Rwanda begins Lenacapavir rollout across 12 health centers to expand HIV prevention

RWANDA—Rwanda will begin administering six-monthly lenacapavir injections on December 1 at 12 selected health centres to expand access to HIV prevention and reduce new infections.

The Rwanda Biomedical Centre (RBC) confirmed that the drug arrived in the country on November 3.

The initial rollout will cover all five provinces, including the City of Kigali, and provide an alternative to daily oral pre-exposure prophylaxis (PrEP).

Speaking to The New Times, Dr Zephanie Nzeyimana, HIV Key Population Strategic Officer at RBC, said the injections would be provided free of charge, with selected district hospitals supporting participating health centres.

In Kigali, the selected facilities are Remera Mental Health Centre, Kacyiru, Kabusunzu and Gikondo health centres.

Other participating facilities include Mukarange and Nyamata in the Eastern Province; Rubengera and Gisenyi in the Western Province; Muhoza and Kinigi in the Northern Province; and Gitarama and Rango in the Southern Province.

Expanding HIV prevention choices

Lenacapavir will complement existing prevention options, including daily oral PrEP and injectable cabotegravir.

According to Nzeyimana, eligibility will follow a risk-based approach targeting people at substantial risk of acquiring HIV, including female sex workers, men who have sex with men, and HIV-negative partners in serodiscordant relationships.

Unlike daily oral PrEP, lenacapavir requires administration only twice a year, potentially reducing adherence challenges associated with taking medication every day.

Clinical trials have demonstrated high efficacy in preventing HIV infection when the drug is administered as prescribed.

Although the medicine will be free, some associated healthcare services may remain subject to existing health insurance arrangements, including community-based health insurance.

To support implementation, RBC and its partners have trained healthcare workers to provide information about the injection through health facilities and community outreach programmes.

Public awareness campaigns will also address misinformation and explain eligibility requirements.

Global rollout and pharmaceutical access

Developed by Gilead Sciences, lenacapavir received approval from the US Food and Drug Administration (FDA) on June 18, 2025, under the brand name Yeztugo.

It is indicated for HIV prevention in eligible adults and adolescents at risk of sexually acquiring the virus.

On July 14, 2025, the World Health Organization (WHO) recommended lenacapavir as an additional PrEP option, recognising its potential to expand prevention choices.

The drug targets the HIV capsid, a protein structure essential to the virus’s replication and survival.

Meanwhile, in September 2025, international health organisations announced agreements with generic manufacturers to supply the medicine at about US$40 per person annually across 120 low- and middle-income countries from 2027, subject to regulatory approvals.

Generic production could improve affordability and support wider access as more countries incorporate the injection into national HIV prevention programmes.

Rwanda’s introduction follows launches in Kenya on February 26, 2026, at Riruta Health Centre in Nairobi, and Uganda on April 17, 2026, at Lira Regional Referral Hospital.

The rollout comes as Rwanda continues expanding HIV treatment coverage.

According to the HIV, STIs and Viral Hepatitis Annual Report 2024/2025, more than 229,000 people were receiving antiretroviral therapy as of June 2025, representing 96.9% treatment coverage.

One-year retention in care stood at 94%, while many patients were receiving medication supplies covering three to six months.

The availability of twice-yearly lenacapavir introduces another delivery option for HIV prevention, with implications for treatment procurement, healthcare workforce training and the integration of long-acting medicines into national prevention programmes.

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