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Eswatini has taken a historic step in Africa’s HIV response by approving the twice-yearly anti-HIV injection, lenacapavir, offering protection to its citizens.
We are getting clearer data on where 15 to 24 year olds are most likely to be living with HIV. The numbers show that young people in Africa are affected far more than anywhere else, according to organisations like UNICEF and the WHO.
Eastern and Southern Africa’s adolescent girls are the biggest sufferers. One third of sexually active women in this part of the world will become pregnant before they turn 20 years old.
Due to systemic gender discrimination in these parts of the world, lack of proper health services, and social stigma attached to anyone living with HIV/AIDS, at least double as many girls as boys now pick up the virus.
As a result of this increased vulnerability, girls aged 15-24 will find it more difficult to access HIV prevention consistently. Daily oral pills, though effective, require a great deal of commitment on the part of a young person – especially with school or work – and there’s little discretion in the method.
Because of this, HIV prevention tools that rely on daily routines often fail to meet young people where they are.
This is where Eswatini’s biannual injectable potentially changes the game. Administration of an injectable PrEP, which can be given every six months, will allow for less frequent dosing and decrease the likelihood of missed doses.
Long-acting injectable PrEP is a private and independent method of HIV prevention that adolescents have identified as a need, and is rarely provided within current healthcare systems. For females 15-24 years old who have the highest rates of HIV infection on the continent, long-acting injectable PrEP may be their only option for HIV prevention.
The hope is that the success of this initiative will continue to build momentum for increased medical access. To make the injectable available to more people, additional governments across Africa will need to first adopt the product, provide support to make it affordable through funding from global donors, and include youth as a central voice in the implementation of any treatment.
