On 5 June 2026, President Cyril Ramaphosa launched the national rollout of lenacapavir — a twice-yearly injection that prevents HIV — at Lilian Ngoyi Stadium in Secunda. Twenty-one-year-old Jane Mndebele became the first South African to receive it.
More than 55,000 people had been initiated on the injection by 7 September 2026. Nearly nine in ten people choosing it in the Western Cape are first-time users of long-acting HIV prevention. The government's target is one million people by the end of 2027.
What is lenacapavir?
Lenacapavir is an antiretroviral medicine that blocks HIV from entering cells. In prevention use, a single subcutaneous injection under the skin of the abdomen or thigh provides roughly six months of protection. That means two shots a year instead of 365 daily pills.
In clinical trials, lenacapavir showed more than 96% effectiveness at preventing HIV — the highest efficacy ever recorded for an HIV prevention method.
Why this matters in South Africa
South Africa has the largest HIV burden in the world. Daily prevention pills (PrEP) have been available since 2016, but uptake has been limited — adherence is hard, stigma is real, and many people struggle to take a pill every day without anyone knowing.
A twice-yearly injection changes that. You get it at a clinic, you don't have to think about it again for six months, and there is nothing to hide at home.
Who can get it?
The rollout targets people at substantial risk of HIV acquisition. In practice this includes:
- HIV-negative partners of HIV-positive people
- People with multiple sexual partners or recent STI diagnoses
- Adolescent girls and young women in high-burden districts
- Men who have sex with men
- Sex workers and their clients
- Anyone who finds daily pills difficult to take consistently
Where to get it
Lenacapavir is being distributed through public sector clinics, NGO partners, and selected private providers. Availability varies by province — the Western Cape and Gauteng were prioritised in the initial phase, with other provinces following.
To find a clinic near you that offers lenacapavir, ask at your local clinic, or contact the National AIDS Helpline on 0800 012 322 (toll-free).
What about side effects?
The most common side effects reported are mild injection-site reactions — redness, swelling, and mild pain at the injection site. These usually resolve within a few days. Serious side effects are rare but possible.
Lenacapavir does not protect against other STIs or against pregnancy. Condoms remain important for both.
The bigger picture
South Africa is not alone in rolling out lenacapavir. The World Health Organization issued guidelines supporting lenacapavir for HIV prevention in mid-2025. Several other African countries have begun their own rollouts.
For people living with HIV in South Africa, the arrival of lenacapavir is significant for a second reason: it reduces the risk of transmission to HIV-negative partners in mixed-status relationships. U=U (Undetectable equals Untransmittable) already made transmission impossible when the positive partner is virally suppressed. Now the negative partner has their own additional layer of protection.
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