Uganda’s Ministry of Health is set to initiate the rollout of long-acting injectable lenacapavir for HIV prevention, beginning at Lira Regional Referral Hospital.
The introduction follows 2025 guidance from the World Health Organization (WHO) recommending lenacapavir as an additional pre-exposure prophylaxis (PrEP) option. Administered twice yearly, lenacapavir represents a departure from daily oral regimens and shorter-acting prevention methods.
Health officials indicate that implementation will prioritise districts with high HIV burden and key populations at elevated risk. Eligibility will be restricted to individuals who test HIV-negative and meet clinical criteria following screening, reflecting its use as a preventive—not therapeutic—intervention.
Initial rollout sites include districts in the Ankole sub-region—Kazo, Mbarara, and Ibanda—alongside more than 120 health facilities nationwide. Service delivery is being preceded by health worker training on PrEP and post-exposure prophylaxis protocols.
Lenacapavir’s long-acting formulation may address persistent challenges with adherence associated with daily oral PrEP, particularly among populations facing structural barriers such as stigma, mobility, and limited access to services. However, health officials emphasise that it will complement, rather than replace, existing prevention strategies, including condom use.
Uganda’s HIV epidemiology underscores the potential relevance of expanded prevention options. An estimated 1.5 million people are living with HIV, including approximately 930,000 women, 570,000 men, and 71,000 children. In 2025, around 32,000 new infections were reported, with a disproportionate burden among women (21,000) compared with men (11,000).
Subnational disparities remain pronounced. In the Ankole region, prevalence ranges from 11% in Kiruhura to 4% in districts such as Kazo and Isingiro, with higher rates consistently observed among women than men. These patterns highlight the need for targeted, differentiated prevention approaches.
Although lenacapavir has demonstrated high efficacy in clinical studies, questions remain regarding implementation, including service readiness, equitable access, and sustained demand generation—factors that have previously affected uptake of oral PrEP in similar settings.
The extent to which this intervention will contribute to reducing new infections will depend on effective integration within existing HIV prevention programmes and the ability to reach populations at highest risk.
