Rwanda’s healthcare authorities have announced a new initiative to address rising HIV infections among youth and sex workers. Starting December 2024, the country will introduce a long-acting injectable medication, Cabotegravir (CAB-LA), to prevent new HIV infections.
CAB-LA is an injectable antiretroviral drug designed to prevent HIV transmission. Approved by the World Health Organization (WHO) in 2022, the medication provides an alternative to daily oral pills. It works by enhancing the body’s immunity to block HIV from entering and replicating in cells. The injection is administered once every two months after an initial two-dose regimen in the first two months.
Statistics reveal that nine new HIV infections occur daily in Rwanda, with youth and women disproportionately affected. Young people account for 35% of new cases, with girls bearing the highest burden. Nationwide, an estimated seven out of every 100 daily deaths are attributed to AIDS-related complications.
The global HIV landscape also highlights the urgency of the intervention. Over 1.3 million new infections occur annually, 63% of which are in sub-Saharan Africa. CAB-LA is expected to significantly reduce the prevalence of new cases in Rwanda.
The CAB-LA program will initially launch at two health centers in Kigali. The target groups include sex workers, serodiscordant couples (where one partner is HIV-positive), adolescents, and other vulnerable populations. Rwanda Biomedical Centre (RBC) has emphasized that this method will alleviate the stigma associated with daily pill regimens.
CAB-LA injections were first administered in Zimbabwe in 2022, followed by approval in Zambia and South Africa. While implementation is underway in these nations, Rwanda’s adoption of CAB-LA marks a significant step in tackling HIV prevention innovatively.
Despite prior efforts such as free condom distribution through vending booths in urban areas, uptake has been limited. Health workers report that only 2% of youth request condoms, often fearing judgment or stigma.
Laurence Nirere, a community health worker in Rubavu District, explained the challenge: “Young people fear being judged when they ask for condoms, thinking we will assume they are engaging in sexual activity. We focus on educating them about the importance of prevention, especially through condom use, to avoid many diseases.”
The introduction of CAB-LA provides an opportunity to address the gaps left by previous initiatives. By reducing the stigma surrounding daily preventive measures and offering a discreet, effective alternative, Rwanda aims to curb new infections and protect its most vulnerable populations. The program’s success could serve as a model for other nations facing similar challenges.
