Nigeria Expands HIV Prevention Options as NACA Warns of 45,000 New Infections
With daily pills and long-acting injections now available, health authorities say accurate information and consistent use will be critical to preventing new HIV infections.
By Abdullahi Yusuf
Nigeria is expanding the range of tools available to prevent HIV infection, with health authorities placing greater emphasis on pre-exposure prophylaxis (PrEP), long-acting injections, condoms, testing and accurate public information as the country works to reduce new infections.
The renewed focus followed a two-day training for journalists and social media influencers organised by the National Agency for the Control of AIDS (NACA) in collaboration with the World Health Organisation (WHO) in Lagos, where health officials outlined the latest developments in HIV prevention and sought to counter persistent misinformation about the virus.
NACA Director-General, Dr Temitope Ilori, said Nigeria recorded about 45,000 new HIV infections in 2025, while figures for the current year were still being compiled. She said the emergence of new infections, particularly among young people, showed that prevention could not be allowed to lose momentum.
Nigeria remains on course towards HIV epidemic control, she said, but warned that inadequate knowledge, misinformation and declining use of some established prevention measures could undermine progress.
At the centre of the new prevention approach is PrEP antiretroviral medication taken by people who are HIV-negative to reduce their risk of acquiring the virus.
“It is not a cure. They are prevention strategies,” Ilori said, stressing that PrEP is intended for people who face substantial risk of HIV infection rather than as a treatment for those already living with the virus.
Nigeria now has several PrEP options, giving people alternatives depending on their circumstances and ability to maintain a prescribed schedule.
These include daily oral PrEP, long-acting injectable cabotegravir (CAB-LA), administered every two months, and lenacapavir (LEN-PrEP), a long-acting injectable option administered every six months.
The Federal Ministry of Health and Social Welfare, with support from WHO and other partners, formally introduced lenacapavir in Nigeria in March 2026. The initial rollout covered eight states: Benue, Akwa Ibom, Anambra, Ebonyi, Gombe, Kwara, the Federal Capital Territory and Cross River, as part of efforts to expand access to longer-acting HIV prevention.
For people who find daily medication difficult to maintain, the six-monthly option offers a different approach to prevention. WHO says expanding PrEP choices can help people select methods that better fit their preferences and circumstances, while lenacapavir has been recommended as an additional twice-yearly HIV prevention option.
But health officials stressed that having more options does not remove the need for adherence.
Dr Oluwafunke Odunlade, WHO Technical Officer for HIV, Viral Hepatitis and STIs in Nigeria, explained that PrEP works by ensuring preventive antiretroviral medicine is available in the body before HIV exposure, helping prevent the virus from establishing infection.
She said people must first be tested for HIV before starting PrEP.
“If somebody has HIV already established, the drug will not work. It is best that they are linked to care to actually be on the proper HIV medications,” she said.
Odunlade said people taking oral PrEP must follow the prescribed daily schedule, while those using injectable options must return to health facilities at the recommended intervals.
She also cautioned that protection should not be assumed to be immediate in every circumstance, particularly when beginning long-acting prevention, and said users should follow clinical instructions on loading doses and subsequent appointments.
Nigeria’s expansion of PrEP options comes as the country tries to make HIV prevention more accessible to people who may find conventional approaches difficult to sustain.
WHO says oral PrEP is highly effective when taken as directed, while long-acting injectable options provide alternatives for people who face challenges associated with daily pills, including adherence, stigma or access to healthcare.
Ilori, however, said PrEP should not be presented as a replacement for other prevention measures.
She described condoms as an “old faithful” prevention tool, noting that they can help protect against HIV and other sexually transmitted infections as well as unintended pregnancy.
She also encouraged safer sexual behaviour, including abstinence where possible and mutual faithfulness between partners.
The NACA director-general expressed particular concern about young Nigerians, saying gaps in HIV knowledge and the spread of misinformation were contributing to vulnerabilities among younger people.
For that reason, NACA brought journalists and digital influencers into the prevention conversation, seeking to take accurate information beyond health facilities and into the platforms where young Nigerians increasingly obtain information.
Some of the most persistent misconceptions concern how HIV is transmitted.
HIV is not spread through ordinary social contact such as hugging, shaking hands or sharing an office. Mosquitoes also do not transmit the virus.
The virus can be transmitted through certain forms of sexual contact and exposure to infected blood, while mother-to-child transmission can occur during pregnancy, childbirth or breastfeeding without appropriate interventions.
Health officials say the fight against HIV therefore depends not only on medicines but also on people understanding how the virus is transmitted, how it can be prevented and where to obtain appropriate services.
At the same time, officials stressed that HIV prevention must be accompanied by effective treatment for people already living with the virus.
Ilori said an HIV diagnosis should no longer be regarded as a death sentence, noting that antiretroviral treatment can suppress the virus and enable people living with HIV to live healthy lives.
When treatment successfully suppresses HIV to an undetectable viral load and the suppression is maintained, a person does not sexually transmit HIV, the principle commonly expressed as “U=U”, or undetectable equals untransmittable. WHO similarly states that people on antiretroviral treatment with no detectable virus in their blood do not transmit HIV sexually.
Odunlade also warned against viewing PrEP as a standalone solution, pointing to the continuing burden of sexually transmitted infections such as syphilis, gonorrhoea and chlamydia.
She said people using PrEP should continue to consider other preventive measures, including condoms, and should remain connected to appropriate healthcare services.
The expansion of HIV prevention is part of a wider shift in Nigeria’s national response.
NACA launched its National Strategic Plan 2026–2030 in June, setting out a framework focused on sustaining progress, strengthening domestic ownership, integrating HIV services into the wider health system and expanding innovative approaches to service delivery.
The agency is also supporting community-led efforts to explain newer prevention options. A national training programme held in Abuja in June and July focused on building community capacity around oral PrEP, CAB-LA and lenacapavir as Nigeria expanded its LEN-PrEP rollout.
Nigeria’s HIV response is therefore entering a more technologically diverse phase, but the arrival of new tools does not by itself guarantee fewer infections. The real measure of progress will be whether innovation is matched by knowledge, access, adherence and a public understanding strong enough to prevent misinformation from filling the gaps.
With more prevention choices now available than at any previous point in the national response, Nigeria’s challenge is no longer simply finding another tool against HIV. It is making sure the tools already within reach are understood, trusted and used correctly, before another generation of infections turns preventable risk into permanent consequence.
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