Online Reporter
Robin Muchetu, Health and Gender Editor
TWENTY-NINE-YEAR-OLD Linda Moyo* (not her real name) from Bulawayo has tried all forms of Pre-Exposure Prophylaxis (PrEP) available in Zimbabwe since 2021, in a bid to protect herself from HIV infection.
She was introduced to PrEP by her partner.
Recently, she hoped on to the most recent addition to PrEP in Zimbabwe, long acting Lenacapavir, a twice-yearly HIV prevention injection that is being given to HIV negative people.
The jab is available to all persons who feel they are at risk and vulnerable to HIV infection. The country has been offering the Dapivirine vaginal ring, oral PrEP, long acting Cabotegravir, injected after every two months and now Lenacapavir which protects one for a total of six months.
For Linda, now PrEP ambassador, hers was a choice she made after completing her tertiary studies and getting into a romantic relationship.
Speaking during a Ministry of Health and Child Care Lenacapavir and HIV Prevention media training facilitated by Organisation for Public Health Interventions and Development (OPHID) and Health Communicators Forum, Linda said she has tried almost all PrEP forms since 2021.
“I had my first boyfriend after university and he introduced me to HIV prevention. When I met him, he took me for HIV testing and he told me he was on PrEP, for me it was something new and my first impression was that this person is very promiscuous, why was he eager to protect himself. I played along and trusted him and started taking the pills,” she said.
This is when her journey to try out any new and improved interventions to prevent HIV infection started, she has not turned back.
She said taking HIV prevention comes with some responsibility as one is not protected from Sexually Transmitted Infections and pregnancy.
“At the clinic that I started taking PrEP they sat me down and asked if I was going to be doing away with condoms as a form of protection as PrEP was going to protect me from HIV infection only. Because of the pregnancy concerns I was also initiated on birth control,” she added.
She said the motivation to keep going and trying new interventions is also inspired by the need to remain HIV negative and what is working.
“It is important to assess your lifestyle, see how you are living and know how best to protect yourself. One must assess each method and see what suits you better. My understanding of HIV prevention is an act of taking measures to prevent oneself from infection.
The different methods available allow individuals to choose what suits their lifestyles and to be in control of their future. I chose this as I understand that my health is my responsibility and this allows me to have peace of mind,” she said.
She started her PrEP journey in 2021 where she accessed oral tablets and because she was living with her parents it was difficult to hide the tablets.
“I could not have conversations around sex with my parents, worse still them finding out that I was taking PrEP. I would take the pills at about 9pm because we would have family time at 8pm watching the news so I could not take them there as this routine would have easily been picked up.
So, I opted for bed time,” said Linda.
Antiretrovirals for prevention and treatment, if in tablet form, need to be taken consistently and at the same time for them to be effective. One should never miss a dose or drink them at varying times as it eventually creates resistance.
This presented challenges too.
“The pill was so big and difficult to swallow, it also made me nauseous, I would get heartburn and vomit and I had to explain what’s wrong with me.”
She moved to a different city and continued with her PrEP and the journey became much easier as she was living with relatives and she could take her pills with no challenges.
In 2023 she was introduced to the Dapivirine Ring by her service providers.
“It is a small silicon ring that is inserted into the reproductive organ and is very discrete. I considered this one to be better than the pills as it was hidden away inside me. My only challenge was that I had to go to a health facility every month to take it out and have a new one inserted but it was a good product. Another challenge was that I constantly wanted to touch it and feel if it’s there inside and one time it fell out to the base and I had to pull it out,” she said.
The silicone ring is inserted and replaced each month and works by slowly releasing the Antiretroviral Dapivirine into the reproductive organ.
The ring has been hailed in that it expands women’s options and enables them to choose the best method that meets their individual preferences in controlling the virus spread.
In 2024 Linda moved to try the Cabotegravir Long Acting injectable that had been introduced giving her more options.
“I got this one at my usual service provider and it required me to come in after two months for the injection. I liked it because it was also discrete, the only challenge was the pain during the injecting process. It also worked well for me, like the Dapivirine ring, I did not experience much side effects,” she added.
On 14 March 2026 Linda was introduced to the game changer-Lenacapavir injection, the new additional intervention that is now available.
“This one will require that I go to the facility after every six months. That is the one I have started using. The injection site was painful for just a week and it disappeared after that. I used pain killers and a cold compress to reduce the effects. Of all the interventions I have tried, this is the best for me so far because I am protected for a longer period than all the other methods,” she said.
“HIV prevention is not a one size fits all method; experiences vary from one individual to the other. For me Lenacapavir is the best fit because it is convenient, private and it is long acting.”
However, she said her family is still unaware that she is on PrEP as the conversation is still a ‘taboo’ in her family and possibly many other families too, making the need to demystify issues around sex and HIV in order for young people to access information and services more openly.
Lenacapavir comes in two forms: a tablet taken by mouth and an injection given under the skin. Dosing starts every six months thereafter to continue routine Lenacapavir use. Deviations from the dosing schedule should be avoided. It is important to receive LEN injections on time to ensure continued HIV protection.
Lenacapavir is indicated for PrEP to reduce the risk of acquiring HIV in adults and adolescents weighing at least 35kg.
HIV testing and clinical assessment are required before starting and before follow-up Lenacapavire injections. –@NyembeziMu
