The South African government plans to introduce a twice-yearly injectable PrEP (pre-exposure prophylaxis) to communities vulnerable to HIV, including men who have sex with men (MSM) and transgender individuals.
According to Bhekisisa, the Department of Health intends to roll out lenacapavir at around 300 clinics from April 2026. Administered every six months, lenacapavir is a highly effective form of PrEP that prevents HIV infection.
Currently, PrEP in South Africa is available in pill form, provided free of charge at government clinics. To remain protected, HIV-negative individuals must take the pill daily.
Setbacks Due to Funding Cuts
MSM and transgender individuals are among the primary groups targeted for PrEP. However, access to PrEP is likely to have declined among these populations following the closure of several community-focused clinics due to funding cuts by the United States government.
Global Fund Support
Bhekisisa reports that the government plans to purchase lenacapavir from Gilead Sciences using R513 million ($29.2 million) provided by the Global Fund to Fight HIV, TB and Malaria. The funding is expected to cover almost half a million people for two years.
From April 2027, the Department of Health plans to procure cheaper generic versions of lenacapavir as they become available, expanding access to more clinics nationwide.
Priority Groups
The government will prioritise girls and young women aged 15 to 24, MSM, transgender individuals, sex workers, and pregnant and breastfeeding women for access to injectable PrEP.
WHO Endorsement
In July, the World Health Organization (WHO) issued new guidelines officially recommending injectable lenacapavir as a twice-yearly PrEP option for HIV prevention.
“While an HIV vaccine remains elusive, lenacapavir is the next best thing: a long-acting antiretroviral shown in trials to prevent almost all HIV infections among those at risk,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, at the time.
A Potential Game-Changer
Injectable PrEP options such as lenacapavir could transform HIV prevention. The requirement of taking a daily pill can lead to “pill fatigue” for some users, while a quick injection just twice a year may encourage greater consistency. This breakthrough has the potential to significantly strengthen efforts to curb the HIV epidemic in South Africa.
One Response
$28 000 for 2 shots per year.
After grants, government and creating generic still will be R2500 per year
This is the cost to protect aganst AIDS for a year. I can afford it, but for trans people currently choosing between food and medicine, I am not sure.