A new community survey by OUT LGBT Well-being has found overwhelming interest among gay, bisexual and other men who have sex with men (MSM) in Lenacapavir (LEN), the groundbreaking HIV prevention injection set to roll out in South Africa this month.
The online survey, conducted between 22 May and 2 June 2026, gathered 277 responses from MSM across the country to better understand community perceptions, concerns and preferences regarding LEN.
Lenacapavir is a new form of Pre-Exposure Prophylaxis (PrEP) that protects against HIV infection. Unlike traditional oral PrEP, which requires taking a pill every day, LEN is administered as injections only twice a year.
The findings suggest that LEN could significantly improve both uptake and adherence to HIV prevention among MSM, a group that continues to experience a disproportionately high burden of HIV in South Africa.
Strong Preference for Twice-Yearly Injections
According to the survey, 85% of respondents said they were keen to start LEN when it becomes available, while 87% indicated that they would prefer receiving injections every six months rather than taking a daily HIV prevention pill.
“The findings show that many MSM are excited about the arrival of Lenacapavir and see it as a more convenient and manageable option than daily oral PrEP,” said OUT LGBT Well-being Executive Director Dawie Nel.
“For years, we have known that remembering to take a daily pill can be challenging for many people. The strong preference for twice-yearly injections suggests that LEN could help more people start and stay on HIV prevention, which is extremely encouraging.”
Health Minister Dr Aaron Motsoaledi confirmed last month that South Africa will begin rolling out LEN in June through selected public healthcare facilities.
Initial Rollout to Prioritise High-Risk Groups
The injection will initially be available at 360 public health facilities located in areas with the highest HIV burden. It will not yet be offered in the private healthcare sector.
The Department of Health has said the programme will prioritise groups at higher risk of HIV infection, including men who have sex with men, transgender people, people who inject drugs, adolescent girls and young women up to the age of 24, pregnant and breastfeeding mothers, and female sex workers.
Concerns About Side Effects and Access
While interest in LEN was high, the survey also highlighted several areas where more public education is needed.
Respondents expressed uncertainty about where LEN would be available and whether it is safe for people who use drugs or those living with mental health conditions.
Side effects emerged as the leading concern among respondents, followed by worries about potential costs and the risk of acquiring other sexually transmitted infections.
“These findings tell us that there is still a need for clear, accessible and community-centred education about Lenacapavir,” said Nel.
“People want accurate information about how the injection works, who can use it, its safety profile and where they will be able to access it. As the rollout begins, ensuring communities have trusted information will be essential.”
LGBT-Affirming Clinics Remain Preferred
The survey also reinforced the importance of LGBT-affirming healthcare environments for MSM seeking HIV prevention services.
Nearly half of respondents (47%) said they would prefer accessing LEN at an LGBT-affirming clinic, compared to just 18% who selected Department of Health facilities as their preferred option.
Concerns about public sector clinics centred on long waiting times and perceptions that many facilities remain unwelcoming towards MSM.
“The message from the community is clear: respectful, affirming and non-judgemental healthcare matters,” Nel noted.
“Many MSM continue to feel more comfortable accessing services in environments where they know they will be treated with dignity and understanding. The successful rollout of LEN will depend not only on making the medication available but also on ensuring that healthcare services are welcoming and accessible to the communities that need them most.”
