Online Reporter
Theseus Shambare
IN the Munyuki area, a sprawling settlement in Harare’s northeast dormitory town, Epworth, survival is a daily calculation.
Water shortages shape routines. Informal trade sustains households.
And for 30-year-old Melody Dengu — a sex worker and mother of two boys — health is not an abstract policy discussion.
It is a negotiation with risk.
In January, long before the official launch ceremonies and public speeches, Melody walked into Epworth Poly Clinic and chose something new: Lenacapavir, a long-acting injectable for HIV prevention.
“There was fear,” she said in an interview, seated outside her modest home as children’s voices drift through the dusty lanes.
“When you hear about a new injection, you think maybe it is dangerous.”
For six years before that, she had been on daily oral Pre-exposure prophylaxis (PrEP), starting in 2019.
The pills worked.
She remained HIV negative.
But adherence carried a mental weight.
“You worry about forgetting,” she said.
“Sometimes you are tired. Sometimes you travel. If you miss, you panic.”
That quiet anxiety is one challenge health systems across the world have struggled to address.
The World Health Organisation says expanding HIV prevention options — including long-acting injectables — is central to ending AIDS as a public health threat by 2030.
The reasoning is simple: prevention must fit people’s lives, not the other way around.
In Munyuki, life rarely follows a fixed schedule.
From suspicion to confidence
When Melody first heard about Lenacapavir, rumours travelled faster than facts.
Some said new medicines are experimental.
Others warned they cause infertility.
A few insisted injections would bring severe side effects.
“At first I thought maybe I should wait,” she admitted.
But counselling sessions did more than reassure — they were grounded in science.
Nurses explained that Lenacapavir had undergone extensive international clinical trials before rollout.
Large-scale international clinical trials conducted across the United States, South Africa and other countries demonstrated that when administered correctly, Lenacapavir provides highly effective protection against HIV with minimal serious side effects.
Most reactions were mild, limited to temporary injection-site pain, headache or fatigue.
The World Health Organisation has emphasised that long-acting HIV prevention options expand protection for people who struggle with daily pill adherence — a challenge well documented in global prevention programmes.
For Melody, the information mattered.
“They told us everything — what to expect, what side effects are normal and that you still need condoms,” she said.
Like many trial participants worldwide, she experienced only mild injection pain lasting two days.
“After that, everything was normal,” she said.
“Now I am relaxed. I do not stress about pills.”
Her decision would later carry her to a public stage during the official launch in Epworth, where she spoke as one of the pioneers.
But the real story unfolded quietly months earlier — in a clinic room where information replaced fear.
Community voices
In Epworth, the shift towards long-acting prevention is not unfolding in isolation.
It is being shepherded by community structures deeply embedded in the lives of sex workers.
Springs of Life Zimbabwe (SLZ), a sex worker-led organisation, has become a bridge between biomedical innovation and lived experience.
Mitchelle Zengeya
SLZ advocacy officer Mitchelle Zengeya received her own injection at the official launch and has since been encouraging sex workers to consider the option as part of the national drive to reduce new HIV infections.
“This is about protecting ourselves and supporting the national effort to prevent more HIV cases,” she said.
Before the launch, approximately 40 sex workers passed through the organisation’s offices to receive information about the injection.
Some chose to be injected after those sessions.
Others, armed with knowledge, went directly to Epworth Polyclinic.
Mitchelle said none of the sex workers they assisted have reported complications.
“We monitor and follow up. So far, no serious issues,” she said.
Their work extends beyond referrals.
The organisation offers psychosocial support, counselling and condom distribution.
Crucially, they promote what they call “double prevention” — combining injectable protection with consistent condom use.
That layered message mirrors WHO’s prevention framework, which advocates combination strategies rather than reliance on a single tool.
More faces, more stories
Melody is not alone in her decision.
Grace Tembo, meanwhile, emphasised informed choice.
She took part in counselling sessions at SLZ before receiving the injection and says understanding how it works gave her confidence.
“Knowing the science behind it made me feel empowered. I am making an informed decision for my health,” she said.
For Brendon Msipa, a male sex worker, the injection represents male engagement in prevention.
“Many men think HIV prevention is just women’s responsibility. Taking this injection shows that men can and should protect themselves too,” he said, challenging gender norms and encouraging other men to participate.
Alfred Ragara focuses on the community ripple effect.
As a peer educator, he sees his decision influencing others.
“When my peers see me taking the injection and staying healthy, it encourages them to also seek protection. It is about leading by example,” he said, underscoring how individual choices can strengthen community health.
Together, their experiences show that Lenacapavir is not just a biomedical tool — it is a catalyst for autonomy, knowledge, gender equity and community leadership in HIV prevention.
Across the region, similar transitions are unfolding.
In South Africa, differentiated service delivery models are integrating long-acting HIV prevention to meet diverse lifestyle realities.
In Kenya, peer educators have been central to dispelling myths surrounding biomedical innovation.
In the United States, early scepticism around long-acting HIV prevention gradually eased as community-level education increased.
Zimbabwe’s approach — embedding peer voices like Melody’s and Mitchelle’s into the rollout — reflects lessons drawn from those experiences.
Demystifying the needle
New medicines often arrive accompanied by doubt.
Historically marginalised communities, including sex workers, may carry additional scepticism shaped by stigma and exclusion.
Public health experts argue that transparency and community ownership are essential.
Lenacapavir does not eliminate the need for condoms.
It does not prevent other sexually transmitted infections.
It is not a cure.
And it does not override the importance of regular health check-ups.
What it offers, according to global guidance, is sustained HIV prevention for those who struggle with daily adherence.
Melody’s explanation is less technical but equally clear.
“This is extra protection,” she said. “You still protect yourself.”
That clarity cuts through misinformation more effectively than technical brochures.
Ending AIDS as a public health threat by 2030 is a target debated in international forums and health assemblies.
But its success depends on individual choices made in places like Munyuki.
Here, innovation must compete with rumour. Science must earn trust.
Mitchelle believes the growing number of sex workers seeking information signals a turning point.
“When women see someone they know standing up and saying it is safe, it changes things,” she said.
As afternoon shadows stretch across the settlement, Melody prepares to fetch water.
Her life remains shaped by the same economic pressures, the same social stigma, the same daily uncertainties.
But one uncertainty has eased.
“I feel secure,” she said quietly.
In the global narrative of HIV prevention, Lenacapavir represents scientific progress.
In Munyuki, it represents something more intimate: relief from daily anxiety, confidence in choice and the power of informed voices to shift community perception.
Policy can introduce a medicine. International bodies can endorse it. Governments can launch it.
But acceptance begins in homes like Melody’s; where fear is confronted, myths are dismantled and a woman decides that protecting her future is worth trusting something new.
Peter Tanyanyiwa