The Rwanda Biomedical Centre (RBC) is finalising preparations for the rollout of lenacapavir, a long-acting injectable drug for HIV prevention, anticipated to be launched in November.
The preparations embody web site choice, coaching of well being employees, and procurement of important provides.
ALSO READ: How Rwanda met international HIV targets forward of schedule
The injectable, which is run as soon as each six months, can be added to Rwanda’s present pre-exposure prophylaxis (PrEP) choices.
In keeping with Dr. Zephanie Nzeyimana, HIV Key Inhabitants Strategic Officer at RBC, having lenacapavir in Rwanda is a serious step ahead in public well being because it makes prevention simpler than taking each day tablets, and it additionally helps scale back stigma.
Rwanda has recorded regular progress in HIV therapy protection. As of June 2025, greater than 229,000 folks have been receiving antiretroviral remedy, representing a 96.9 p.c protection fee, in accordance with the HIV, STIs and Viral Hepatitis Annual Report 2024/2025.
Retention in care has additionally remained excessive, with 94 p.c of sufferers staying on therapy after one yr. As well as, many sufferers now obtain medicines for 3 to 6 months at a time, lowering the necessity for month-to-month clinic visits.
Kids, adolescents nonetheless lag behind
Gaps stay amongst kids and adolescents. As an example, protection amongst kids aged 0-14 stands at 75 p.c. The report reveals that lots of these lacking from care have been by no means recognized early, notably these born to moms dwelling with HIV.
For adolescents and younger adults aged 15-24, some discontinue therapy after beginning. Comparable patterns are additionally seen amongst males aged 25-49, who’re much less constant in follow-up care.
Throughout the reporting interval, 11,162 folks have been newly enrolled on therapy, whereas 1,987 who had dropped out have been traced and returned to care. Nonetheless, 3,258 folks have been newly misplaced to follow-up, and 1,683 deaths have been recorded.
Even amongst these nonetheless in care, challenges stay in monitoring. Viral load testing protection stands at 88 p.c, affected by missed appointments and delays in pattern assortment and processing.
Rwanda has already met international HIV targets, with most individuals dwelling with HIV realizing their standing, on therapy, and attaining viral suppression.
Well being officers now say consideration is shifting from increasing entry to making sure continuity of care, particularly amongst kids and younger folks.
To handle these gaps, RBC and the Ministry of Well being have launched new approaches, together with the ATLAS mannequin, being carried out in 30 well being amenities. The mannequin is designed to make providers extra adolescent-friendly and strengthen adherence amongst younger folks.
One other initiative, LIFT-UP, focuses on figuring out kids and adolescents who usually are not but in care, though its attain remains to be restricted to chose districts.
Well being employees are additionally receiving mentorship and coaching, alongside efforts to strengthen provide methods for paediatric medicines and check kits to keep away from inventory shortages.
Boundaries start early in life
In keeping with Dr Gilbert Mbaraga, Medical Supervisor at AHF Rwanda, kids and adolescents proceed to lag behind adults in HIV analysis, therapy protection and viral suppression.
He defined that the hole begins early. Some HIV-exposed infants miss early toddler analysis, whereas others who contract HIV by way of mother-to-child transmission develop up undiagnosed when they don’t present apparent signs, resulting in delayed therapy.
“Some dad and mom keep away from testing their kids attributable to worry of discrimination or considerations that their very own HIV standing might be uncovered,” he mentioned.
“Adolescents, on their half, typically keep away from testing attributable to worry of judgment from friends, members of the family, or well being employees. Well being providers are designed for adults and should not adequately handle adolescents’ wants for privateness, confidentiality, and psychosocial help.”
RBC has expanded HIV testing providers by way of voluntary counselling and testing, self-testing, accomplice notification, and community-based outreach. Nonetheless, officers say extra focused efforts are wanted to succeed in adolescents and younger folks.
Dr. Mbaraga famous that some kids usually are not knowledgeable of their HIV standing on the applicable age, making it troublesome for them to grasp the necessity for lifelong medicine, which impacts consistency in taking therapy.
Psychosocial pressures additional complicate adherence. Adolescents typically face melancholy, nervousness, stigma, peer stress, and relationship considerations, all of which may have an effect on engagement in care.
Therapy fatigue can also be widespread, particularly amongst those that have been on medicine since childhood. The transition from paediatric to grownup care providers may result in lack of follow-up when help methods turn into much less structured, the skilled famous.
In keeping with Mbaraga, financial and social challenges reminiscent of transport prices, meals insecurity, college schedules, and restricted caregiver help additional disrupt clinic visits.
Rwanda has prioritised kids, adolescents and younger folks dwelling with HIV by way of peer-led approaches reminiscent of Neighborhood Adolescent Therapy Supporters (CATS), alongside psychosocial help and lively tracing of those that miss appointments.
