Uganda expands HIV prevention options with injectable CAB-LA

UGANDA—Uganda’s Ministry of Health plans to release a new long-acting injectable HIV prevention medicine, Cabotegravir (CAB-LA), in September, after receiving approximately 10,000 doses from the United States Agency for International Development (USAID).

According to Dr. Herbert Kadama, the ministry’s PrEP coordinator, CAB-LA implementation will begin at seven facilities sponsored by PEPFAR and USAID, with plans to expand to four additional sites by February 2025 with Global Fund support.

CAB-LA, which is given every two months, is specifically developed to prevent HIV transmission through any exposure. The drug is injected into the buttock, from where it is gradually released into the body, allowing it to build up in the cells and offer protection against HIV infection.

During a media event in Kampala, Dr. Kadama emphasised the need of assessing each individual’s HIV risk before starting treatment.

He stated that CAB-LA is appropriate for HIV-negative individuals who are at risk, with the injection administered every two months as long as the danger exists.

Uganda currently offers two HIV pre-exposure prophylaxis (PrEP) options: oral PrEP and vaginal ring.

Since the introduction of oral PrEP in 2017, the number of users has increased from 800 to more than 700,000.

In addition, 279 women have used the vaginal ring, which must be updated every 28 days, at seven facilities around the country, including those in Mbarara, Eastern, and Northern regions. The Global Fund is expected to help expand the use of the vaginal ring in more facilities.

Dr. Kadama further stated that current PrEP choices are accessible at seven public health centres financed by the PEPFAR-USAID Mosaic project.

Mbarara Health Centre IV, Bufunda Health Centre II, Gulu Regional Hospital, Kitgum Hospital, Namakwekwe, Bison Health Centre III, and Malawa Health Centre IV are some of these facilities.

However, he stated that the availability of resources will determine whether these services are expanded nationwide.

In addition to CAB-LA, Dr. Flavia Matovu, Director of Research at MU-JHU, addressed continuing research into other injectable PrEP medications such as Lenacapavir and F/TAF.

F/TAF is already approved in Western nations to prevent HIV transmission in males who have sex with men and transgender women.

Dr. Matovu emphasised that Lenacapavir, which is effective for six months after administration, has shown remarkable potential in HIV prevention, especially in young women. Unlike CAB-LA, Lenacapavir requires only two injections per year.

Despite the positive results, Dr. Matovu stressed that further research is necessary to determine the most effective delivery methods for Lenacapavir in Uganda.

This research will explore various options, including providing the drug at facilities, pharmacies, or even in people’s homes.

Commenting on the new developments, Dr. Diana Atwine, Permanent Secretary in the Ministry of Health, emphasized that these prevention strategies are crucial to Uganda’s National HIV Prevention Strategy.

The strategy aims to reduce the country’s HIV prevalence and curb the 38,000 new infections reported in 2023.

Dr. Atwine expressed optimism about new products like injectable Lenacapavir and the PrEP ring, highlighting the Ministry’s commitment to expanding access and ending HIV as a public health threat by 2030.

She also called for increased awareness of HIV prevention, particularly regarding the importance of behaviour change.

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