Sex Workers Scramble As Anti-HIV Injection Runs Out

Sex worker

 

A severe supply deficit of the newly introduced, long-acting injectable HIV prevention drug, Lenacapavir, has sparked widespread concern among sex workers and high-risk populations across several states in Nigeria.

Barely six months after the Federal Government of Nigeria flagged off a pilot distribution of the twice-yearly pre-exposure prophylaxis (PrEP) jab, health facilities in states including Benue, Kwara, Gombe, and Cross River have completely exhausted their allocated stocks, leaving waiting lists growing and vulnerable users at risk.

A Breakthrough Tool Meets Unprecedented Demand

The Federal Government received an initial batch of 11,520 doses of Lenacapavir on March 19, 2026, distributing them five days later across 10 pilot locations Benue, Kwara, Akwa Ibom, Cross River, Gombe, Anambra, Ebonyi, Kano, Lagos, and the Federal Capital Territory.

Unlike traditional oral PrEP, which requires users to strictly adhere to a daily pill regimen, Lenacapavir is administered as a subcutaneous injection once every six months. Public health experts have praised the drug as a game-changer in HIV prevention, offering near-complete protection against the virus while removing the daily burden of pill compliance.

For sex workers, the injectable option quickly became the gold standard of care. Health workers at designated clinics in Calabar, Cross River State, noted that after initial hesitation tied to stigma and low awareness, demand skyrocketed once the benefits of the drug became widely known among peer networks.

"Clients now explicitly request the injection over oral pills," said a counselor at the Infectious Disease Unit of General Hospital, Calabar. "It offers total discretion and convenience, especially for sex workers who may face privacy challenges or stigma carrying around daily medications. But because stock has run out, we have to advise them to return to daily oral PrEP while awaiting new shipments."


Pilot States Depleted Across the Country

The stock-outs have hit multiple pilot zones hard, revealing an acute mismatch between initial federal allocations and real-world demand.

  • Kwara State: Over 800 doses assigned to the state were completely depleted weeks ago. State AIDS Programme Coordinator Muhammed Rasheed confirmed that health centers are awaiting an additional shipment of at least 1,000 doses to clear backlogs. Visits to designated facilities, such as Sobi Specialist Hospital in Ilorin, confirmed that prospective clients are currently turned away empty-handed.
     

  • Benue State: Officials reported rapid early uptake that quickly overwhelmed available inventory, leaving participating health centers with empty pharmacies despite high daily walk-ins.
     

  • Cross River State: Health providers report growing waiting lists as counseling efforts successfully drove demand beyond initial consignment numbers.
     

The National Agency for the Control of AIDS (NACA) pointed out that while global funding shifts, logistics delays, and delivery constraints have hindered distribution pipelines, individual state stock-outs should be viewed as localized bottlenecks under a pilot framework rather than a universal national failure. Officials clarified that the pilot was deliberately designed to stress-test supply chains, storage capabilities, and client demand before rolling out the injection nationwide.

The Disparity: Stock-Outs vs. Low Awareness

While states like Benue and Kwara struggle with severe shortages, a stark contrast exists in Lagos State. Health officials in Lagos reported having surplus doses sitting in storage, alongside a struggle to attract enough eligible individuals to receive the jab.

"We have more than enough doses to the point that we are actively encouraging people to come forward," an official from the HIV Unit of the Lagos State Ministry of Health stated. "Our challenge in Lagos is not supply, but raising sufficient awareness so that at-risk populations utilize the resource."

Public health advocates argue that this geographic mismatch highlights a critical need for dynamic redistribution mechanisms, allowing surplus stock in urban centers like Lagos to be swiftly redirected to high-demand regions suffering from deficits.

Fear of Disruption and Calls for Action

The sudden exhaustion of supplies has raised anxieties among sex workers and civil society organisations focused on HIV prevention. Because PrEP treatments require uninterrupted protection schedules to maintain immunity against infection, experts warn that delays in getting follow-up doses could leave vulnerable individuals exposed during high-risk contacts.

Advocates and community leaders are urging the Federal Ministry of Health, NACA, and international donor partners to fast-track procurement of fresh consignments, streamline distribution channels, and transition Lenacapavir from a restricted pilot initiative into a fully funded national healthcare program. Without immediate supply chain stabilization, health campaigners warn that Nigeria risks undermining years of hard-won progress in reducing new HIV infections among key populations.



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