Ever since Gerald Muwonge tested positive for HIV eight years ago, keeping his viral load in check has meant carrying around vials of pills for his daily treatment regimen while dodging the stigma this could mean for a gay man in Uganda.
But he hopes that could soon change thanks to an injectable treatment that only needs to be taken once every two months.
In October of last year, about 200 patients in the east African country began a trial of a World Health Organization-approved injection containing the drugs cabotegravir, or CAB-LA, and rilpivirine. Results are due in 2024.
The treatment, developed by British drugmaker GlaxoSmithKline, is the first non-pill option against HIV, and studies have shown similar efficacy as daily oral pills.
“These drugs, you have to take them every day, and if you are taking them at exactly 9 a.m., it should be that way until you die,” said Muwonge, a 27-year-old activist for lesbian, gay, bisexual, transgender and intersex (LGBTI) rights.
He says the strict regimen of taking the pills messes with his head.
Muwonge, who is not among the patients in the trial, said the new injectable treatment option could help to reduce the stigma HIV patients suffer, particularly gay men like himself.
Homosexuality is illegal in Uganda, and gay people often face arrest, ostracism and violence at the hands of law enforcement or local vigilantes.
Many who have HIV have not come out to friends, family members and co-workers and prefer to hide that they have an illness that disproportionately affects the LGBI community.
The GSK treatment secured U.S. approval in January 2021.
GSK struck a deal in July to allow low-cost generic versions to be used in the developing world for a version of the drug used for HIV prevention but said the first generics will potentially only become available in 2026 because of regulatory requirements for manufacture and use.
In the interim, GSK said it was working on providing governments the regimen free of charge to run studies. Trials are also taking place in Kenya and South Africa.
William Tamale, a manager of the injectable antiretroviral treatment programme at Uganda’s Joint Clinical Research Centre, said the drugs were “very promising.”
The JCRC was chosen to administer the trial of the injectable drugs and Tamale is in charge of that progamme in Uganda, where at least 1.4 million people live with HIV/AIDS.