How the new HIV prevention rollout in Uganda is a game-changer for risk communities

In a significant move to enhance HIV prevention efforts, Uganda’s Ministry of Health has announced the initiation of the first dose of the long-acting HIV prevention drug Cabotegravir (Cab-LA).

This rollout marks a pivotal shift in the country’s approach to HIV prevention, particularly in regions witnessing a spike in new infections.

Dr. Herbert Kadama, the Ministry’s Pre-Exposure Prophylaxis (PrEP) coordinator, shared that the inaugural recipient of the Cabotegravir injection was a walk-in patient at a health facility in Mbarara, a district currently grappling with an increase in HIV cases.

“This is a momentous occasion for our health system,” Dr. Kadama noted, emphasizing the importance of this long-acting alternative. “Cabotegravir is now accessible to anyone at risk, providing a simpler option for those who may struggle with daily medication.”

The drug requires two initial doses administered four weeks apart, followed by a maintenance dose every eight weeks.

This regimen aims to alleviate the burden of daily adherence that many oral PrEP users face. While the potential of Cabotegravir is promising, the current supply in Uganda is limited to 7,500 doses, primarily obtained through donations from the U.S. President’s Emergency Plan. Additional doses are expected from the Global Fund by February.

“Equitable access to PrEP is essential,” urged a representative from a leading Civil Society Organization advocating for HIV prevention.

“Many developing countries bear the brunt of HIV but often find preventive measures financially out of reach. We must ensure that those who need it most can access it without barriers.”

This call for equity underscores the pressing need for sustainable funding and resources to support comprehensive HIV prevention strategies.

The introduction of Cabotegravir comes as the use of oral PrEP in Uganda has surged from just 800 users in 2017 to around 700,000 today.

However, health professionals have noted a troubling trend: many users discontinue their treatment due to the challenges associated with daily medication.

“We need to provide options that fit the lifestyles of those at risk,” Dr. Kadama stated. He highlighted the importance of community outreach and education to raise awareness about the new options available.

Moreover, the broader implications of this rollout extend beyond just the medical realm. It represents a significant step towards destigmatizing HIV prevention in Uganda.

As health officials work to promote long-acting prevention methods, they are also engaging community leaders and advocates to foster an environment of acceptance and support.

“Community engagement is crucial,” emphasized Dr. Kadama. “We need to empower individuals to make informed choices about their health without fear of judgment.”

In addition to Cabotegravir, ongoing research efforts are underway, with participants in the Lenacapavir study in regions like Mityana, Kalangala, and Masaka receiving continued support.

Dr. Flavia Matovu Kiweewa, a Senior Research Scientist at the Makerere University – Johns Hopkins University Research Collaboration, emphasized the significance of these studies.

“We are committed to ensuring that participants receive the necessary resources until these drugs are available more broadly.”

This commitment to research not only enriches the medical community’s understanding of HIV prevention but also ensures that Ugandan voices are central to shaping future healthcare solutions.

As Uganda embarks on this new chapter in HIV prevention, the Ministry of Health remains optimistic about expanding access to long-acting prevention methods, paving the way for a healthier future for at-risk communities.

The success of Cabotegravir could set a precedent for innovative approaches to public health challenges, fostering a culture of prevention and care that is both inclusive and effective.