CAB-LA, which is administered every two months, Lenacapavir is only required twice a year.”
Despite Lenacapavir’s success, Dr. Matovu emphasized the need for further research to determine the best delivery methods for Uganda. “We must consider whether to provide it in facilities, pharmacies, or even in people’s homes. The research continues even after a product is proven effective,” she said.
Dr. Diana Atwine, Permanent Secretary of the Ministry of Health, affirmed that these new prevention strategies are integral to Uganda’s National HIV Prevention Strategy, which aims to combat HIV prevalence and reduce new infections. “New products like injectable Lenacapavir and the PrEP ring offer hope. We remain committed to expanding access and ending HIV as a public health threat by 2030. These global advancements are being adopted as part of our national strategy to address the 5.5% prevalence rate and the 38,000 new infections reported in 2023,” Dr. Atwine stated.
She also urged journalists to use their platforms to educate communities on HIV prevention, particularly on the importance of behavioral change.