The U.S. just shipped two million doses of lenacapavir, a groundbreaking twice-a-year HIV-prevention injectable medication, to the African nations of Eswatini and Zambia, the U.S. State Department announced on Tuesday.But the future of HIV-prevention efforts in the continent remains in doubt since the current presidential administration halved funding for the Presidents Emergency Plan for AIDS Relief (PEPFAR), a 22-year-old HIV prevention program credited with saving 26 million lives since its inception. Related Trumps PEPFAR cuts are crippling LGBTQ+ rights & worsening the HIV crisis in Africa The lenacapavir shipment came through a partnership between the Department of State, Gilead Sciences (the developer of the drug), and the Global Fund to Fight HIV, Tuberculosis, and Malaria.Lenacapavir is a twice-yearly injectable drug that stops HIV from replicating inside cells, thereby reducing the risk of transmitting the virus to other people by 96%. HIV advocates hope it will help reduce national transmission rates because the medication is easier to take than the many current once-a-day medications. Never Miss a Beat Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights. Subscribe to our Newsletter today The medication aims to reach targeted populations in high-burden HIV countries, a phrase meaning the groups most at-risk for contracting HIV in countries with high rates of HIV infections and related deaths.The arrivals of the first doses of lenacapavir in Eswatini and Zambia mark an important milestone in HIV prevention and reflect our commitment to supporting communities with the greatest need. For the first time, a new HIV medicine is reaching communities in sub-Saharan Africa in the same year as its U.S. approval,said Daniel ODay, chairman and CEO of Gilead Sciences, referring to the U.S. Food and Drug Administrations (FDA) June 18 approval of the drug. The State Department noted that lenacapavir has the potential to be particularly helpful for pregnant and breastfeeding mothers, as it safely protects them during and after pregnancy to prevent mother-to-child HIV transmission. But the State Departments press release about the drug shipment doesnt mention any other groups most at-risk for contracting the virus, which raises concerns.The current presidential administration has generally sought to defund all U.S. foreign aid as well as programs that acknowledge LGBTQ+ people in any way.A February memo from the State Departments Global Health Security and Diplomacy program stated that PEPFAR-funded PrEP would not be given to individuals other than pregnant and breastfeeding women who may be at high risk of HIV infection. This directive excluded HIV-prevention medication from being given to men who have sex with men; girls and young women between the ages of 15 and 24 who are not pregnant or breastfeeding; sex workers; people who inject drugs; and people who were previously on a PrEP regimen.Its unclear whether this prohibition has since been rescinded or whether it will also apply to the lenacapavir distribution. Furthermore, while Congress appropriated $7.1 billion for PEPFAR in the 2024 federal budget, the White House cut the programs 2025 funding to $4.85billion and plans on reducing PEPFARs 2026 funding to $2.9 billion. Though next years federal budget is still being negotiated in Congress, the president has demonstrated a willingness to illegally defund any programs he personally disapproves of, leaving the actual funding levels in complete uncertainty.This is particularly concerning, considering that lenacapavir is intended as a twice-a-year injectable medication. Even if Eswatini and Zambia receive the second doses of the drug in 2026, the closure of African HIV-prevention programs and clinics (due to PEPFARs slashed funding) and the exclusion of LGBTQ+ people from medication could worsen the continents epidemic regardless.Subscribe to theLGBTQ Nation newsletterand be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.