As the African Sex Workers Alliance (ASWA), we welcome Kenya’s historic receipt of the long-acting HIV prevention drug Lenacapavir—making Kenya the first East African country to secure starter doses for rollout. This is a major milestone in the fight against HIV/AIDS.
The twice-yearly injectable Pre-Exposure Prophylaxis (PrEP) offers a powerful, discreet, and effective option, protecting HIV-negative individuals for six months at a time. It has been endorsed by the World Health Organization and approved by regulatory authorities based on strong evidence of its effectiveness.
However, we emphasize that this scientific breakthrough will only realize its full public health potential if all populations at highest risk of HIV infection are guaranteed equitable access—especially sex workers, who continue to face disproportionate vulnerability due to structural barriers, stigma, criminalization, and limited access to health services.
Across Africa, sex workers carry a significantly elevated risk of HIV infection compared with the general population due to multiple, intersecting factors including lack of legal protections, discrimination in health settings, economic insecurity, and frequent mobility.
While daily oral PrEP has proven effective, it is often impractical for many sex workers who struggle with adherence because of irregular schedules, stigma, and mobility. Long-acting PrEP such as Lenacapavir addresses many of these challenges and represents a game-changing preventive tool—but only if it reaches those who need it most.
We therefore call on governments, donors, and implementers to:
- Ensure Lenacapavir is available at low or no cost for sex workers and other priority populations, eliminating financial barriers that restrict access to the most privileged.
- Invest in and expand community-led, peer-driven services so sex workers can access prevention safely, respectfully, and without fear of stigma, discrimination, or legal repercussions.
- Advance policy reforms that protect the rights and dignity of sex workers, including decriminalization of sex work and enforcement of nondiscrimination in healthcare settings.
- Integrate long-acting PrEP into national HIV strategies as part of comprehensive, tailored prevention packages that reach marginalized communities.
Access to life-saving prevention must not depend on occupation, income, or social acceptance. We believe Lenacapavir’s introduction presents a catalytic opportunity to close prevention gaps, reduce new infections, and accelerate progress toward ending HIV/AIDS as a public health threat—if equity, dignity, and human rights remain at the center of implementation.
