By Angella Langat, MBS, director at the National Syndemic Diseases Council

In 2025, the World Health Organization recommended six-monthly injectable lenacapavir as an additional HIV prevention option. Kenya has now integrated long-acting injectable PrEP into its HIV prevention framework.

This is a scientific milestone. But beyond the clinical breakthrough lies a deeper test — whether innovation in this country can move forward without leaving dignity behind.

Twice-yearly injectable Lenacapavir offers something powerful: fewer clinic visits, no daily pills, and greater discretion for people who struggle with adherence or stigma.

Lenacapavir is not a vaccine. It is an antiretroviral medication taken by HIV-negative individuals before potential exposure to prevent HIV infection — a form of pre-exposure prophylaxis (PrEP).

And the need is urgent.

Kenya recorded 19,991 new HIV infections in 2024 — a 19% increase from the previous year. Eight in ten new infections among those aged 10–24 years occurred among adolescent girls and young women. Ten counties account for 60% of all new infections.

At the same time, PrEP uptake has shown signs of strain. PrEP initiations declined by 29% between July–September and October–December 2025

Biomedical innovation alone does not guarantee equity.

If human-rights safeguards are not deliberately embedded, long-acting PrEP could reproduce the very barriers that have slowed prevention for years: stigma, breaches of confidentiality, moral judgment, and uneven county-level access.

The Constitution guarantees every Kenyan the right to the highest attainable standard of health. The real question now is whether that right will shape how this prevention tool is delivered.

A discordant couple

Consider John and Felisha... They are married. They attend church every Sunday. They are raising two children. They are also HIV-discordant — John is living with HIV, Felisha is not.

For them, prevention is not about lifestyle. It is about longevity. It is about protecting a marriage they cherish and ensuring their children grow up with both parents healthy.

When they hear about a twice-yearly injectable option, they hear relief. But they also worry.

They worry about confidentiality. In many communities, being seen at a clinic can trigger speculation. A poorly handled appointment message. A casual comment from a provider. A separate queue that silently labels clients. Any of these can expose families to gossip and stigma.

They worry about judgment. In a religious society like Kenya, prevention is sometimes mischaracterised as a license for promiscuity. That framing is deeply misleading. Long-acting PrEP is not a moral statement. It is a health protection tool.

And they also worry about safety. Because this is new science.

Long-acting PrEP represents a major biomedical breakthrough. The WHO guidelines emphasize equity, human rights, and simplified testing approaches using rapid diagnostic tests prep guidelines from WHO.

But implementation is where trust is earned.

Kenya has made progress in treatment — reaching 96% viral load suppression among completed tests in late 2025. Yet 13 in every 100 people living with HIV were not on treatment in 2024. AIDS-related deaths increased slightly to 21,007 in 2024.

Progress is real. But it is fragile.

If Kenya is to maintain public confidence — especially among parents, faith leaders, and community elders — innovation must be paired with visible safeguards:

First, confidentiality by design. Discreet client flow, strict data protection, secure digital systems, and controlled access to records.

Second, informed and voluntary consent. Clients must understand benefits, risks, and alternatives. Refusal must never mean exclusion from other services.

Third, non-discrimination in service delivery. Prevention must be accessible to adolescents, young women, key populations, and discordant couples — without stigma.

Fourth, credible pharmacovigilance. County-level adverse event reporting systems must be strengthened. Safety data must be published transparently.

For John and Felisha, dignity means protection from HIV and protection from stigma. For a 19-year-old navigating university life in Homa Bay — one of the counties with high HIV burden , dignity means agency without exposure.

For a parent listening to church announcements, dignity means knowing their daughter is protected, not judged.

Kenya has regional credibility in HIV leadership. Long-acting PrEP could strengthen the prevention pillar and accelerate progress toward ending HIV as a public health threat.

How will we measure success?

But success will not be measured only by procurement numbers or injection coverage rates.

It will be measured by trust. Trust that clinics protect privacy. Trust that consent is genuine. Trust that safety is monitored transparently. Trust that science and faith can align in protecting life. Innovation without dignity breeds suspicion. Innovation with dignity builds confidence.

If Kenya does this well, long-acting PrEP will not be remembered as controversial.

It will be remembered as leadership — science delivered with conscience, and prevention delivered with respect for the families it is meant to protect.