Нигерия запускает программу PrEP: новые методы профилактики ВИЧ и важность соблюдения режима лечения

For years, Nigeria’s fight against HIV has centred on testing, treatment and condom use. However, a new chapter is emerging in the country’s prevention efforts, as medical advances offer people more options to stop the virus before it takes hold. At the centre of this prevention strategy is pre-exposure prophylaxis, popularly known as PrEP; a preventive intervention that allows HIV-negative people at substantial risk of acquiring the virus to take antiretroviral medicines before potential exposure. For the National Agency for the Control of AIDS (NACA), PrEP represents more than another medical intervention. It is part of a broader shift towards giving people more options to protect themselves from HIV. Speaking at a training for journalists and social media influencers on PrEP, recently in Lagos, the Director-General of NACA, Dr Temitope Ilori, said Nigeria must strengthen prevention alongside treatment if the country is to sustain progress towards epidemic control. She stressed that PrEP is not a cure for HIV, but a prevention strategy designed for people who are HIV-negative and may be at increased risk of acquiring the virus. “Amongst the pre-exposure prophylaxis, these are drugs that you can take to prevent coming down with HIV. They are not a cure. They are prevention strategies,” Ilori said. According to Ilori, Nigeria has oral PrEP, which is taken daily, as well as injectable options. The country is also beginning to introduce lenacapavir, or LEN PrEP, a long-acting injectable option administered every six months. The development is significant because prevention is not one-size-fits-all. While some people may find daily tablets convenient, others may struggle with remembering to take medication consistently. Long-acting prevention could therefore offer an alternative for people who prefer less frequent dosing. Ilori said the available options are particularly important for people considered to be at higher risk of HIV infection, including some key populations and people whose circumstances expose them to increased risk. “We are not saying every Nigerian should use PrEP, but we’re saying those that are most at risk, most vulnerable to contracting HIV, have this option of using PrEP and staying safe,” she said. Describing condoms as an “old faithful” prevention tool, the NACA DG said they can help prevent HIV, sexually transmitted infections and unintended pregnancies. She also encouraged safer sexual behaviour, including abstinence where possible and mutual faithfulness between partners. Ilori disclosed that Nigeria recorded about 45,000 new HIV infections in the previous year, although she said figures for the current year were still being compiled. While the country remains on track towards epidemic control, she warned that complacency could undermine the gains made. Of particular concern is the level of HIV knowledge among young people. According to the NACA DG, young Nigerians are increasingly exposed to misinformation and may not have adequate information about how HIV is transmitted or prevented. This knowledge gap, she said, is one of the reasons NACA brought journalists, traditional media practitioners and social media influencers together for the PrEP training. The objective is to take HIV prevention information beyond health facilities and into the spaces where young people live, communicate and consume information. For Ilori, the battle against HIV is not only being fought in hospitals and laboratories. It is also being fought on television, radio, newspapers, social media platforms and mobile phones. She urged journalists and influencers to help dismantle persistent myths about HIV transmission. HIV cannot be transmitted through ordinary social contact such as hugging, shaking hands or sharing an office. Mosquitoes also do not transmit HIV. Rather, HIV can be transmitted through infected blood and sexual contact, while mother-to-child transmission can occur during pregnancy, childbirth or breastfeeding if appropriate interventions are not provided, she explained. The renewed emphasis on PrEP comes at a time when condom use is reportedly declining, particularly among young people. Ilori expressed concern about the trend, urging sexually active young people to use condoms to reduce their risk of HIV and other sexually transmitted infections. The concern is that declining condom use could create additional vulnerabilities even as new HIV prevention tools become available. Ilori emphasised that an HIV diagnosis is no longer the death sentence it was once perceived to be. She said people who test positive can access antiretroviral medicines through government-supported services, with treatment helping them maintain their health and suppress the virus. This is where the principle of “U=U” — undetectable equals untransmittable — becomes critical. When a person living with HIV takes treatment consistently and achieves and maintains an undetectable viral load, they do not sexually transmit HIV, the DG explained. She, therefore, urged people living with HIV to remain on treatment and adhere to their medications. The World Health Organisation’s Technical Officer for HIV, Viral Hepatitis and STIs in Nigeria, Dr Oluwafunke Odunlade, similarly explained that PrEP works by ensuring that preventive antiretroviral medicines are available in the body to stop HIV from establishing an infection following exposure. She stressed that PrEP must be used correctly and consistently to provide the intended protection. This is particularly important as Nigeria expands access to different PrEP options. Odunlade noted that people taking daily oral PrEP must adhere to the prescribed schedule, while those using injectable options must return for their injections at the recommended intervals. She explained that PrEP consists of antiretroviral (ARV) medicines designed to prevent HIV from establishing itself in the body following exposure to the virus. She said the medicines work by blocking the virus from establishing an infection, stressing that PrEP is strictly a preventive intervention and cannot be used to treat an already established HIV infection According to her, individuals seeking PrEP must first undergo HIV testing at a healthcare facility to confirm that they are HIV-negative before commencing the preventive medication. “If somebody has HIV already established, the drug will not work. It is best that they are linked to care to actually be on the proper HIV medications,” she said. She noted that Nigeria currently has different PrEP options, including daily oral PrEP, injectable cabotegravir, known as CAB-LA, administered every two months, and lenacapavir (LEN), administered every six months. She, however, cautioned that the effectiveness of the various options depends largely on adherence to the prescribed schedule. Odunlade explained that people commencing LEN PrEP may require loading doses and that full drug action does not necessarily occur immediately after the first dose. “The drug doesn’t start the full work on the very first day that you are taking it. You still need a couple of times for the full action of the drug to come in,” she said. She urged people using daily oral PrEP to take the medication consistently, while those using injectable options should return to health facilities at the recommended intervals. She warned that stopping PrEP after taking it for a short period could leave an individual vulnerable to HIV infection. The WHO official also emphasised that HIV prevention should not be limited to PrEP, noting that sexually transmitted infections such as syphilis, gonorrhoea and chlamydia remain prevalent. She therefore encouraged people to combine PrEP with other preventive measures, including condom use. She noted that LEN PrEP was introduced in Nigeria earlier in 2026 and that only a limited number of people had so far received the first dose, with those beneficiaries expected to return for their second dose after six months. According to her, the choice of PrEP option should be based on individual needs and appropriate medical assessment. Whether prevention comes in the form of a daily pill, a two-monthly injection or a six-monthly injection, adherence remains central to effectiveness. As Nigeria works towards epidemic control, the next phase of the HIV response may depend as much on what people know as on what medicines are available. 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