SOUTH Africa finds itself on the cusp of introducing an innovative injection designed to prevent HIV called Lenacapavir. The new medication is believed to bolster the nation’s efforts against HIV, potentially providing a more efficient prevention method for countless individuals vulnerable to infection.

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A step forward

Many believe this injection is a pivotal advancement in HIV prevention, particularly beneficial for those who found maintaining a consistent daily regimen of oral pre-exposure prophylaxis (PrEP) challenging.

Lenacapavir is a long-acting antiretroviral agent and an HIV-1 capsid inhibitor and requires administration only twice annually.  

Positive trials

The outcomes from clinical trials had fuelled an increasing sense of optimism surrounding this pharmaceutical agent. The Department of Health said that the PURPOSE studies yielded notably successful efficacy.

One trial, conducted among women, demonstrated a 100% efficacy rate throughout the study period, while another trial, involving men who have sex with men and transgender women, indicated an efficacy rate of around 96%.

Challenges of PrEP

The Department of Health believe that this biannual injection might serve to alleviate various obstacles frequently associated with the daily use of oral PrEP.

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These include the social stigma some individuals face, the weariness of daily pill-taking, instances of forgetfulness and challenges related to maintaining regular clinic attendance. 

Wentworth’s Marvin Rall, an HIV lay counsellor who currently uses PrEP, noted that daily medication can present challenges.

“The side effects are often painful, particularly severe back pain associated with the kidneys, even when one maintains a high fluid intake. Taking it every day at the same time poses yet another challenge,” he shared. 

Combating the stigma

Rall noted that there is a large number of people in the community who do not take PrEP, due to societal issues. 

“Many people cannot look past the stigma. Destigmatisation is a huge challenge. We are far from accepting and being supportive of others with regards HIV and PrEP. There is a clear lack of education on PrEP and its consequences can be detrimental,” said Rall. 

The target of Lenacapavir

According to the Department of Health, the implementation of this rollout will prioritise adolescent girls and young women, women who are pregnant or breastfeeding, female sex workers, men who engage in sexual activity with other men and other populations identified as high-risk.

Also read: Why you should discuss HIV with your teenager

The South African Health Products Regulatory Authority (SAHPRA), which formally registered the medication in October 2025, clarified that Lenacapavir is utilised to diminish the risk of HIV infection in HIV-negative adults and adolescents weighing at least 35kg who are susceptible to acquiring the virus.

“It should consistently be employed in conjunction with safer sexual practices, such as the use of condoms, to mitigate the risk of acquiring other sexually transmitted infections,” SAHPRA advised.

As the country progress with preparations for the rollout of Lenacapavir, there is a renewed sense of hope to overcome HIV.

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