By Just three months after its national launch, South Africa’s rollout of lenacapavir—a twice-yearly injectable pre-exposure prophylaxis (PrEP) for HIV prevention—is demonstrating strong momentum across the country.
The Department of Health reported that 55,123 individuals have been initiated on the long-acting prevention option across six provinces. The initial figures reflect significant public demand for an alternative to daily oral PrEP, particularly among women.
Strong Demand Driven by Women and Young Mothers
Launched on 5 June 2026 by President Cyril Ramaphosa and Health Minister Dr Aaron Motsoaledi, lenacapavir represents a key milestone in expanding South Africa’s biomedical HIV prevention portfolio.
Data released by the Department shows that women make up 71% of all recipients to date, with pregnant and breastfeeding mothers constituting the majority of this group. The high uptake among women highlights the critical role long-acting injectables can play in overcoming adherence challenges often associated with daily oral tablets, especially for populations facing gender-based vulnerabilities or routine healthcare barriers.
Provincial Distribution and Reach
The implementation is currently active across 360 public health facilities spanning 24 districts. Gauteng leads the country in adoption, accounting for nearly half of all initiations.
- Gauteng: 26,357 initiations
- KwaZulu-Natal: 11,941 initiations
- North West: 4,479 initiations
- Western Cape: 4,446 initiations
- Mpumalanga: 4,294 initiations
- Eastern Cape: 3,606 initiations
Integration into Comprehensive Prevention Care
Lenacapavir is not being distributed as a standalone intervention, but rather integrated into the broader public health framework alongside existing options, such as daily oral PrEP and condoms. This client-centred “PrEP-choice” model allows individuals to select the prevention method that best aligns with their lifestyle and personal circumstances.
The South African Health Products Regulatory Authority (SAHPRA) registered and approved lenacapavir following a comprehensive evaluation of its safety, efficacy, clinical trial data, and manufacturing standards.
To support the expanded distribution, the Department of Health is working in tandem with provincial authorities, healthcare personnel, and implementing partners to oversee commodity supply chains, monitor service delivery quality, and track client follow-up care.
Safety Monitoring and Pharmacovigilance
As the rollout continues to scale, health officials are emphasizing public safety and post-market surveillance. The Department has reinforced its pharmacovigilance protocols to monitor and investigate any reported adverse reactions.
Recipients who experience persistent or severe side effects following an injection are urged to report them immediately to their nearest public health facility. Health authorities maintain that rigorous clinical monitoring remains central to the responsible, evidence-based scaling of lenacapavir nationwide.
