Sex workers and other eligible Nigerians are increasingly seeking the twice-yearly injectable HIV-prevention drug, Lenacapavir, as growing demand depletes supplies in some states participating in the Federal Government’s pilot programme.
Findings by Saturday PUNCH showed that Benue, Kwara, Gombe and Cross River states have experienced stock-outs barely months after the rollout of the long-acting injection.
In Cross River, health workers said demand had risen particularly among sex workers, who considered the injection more discreet and convenient than daily oral pre-exposure prophylaxis drugs.
The situation contrasts sharply with Lagos, where health officials said there were more than enough doses but low uptake, prompting appeals for eligible residents to come forward for the injection.
The National Agency for the Control of AIDS linked some of the supply challenges to logistics and funding constraints, although it cautioned that stock-outs in individual states should not be interpreted as a nationwide shortage.
Lenacapavir is an HIV pre-exposure prophylaxis drug developed by Gilead Sciences and recommended by the World Health Organisation as an additional HIV-prevention option.
Administered once every six months, the injectable provides an alternative to daily oral pills and is intended to give eligible people another choice of prevention method.
The WHO endorsed the drug in July 2025.
The Federal Government received 11,520 doses on March 19, 2026, and distributed them five days later to 10 pilot locations — Benue, Kwara, Akwa Ibom, Cross River, Gombe, Anambra, Ebonyi, Kano, Lagos and the Federal Capital Territory.
Benue exhausts stock
In Benue State, more than 2,000 HIV-negative people have received Lenacapavir since its introduction in May, according to the Commissioner for Health and Human Services, Dr Paul Ogwuche.
Ogwuche told Saturday PUNCH that the initial allocation had been exhausted at participating health facilities amid growing enquiries and demand.
“Benue State has recorded strong early uptake of Lenacapavir. Since its introduction in May 2026, more than 2,000 HIV-negative persons have received the injection through the state’s HIV-prevention programme,” he said.
“The initial allocation has been exhausted at the participating health facilities, and the commodity is currently out of stock at the service-delivery level.
“However, this is a temporary stock situation, not a discontinuation of the programme. The Federal Government is already processing additional supplies, while the State Ministry of Health is working with the relevant national programme and partners to facilitate replenishment and minimise any interruption in access.”
The commissioner said some recipients had reported mostly mild side effects, which were being monitored.
“As with any medicine, Lenacapavir can have side effects. Some clients have reported mostly mild side effects, which are being monitored through the programme’s clinical and pharmacovigilance mechanisms.
“Clients are counselled before receiving the injection and advised to report anything unusual or concerning symptoms to their healthcare providers,” he added.
Ogwuche said suspected adverse effects were clinically assessed and documented, with appropriate cases referred through the established pharmacovigilance system.
Kwara awaits 1,000 fresh doses
Kwara State has also exhausted the doses allocated to it by the Federal Government.
The state AIDS Programme Coordinator, Muhammed Rasheed, said more than 1,000 additional doses were expected after the initial supply ran out about two weeks earlier.
“Above 800 doses received in the initial phase were exhausted about two weeks ago.
“People are responding so well to the doses. We are going to extend the doses to more facilities as more comes into the state,” Rasheed said.
He added that prospective beneficiaries were screened to ensure that only eligible HIV-negative people received the injection.
An assessment by Saturday PUNCH at Sobi Specialist Hospital, Ilorin, one of the designated facilities, showed that interested people could not access the drug because it was unavailable.
“Although we have run out of stock for a while now, we can’t tell you more than that. You will need to bring a letter from the ministry to be able to obtain any information from us,” an official who identified herself as Madam Sambo said.
Funding cuts, logistics fuel shortage — NACA
NACA also confirmed that Gombe State experienced some stock-out of Lenacapavir during the second quarter of 2026.
The agency’s Zonal Coordinator for the North-East, Dr John Tobias, said the situation did not necessarily indicate a nationwide shortage, explaining that logistics challenges could affect the movement of commodities from the national pool to states.
Tobias said the current rollout was designed as a pilot to help health authorities understand issues around capacity, storage, demand, awareness and distribution before a wider national programme.
“These states started with Lenacapavir as pilots. It is yet to be rolled out as a national programme for the entire country. It is a learning process to be able to see how we can build capacity around healthcare workers, storage, people understanding the prevention commodity, picking it up and all of that,” he said.
According to him, the pilot had provided lessons on logistics, supply, uptake, awareness and availability.
Tobias said distribution and funding constraints could sometimes leave commodities available at the national level but unavailable in individual states.
“There are instances, like in condoms, for example, where we could have condoms in Lagos, but the logistics to move those condoms to the states can be a challenge, and this has to do much with some funding issues,” he said.
He added that reductions in programme funding had affected several interventions.
“Global Fund has been funding most of these interventions. The problem we currently have is that as of the first quarter of this year, there has been a lot of cutting down of programme costs. And that has affected a lot of interventions, and Lenacapavir won’t be out of it,” Tobias said.
Sex workers seek injection in Cross River
In Cross River State, Saturday PUNCH gathered that the allocated doses had been exhausted amid increasing demand.
Visits to hospitals and health facilities in Calabar showed that uptake, which was initially slow because of low awareness and stigma, had increased in the last two months.
At the University of Calabar Teaching Hospital and General Hospital, Calabar, health workers said the initial allocation had run low since late August.
A health worker at the teaching hospital, who spoke on condition of anonymity because he was not authorised to speak on the matter, said the state received limited doses.
“We received limited doses at the beginning. Uptake was slow in the first month, but after intensive counselling, demand increased. As we speak, we have people on our waiting list,” he said.
At the Infectious Disease Unit of the General Hospital, Calabar, another staff member said sustained sensitisation had driven demand, particularly among sex workers.
“People now come to ask for the injection instead of the daily oral PrEP. It is more discreet and convenient, especially for sex workers. But we have to tell them to continue with oral PrEP pending when new supply comes,” the official said.
Lagos struggles with low uptake
While some pilot states grapple with depleted supplies, Lagos health officials said the state had sufficient doses but was struggling to attract eligible recipients.
An official of the HIV Unit of the Lagos State Ministry of Health, who spoke on condition of anonymity because he was not authorised to speak on the matter, said the state was appealing to residents to take advantage of the drug.
“We have more than enough doses to the point that we are begging people to come and take it. We don’t have any problem with consignment. We have enough. We are the ones begging people to come for it. We just need more awareness; we don’t have enough people coming out,” he said.
The official added that information about the drug was being disseminated through the ministry’s social media platforms.
On reported side effects, the official said established guidelines existed for documenting and reporting reactions.
“There are proper guidelines for every drug in the country, and even if there is any reaction, there is a process for reporting it, and everything is properly done and documented. Side effects are a normal thing,” she added.
Anambra gets fresh supply
Anambra State also exhausted its initial allocation but recently received another batch.
An official of one of the non-governmental organisations involved in administering the drug said eligible residents had rushed the available doses.
“People are coming for the drug. The doses were exhausted before, but we got a supply last week. We have four centres, which are the teaching hospitals, two in Awka and two in Oba and Nnewi,” the official said.
According to the official, some beneficiaries preferred Key Population centres because they could access the drug free of charge.
“People prefer to go to the KP (Key Population) side because the drug is actually free of charge there. You don’t have to pay for a card, as opposed to the teaching hospitals, where you have to spend about N4,000 before you can get a dose. Sometimes, during the One-Stop Shop, you will have to spend N4,000 to get a dose,” the official added.
(Punch)
