Zimbabwe is poised to implement a significant advancement in its national HIV prevention strategy by introducing Lenacapavir, a long-acting injectable drug, to at least 46,500 individuals starting early next year. This marks the country's inaugural rollout of a twice-yearly injection that offers sustained protection against HIV, signaling a major departure from the traditional daily oral pre-exposure prophylaxis (PrEP).

Health officials highlight that Lenacapavir is designed to overcome long-standing challenges associated with oral PrEP, specifically the strict daily adherence that many individuals at high risk of infection find difficult to maintain. By replacing daily pills with a single injection that provides six months of protection, the new drug is expected to significantly improve compliance and effectiveness, particularly benefiting vulnerable groups such as adolescent girls and young women, key populations, and individuals who encounter stigma, mobility limitations, or difficulties with daily medication regimens.

Zimbabwe's national HIV prevention coordinator, Ms. Getrude Ncube, announced at the recent ICASA 2025 conference that the country acted swiftly after approving Lenacapavir, making it the third nation in Africa to authorize its use. The Minister of Health and Child Care, Dr. Douglas Mombeshora, addressed the nation within five days of approval to explain the importance and benefits of Lenacapavir, underscoring the government's commitment to this new prevention method.

Preparations for the comprehensive rollout are already complete. This includes the identification of 40 sites across the nation, thorough assessments of facility readiness, and the comprehensive training of health workers. The initial consignment of doses is anticipated to arrive in January, paving the way for a phased national introduction of the drug. The target of 46,500 beneficiaries for the first phase was determined by national HIV data and Zimbabwe's operational capacity to ensure a smooth and effective rollout.

Priority for the initial phase has been given to districts experiencing persistently high HIV incidence, rising numbers of new infections, and strong uptake of oral PrEP between 2023 and 2025. These strategically selected areas span urban, peri-urban, and rural communities and include Bulawayo, Harare, Chitungwiza, Mutare, Gweru, Kwekwe, Masvingo, Karoi, Mazowe, Shamva, Tsholotsho, Gwanda, and Cowdray Park. The program will primarily focus on populations most susceptible to HIV, such as adolescent girls and young women, female sex workers, and pregnant or breastfeeding women. Future expansion phases will include all provinces as additional supplies of the drug become available.

Despite oral PrEP being accessible since 2018, the 2024 Zimbabwe Demographic and Health Survey reveals that awareness of PrEP remains below 50 percent, with the lowest awareness among young people at the highest risk of infection. This highlights the urgent need for more accessible and user-friendly prevention options like Lenacapavir. To support the rollout and enhance awareness, the Ministry of Health and Child Care is actively expanding its digital demand-creation tools, including Vimbai. Vimbai is an artificial intelligence-powered chatbot developed in collaboration with the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), originally designed to support sex workers. This platform, already operational in Gweru, is now being scaled up to provide information on HIV prevention, self-testing, and mental health support ahead of the Lenacapavir introduction.