South Africa Offers Free HIV Prevention Jab to 456,000

Buhle Sikade takes an injection twice a year that gives her almost foolproof protection against HIV, and soon 456,000 other South Africans will get the same chance for free.

The 22-year-old from Masiphumelele joined a clinical trial in 2022 to test lenacapavir, a new HIV prevention injection. Not a single woman among the 2,134 participants who received the medication contracted HIV.

Starting April 1st, South Africa will become one of the first countries to offer lenacapavir free through 360 government clinics. The Global Fund to Fight AIDS, TB and Malaria is funding the initial shipment, which arrives in mid-February.

Sikade decided to join the trial because young women like her face the highest risk. Women aged 15 to 24 account for about a third of South Africa's 400 daily new infections, despite making up only 8% of the population.

In Masiphumelele, where one in four adults has HIV, Sikade works as a life skills counselor helping children make healthy choices. She knows the risks young women face: relationships with older partners where they can't negotiate condom use, and the threat of sexual violence.

The medication works like what researchers call a "chemical condom." Unlike latex condoms, lenacapavir doesn't require permission from a sexual partner and only needs to be taken twice yearly instead of during every sexual encounter.

Each dose involves two injections into the belly fat, plus pills on the first two days only. The medication then releases slowly into the body over six months, providing continuous protection.

The Ripple Effect

Health economists at Wits University have calculated the potential impact if enough people use lenacapavir. If one to two million South Africans take the injection annually, new HIV infections could decline fast enough to end AIDS as a public health threat by 2043.

Ending AIDS as a public health threat means fewer people would get newly infected than the number dying from other causes like old age. For a country that has battled one of the world's most severe HIV epidemics, that represents a turning point decades in the making.

Linda-Gail Bekker, chief scientist for the ongoing trial, calls it a powerful new tool in the fight against HIV. The injection removes barriers that have made other prevention methods difficult for young women to use consistently.

Starting this April, what worked for Sikade becomes available to hundreds of thousands of others who need the same protection.