Thousands of Eastern Cape residents will soon be able to protect themselves against HIV with just two injections a year, as the provincial department of health begins rolling out a new long-acting prevention treatment aimed at reducing infections.
The department has identified 49 health facilities across the Alfred Nzo, Buffalo City Metro, Nelson Mandela Bay and OR Tambo districts where the first phase of the programme, which introduces Lenacapavir, a long-acting form of HIV pre-exposure prophylaxis (PrEP), will be introduced.
PrEP is medication taken by HIV-negative people to prevent infection.
More than 8,300 people across the four districts are set to benefit.
The first consignment of the groundbreaking new medicine will arrive in SA soon and will be rolled out to 360 government clinics after quality testing. The final date is yet to be announced.
The programme is fully funded by the Global Fund, a worldwide partnership to defeat Aids, tuberculosis (TB) and malaria, which has allocated more than R500m to SA.
Unlike the current treatment, a daily pill, Lenacapavir is administered as a twice-yearly injection.
Health officials say this will make prevention easier and improve protection against HIV.
Bhekisisa Centre for Health Journalism reported last year that in 2024, South Africa had 178, 000 new HIV infections.
News of the rollout was welcomed by Nobom Nini, director of Siphethubomi Health Care Services and a 2025 Dispatch Local Hero.
“The vulnerable group is the youth. They are impatient and cannot afford to be at the clinic on a monthly basis. As a result of that, they drop out of the oral PrEP,” Nini said.
She said it could also improve access.
“Many can’t access facilities on a monthly basis because of studies,” she said.
“Males are people who are afraid of injections, but if you give them just once in six months they would likely accept that over regular pills,” she said.
A representative from the South African National Aids Council (SANAC) said young people were a key target for the programme.
“We are seeing high numbers of youth who are HIV-positive and this will target them to reduce that number.
“There is hope that more people will take it up.”
Provincial health spokesperson Camagwini Mavovana said: “Long-acting injectable prevention significantly improves adherence for individuals who may struggle with daily medication.
“By requiring only two injections per year, Lenacapavir has the potential to expand access to HIV prevention.”
She said the next step would be expanding the programme.
“The next step will be increasing the number of facilities …
“Which districts and how many per province will be decided by the national department of health.”
Mavovana said the 8,305 initial recipients were not specifically selected.
“People will be offered [the injection] as they come,” she said, adding that guidance on targets and priority populations had been provided by the national department of health.
She stressed that the rollout was part of a national phased implementation.
“The World Health Organisation [WHO] released implementation guidelines in July 2025, and the medicine has since progressed through international pre-qualification processes,” she said.
According to the WHO, the injectable PrEP was developed to address challenges associated with daily oral PrEP, particularly for people who struggle to take pills regularly or who visit clinics infrequently.
The PrEP pill did help in reducing the number of people getting infected.
— Agcobile Ben, HIV activist
HIV activist Agcobile Ben welcomed the introduction of the injectable treatment, saying it could help reduce new infections.
“This should have been done a long time ago, because a lot of people do not like taking daily pills, especially those who aren’t living with HIV and have to take the pills to protect themselves from being infected,” Ben said.
“The PrEP pill did help in reducing the number of people getting infected.”
Pam Qavile, programme manager for Beyond Zero, another nonprofit organisation working in HIV prevention, said a wider rollout could help reduce new cases.
“There has been an increase in the number of people initiated on PrEP tablets, however stigma and adherence remain key challenges.
“The injection will definitely help with reduction of new cases especially when we reach full rollout throughout the country,” Qavile said.
Mavovana said long-term sustainability would be addressed in the next phase.
“A domestic sustainability pathway will be articulated during 2026/2027, including options for price reductions, potential generic entry when feasible, and integration into routine provincial budgets.”
The department said facilities selected for the first phase were prioritised based on several factors, including high HIV infection rates, strong performance of existing PrEP programmes and services aimed at priority groups.
These groups included adolescent girls and young women, pregnant and postpartum women, sex workers, men who had sex with men, transgender people and people who injected drugs.
Mavovana said most preparatory work for the rollout had already been completed.
“The department has already completed several preparatory steps, including facility readiness assessments, staff training across all participating districts, and distribution of implementation guidelines and operational resources,” she said.
“The selection of districts and facilities for the initial phase was guided by clear prioritisation criteria informed by epidemiological data and programme performance.
“Priority was given to districts with high HIV incidence and elevated antenatal HIV positivity rates, as well as facilities that serve large catchment populations in high-burden communities and have broad geographic reach.”
According to the Sixth South African HIV Prevalence, Incidence and Behaviour Survey (SABSSM VI) released by the Human Sciences Research Council in August 2024, HIV prevalence in the province declined slightly from 15.9% in 2017 to 13.7% in 2022.
The findings indicated that about 980,000 people were living with HIV in the Eastern Cape in 2022, compared with about one-million in 2017.
The survey found the highest prevalence among people aged 25 to 49, where the rate stood at 27.7%.
Women in this age group were disproportionately affected, with a prevalence of 35.4%, compared with 17.1% among men.
HIV prevalence among men was highest in urban areas (8.7%), while among women it was highest in rural areas (19.8%), highlighting persistent gender and geographic disparities.
Daily Dispatch
Mpumzi Mshweshwe
www.dailydispatch.co.za