Lenacapavir offers new HIV prevention in South Africa

In South Africa, the Department of Health has started more than 55,000 people on lenacapavir, a long-acting injectable medicine that prevents HIV infection.

The medicine, given with initial tablets, blocks a protein HIV needs to reproduce, offering people an alternative to daily prevention pills. Two large studies, Purpose 1 and Purpose 2, demonstrated lenacapavir’s effectiveness.

Purpose 1, conducted with adolescent girls and young women in South Africa and Uganda, found no HIV infections among 2,134 participants receiving the injection during the study’s main analysis. Purpose 2, involving men and gender-diverse people in seven countries including South Africa, showed an 89% lower infection rate with the injection compared to daily tablets. Researchers noted that while these results are strong, they don’t guarantee lifelong protection for every individual.

The studies lasted roughly nine to ten months, meaning longer-term effects and rarer side effects still require monitoring. Currently, officials are focused on ensuring people return for their second doses and understanding why some may discontinue use. The program is reaching mostly women, including those who are pregnant or breastfeeding, and the government is developing a plan to fund future doses and ongoing monitoring to sustain the program’s success.