By Ojoma Akor
Nigeria’s drive to end HIV by 2030 would gain critical ground with the introduction of lenacapavir, a long-acting prevention drug expected to widen access and close persistent gaps among high-risk populations, a public health expert, Dr. Adebayo Opeyemi, has said.
He said the introduction of lenacapavir marks a major step in Nigeria’s fight against HIV.
Dr. Opeyemi, who is also a Senior Program Manager at the Institute of Human Virology Nigeria (IHVN) and HIV Program Lead for the Global Fund GC7 Nigeria TB-HIV Reach Integration and Impact Project (N-THRIP), said the new medication will strengthen—not replace—existing prevention strategies.
“With the strong progress Nigeria is making toward epidemic control, the rollout of lenacapavir will contribute by expanding prevention choices, improving adherence for some populations, and increasing coverage among those at highest risk,” he said.
He stressed that the drug is part of a broader, integrated approach, adding, “lenacapavir will not replace existing methods but will strengthen the prevention toolbox, which is critical to reducing new infections.”
According to Dr. Opeyemi, the drug’s value lies in giving individuals greater control over their health. “People across different high-risk groups will be able to make informed choices to remain HIV-negative. Those on prevention are protecting themselves—whether from known HIV-positive partners or partners whose status they may not know,” he said.
He also underscored the role of treatment in prevention, saying that persons on treatment who achieve viral suppression can take charge of their health and avoid putting others at risk.
Dr. Opeyemi also noted that lenacapavir’s six-month dosing schedule helps address the long-standing challenge of daily medication adherence. “Pill burden has always been an issue,” he said, likening HIV prevention to family planning. “There is no single magic option—some people prefer daily pills, others injections, and some long-term methods.”
While longer-term innovations such as vaccines remain on the horizon, he described lenacapavir as the most advanced option currently available. “It offers protection for six months, after which clients return for another dose. This increases access, expands coverage, and brings more people into prevention services,” he said.
“With these expanded options and continued collaboration among stakeholders, we are on the right track to ending HIV by 2030,” Dr. Opeyemi added.
Lenacapavir, not a standalone fix
Dr. Opeyemi stressed that the impact of lenacapavir will depend on how effectively it is integrated into a broader, combination prevention strategy, warning that it is far from a standalone solution.
He said the drug will be deployed as part of a broader, integrated prevention strategy. “Lenacapavir will not be implemented as a standalone intervention,” he said, emphasizing that effective HIV prevention depends on a combination of behavioral, biomedical, and structural approaches.
The rollout comes at a critical time for Nigeria’s HIV response, as funding constraints continue to threaten the sustainability of prevention programs. Against this backdrop, lenacapavir—widely regarded as a breakthrough in long-acting prophylaxis—offers a new layer of protection, particularly for people who struggle with daily medication or face stigma-related barriers.
Dr. Opeyemi explained that prevention begins with widespread HIV testing. Individuals who test negative are supported in remaining negative through appropriate prevention options. In contrast, those who test positive are immediately placed on treatment—both to improve their health and to eliminate the risk of onward transmission.
He highlighted that lenacapavir expands an already growing toolkit of biomedical prevention options in Nigeria. These include daily oral pre-exposure prophylaxis (PrEP), as well as long-acting injectables such as cabotegravir, administered every two to three months, and lenacapavir, which requires just two injections at initiation and follow-up doses every six months.
“The key value here is choice,” Dr. Opeyemi said. “Individuals can select the option that best fits their circumstances, which can improve uptake and continuity of prevention.”
According to him, lenacapavir is especially useful for people with unpredictable HIV risk or those seeking discreet prevention, as it reduces the need for daily pills or frequent clinic visits.
Ultimately, experts say the success of lenacapavir in Nigeria will depend not just on its scientific promise but on how well it is integrated into existing systems, funded sustainably, and made accessible to those who need it most.
As Nigeria continues to grapple with one of the largest HIV burdens globally, the focus now shifts from innovation to implementation—ensuring that expanded prevention choices translate into fewer new infections.
‘Data, demand creation key to next phase’
As Nigeria moves from planning to implementation in the rollout of lenacapavir, Dr. Opeyemi says the next phase will focus on sustaining delivery, driving demand, and closely tracking performance to guide future expansion.
“With the rollout already in motion, the focus now shifts from preparation to performance—ensuring that what has been carefully designed translates into real, measurable impact on the ground,” he said.
He said the immediate priority is to maintain consistent service delivery across trained facilities, where healthcare providers have been equipped to administer the new prevention option. At the same time, efforts are underway to boost demand through community engagement, awareness campaigns, and trust-building, particularly among populations at higher risk of HIV infection.
“Availability alone is not enough,” Opeyemi noted. “We must ensure that those who need the service understand its value and can access it without hesitation.”
The rollout centers on stronger monitoring systems that track uptake, identify gaps, and guide quick adjustments, alongside continuous mentoring for frontline health workers to maintain quality.
He noted likely challenges, including limited availability of commodities, the risk of diversion, and uneven uptake across states due to differences in awareness, infrastructure, and local context. Ensuring equitable access for vulnerable groups is also a concern.
To address this, authorities are using traceability systems, ongoing training, and data-driven redistribution to move supplies where they are most needed.
In the short term, some states will hold launch activities to boost visibility, while the pilot phase focuses on close monitoring, tracking product use, and documenting lessons. Although adverse reactions are expected to be minimal, health workers remain alert to possible injection-site reactions.
Dr. Opeyemi further highlighted that the success of lenacapavir and other HIV prevention options depends on consistent use. While oral PrEP requires strict daily adherence and injectable cabotegravir depends on timely clinic visits, lenacapavir’s longer dosing intervals may improve convenience. Still, he emphasized that without consistent use, protection drops significantly.
