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• 4 volunteers injected after the launch
From Obinna Odogwu, Awka
For the residents of Anambra State who are exposed to the risk of contracting Human Immunodeficiency Virus (HIV) because of their lifestyles or nature of work, the recent launch of Lenacapavir (Len) in Awka, the state capital, was a relief.
Lenacapavir is a long-acting injectable medication for the prevention of HIV. It’s a pre-exposure prophylaxis (PrEP) for those who are at high risk of contracting the deadly virus.
The launch, which took place at Chukwuemeka Odumegwu OJukwu University Teaching Hospital (COOUTH), Amaku, Awka, was a significant step toward the expansion of access to innovative HIV prevention services across the state. It was carried out by the state Ministry of Health.
Beyond the abovementioned class of people, it was even a greater relief for the general population of the people who were worried about the spread of the virus in the state.
The 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) published in March 2019 by the National Agency for the Control of AIDS (NACA) shows that Anambra has the highest HIV prevalence rate in the South East region with the figure placed at 2.4 per cent.
This is despite the efforts reportedly being made by the governments at all levels and relevant health organisations to tackle the spread of the virus, and protect the country’s rapidly growing population.
For the efforts made earlier, the programme manager, HIV/AIDS Viral Hepatitis and STI Control in the state, Dr. Tonia Mbagwu, said that before now, there was a post exposure prophylaxis (PEP).
“It has been on ground. We use it for those who were exposed to HIV infection”, she said.
She explained that recipients of PEP go to a nearby designated health facility within zero to 72 hours to receive the prevention medication.
“The PEP is taken for 28 days and you stop. It is just like a lady who is on her fertile period and had unprotected sex and she runs to take an emergency contraceptive”, she explained.
Mbagwu, however, said that after a careful study of the impacts of PEP which she described as an emergency prevention mechanism, concerned health experts and stakeholders resolved to step up the fight against the deadly virus.
“So we have come up with a pre-exposure prevention mechanism. This is a mechanism where someone takes the medication before they are exposed to HIV”, she explained.
Explaining further, she narrated thus: “We used to have the oral PrEP, the tablets we take every day. Except you want to take an emergency. We also have emergency oral PrEP. We call it events driven PrEP. You take it every day.
“So, it’s an innovation. In the HIV space we keep having innovative strategies. So after the oral PrEP that is being taken every day, we came up with the injectable cabotegravir. Injectable cabotegravir is taken every two months. It is ongoing in the state.
“Then, every two months, we saw that people are becoming fatigued – you don’t have HIV, so why do you take oral medication every day like somebody that has HIV? Those drugs are antiretroviral.”
Mbagwu, who was visibly excited about the innovation, described Lenacapavir (Len PrEP) as a game changer; explaining that the injections are taken twice in a year; every six months.
“When oral PrEP came in, there was no noise about it. When we started capotigravir there was no noise about it.
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“But for the lenacapavir, it’s just like we are making a lot of noise, the country is shaking because of lenacapavir. I mean, it is something great.
“And we hope that after now, we’ll start having PrEP medication that can take us as far as five years just like what we have in Hepatitis B vaccination”, she said.
The SASCP programme manager made it clear that the long-acting injectable medication for the prevention of HIV is not for people who already have the dreaded virus.
“Like I said, PrEP is for negative people. It is not for those who are positive. It is for negative people that are at high risk. When you say that somebody is at high risk, maybe you are a female sex worker.
“You have people who inject drugs. Those who inject drugs can collect needles from their partner and you don’t know whether your partner has an infection. So we look at those people as those who are in great need of getting PrEP.
“We also have zero discordant couple; couple who that one person is positive, the other person is negative. We advise you to come and take PrEP.
“Then healthcare workers are at risk of contracting HIV. We also encourage them to come for this.”
Mbagwu advised people to always protect themselves against other sexually transmitted infections, warning that PrEP does not protect against them.
“We are looking at combination therapy. We are looking at integration. As much as we are after HIV, we want to see that other sexually transmitted infections (STI) are being curtailed.
“PrEP will prevent you from contracting HIV but it will not stop you from getting candidiasis. It will not stop you from getting Hepatitis B. It will not stop you from getting other sexually transmitted infections.
“So we advise that you do a combined mechanism for prevention of HIV. So you use condoms to prevent other sexually transmitted diseases as much as you are taking PrEP.”
The programme manager said that, at the moment, the injection is provided free of charge at six designated hospitals in the state, namely: COOUTH, Awka; Federal Medical Centre, Onitsha; Comprehensive Health Centres in Ukpo and Neni; Trauma Centre, Oba; and One Stop Shop, Awka.
Also speaking, the state Commissioner for Health, Dr. Afam Obidike, said that the government was very much interested in prevention, arguing that the strategy would help in the efforts to eliminate the deadly virus.
Obidike, while explaining that the state’s relatively high HIV prevalence rate was as a result of the increased public awareness and regular testing among residents, noted that the introduction of Lenacapavir would help in the prevention of the virus among vulnerable populations.
Also speaking, the Chief Medical Director of the teaching hospital, Dr. Maureen Umeakuewulu, said that the timely rollout of Len PrEP would help in the prevention efforts of the government.
Umeakuewulu, who commended the state governor, Prof. Chukwuma Soludo, for his efforts to improve healthcare delivery in the state, encouraged residents of the state to pay attention to their health needs as prevention remains better than cure.
Meanwhile, four people volunteered to take the injection shortly after the launch. These volunteers, according to Mbagwu, had been taking the oral PrEP before.
“They showed interest and we screened them before the launch”, she explained.
At the flag off event were the representatives of the World Health Organization (WHO), National AIDS, Viral Hepatitis, and STIs Control Programme (NASCP), NACA, AHNI, AHF, CHAI, KNCV, JHPIEGO, HA SHMB and others.
