Zimbabwe’s Lenacapavir rollout: The gap between hope and truth

The air in Zimbabwe is heavy. It is thick with anticipation and a quiet, aching desperation. For months, people have talked about Lenacapavir. It is the twice-yearly injectable for HIV prevention. The rollout was deferred, but on February 18, the wait ended. At the Epworth Polyclinic grounds, the country officially made history. There was awareness, pomp, and fanfare. There was music, but under the music, there was a deep human need.

​I am a journalist living openly with HIV. I have watched this milestone through a different lens than most. The global health community is celebrating. They talk about 100% efficacy in clinical trials. They see a scientific triumph. But on our streets and in our clinics, a complex drama is unfolding. A breakthrough designed to protect those who are HIV-negative is being mistaken for something else. To many, it looks like an escape. It looks like the end of "pill fatigue"—the exhaustion that haunts those of us who have lived with the virus for decades.

​Prevention or treatment? Clearing the confusion

For twenty years, the “daily pill” has been the lifeline for People Living with HIV (PLHIV). It is a ritual. It is also a burden. This ritual carries a heavy psychological weight. You wake up, you see the bottle, and you are reminded of your status.

​"I still do not believe you, Catherine," a friend told me recently. She is a fellow advocate. We sat together, and her voice was laced with a stubborn kind of hope. 

"I heard the treatment injectable is available in Namibia. We are tired of taking pills every day. Someone told me she has already ordered her two jabs through omalayistha."

​She was talking about the cross-border transporters. People are so desperate they are willing to buy medicine from the back of a truck. This is the "Lenacapavir Information Gap." 

When people are tired, they hear what they want to hear. They hear "injectable," and they think "freedom."

​The Minister of Health and Child Care, Dr. Douglas Mombeshora, spoke at the launch in Epworth. He knew about the rumours. He spoke directly to the crowd to stop the spread of misinformation. 

​"This rollout has not happened by chance," the Minister said. 

"It is deliberate. It is backed by strong policy. Every innovation must strengthen our health systems. It must serve the people who need it most to prevent the further spread of HIV. Today marks an important day in Zimbabwe’s national response to HIV. We launch Lenacapavir as a long-acting option for prevention. This is a matter of life and health. Do not place your trust in rumours. Do not risk your wellbeing on misinformation."

Dr. Bernard Madzima, the CEO of the National AIDS Council of Zimbabwe, stood by the Minister’s message. 

He described the injectable as an addition to a "choice basket." 

"The country is not abandoning what works, but making the prevention choice grow, the prevention toolbox keeps getting better," said Dr Madzima.

​Then came the voice of the people. Melody Dengu is a sex worker. She is open about her work and her life. She stood on the arena podium and spoke of relief. For her, the pill bottle was more than just medicine; it was a target on her back.

​"Carrying tablets has exposed some of us to violence," she said. 

"When clients see the PrEP pills, they assume we are taking ARVs for treatment. They don’t understand the difference between prevention and treatment. When they see a pill, they see the HIV virus, they even say we have AIDS."

​She explained that the injection is discreet. It is a secret shield. 

"Apart from some pain after the injection, nothing has changed. I feel empowered. The injectable is convenient. There are no missing doses because you forgot your bag or had to travel unexpectedly in our highly mobile job. Many in our sector are ready for this twice-a-year jab," to loud applause.

To a community on HIV treatment, exhausted by pills, "100% effective" sounds like a cure.

​This creates an immense ethical challenge for healthcare providers. How do you explain the truth to a young woman born HIV-positive? She has never known a single day without medication. She sees the news of a twice-a-year shot and thinks her life is about to change. Then, the nurse tells her the shot is only for those who do not have the virus yet.

​"You are the first one to disappoint me," one young woman told me. She was speaking in our weekly Women Vibes virtual WhatsApp group. 

"I had prepared to go to the launch to get my jab. When is research and science going to give us a similar relief?"

​The silence that followed the question was heavy.

​When prevention drives people to test

​At the Epworth facility, Nursing Sister Dhliwayo is in charge of Key Populations. She has seen the community move beyond the old stigmas. 

"Our sex workers have used the daily oral pill since 2016. In 2024, we started CAB-LA, given six times a year.  So we welcome Lenacapavir," said Sister Dhliwayo, speaking from the Sex Workers tent. She was careful to manage misinformation.

" It does not stop pregnancy nor sexually transmitted infections. Our clients know that," she said. 

"For the general public, we have to be clear. This is for those who test HIV negative. This is a shield, not a treatment. Managing that disappointment is the hardest part of the job."

There is a strange irony in this rollout. The desire for the jab is now overcoming the "fear of knowing one's status." 

People who avoided the clinic for years are now coming in. The pursuit of a drug they might not be eligible for is bringing them into the system. If they are negative, they get the shield. If they are positive, they are finally linked to the treatment. Test and treat gets boosted. 

HIV in focus

This news story has been published as part of our HIV in focus news network. This is a network of writers and journalists from our focus countries, dedicated to delivering news on HIV and sexual health. The network aims to amplify the voices of communities most affected by HIV and share the stories that matter to them.

About the writer

Catherine Murombedzi is a freelance health journalist from Zimbabwe. Catherine has won several local and international awards. She is a CNS Health fellow, Mercury Phoenix Trust HIV/AIDS Reporting fellow, and a Taboom Media fellow.