South Africa Begins Public Sector Rollout of Six-Month Injectable Lenacapavir PrEP

South Africa began its public sector rollout of injectable lenacapavir PrEP on 5 June 2026. The injection supplies six months of protection against HIV infection per dose and contains the antiretroviral drug lenacapavir. The launch occurs after many specialised clinics and programmes for key populations funded by PEPFAR were closed in 2025.

Cuts to aid from the United States contributed to the dismantling of trusted pathways for HIV prevention services. Keegan Daniels, a 29-year-old gay man, visited a public hospital outside Cape Town earlier in 2026 to obtain oral PrEP. During the consultation, the doctor reprimanded him, lectured that anal sex is abnormal, chastised him for addressing the doctor as 'sir' rather than 'doctor', assumed his sexual orientation, and discussed marriage as a method to prevent HIV.

"I am gay, but when he told me I was 'homosexual' instead of asking me, I felt as if I was there to be shamed instead of helped," Keegan said. He added that the doctor began discussing the importance of marriage as a method to prevent HIV and the risks associated with anal sex.

Oral PrEP reduces the risk of HIV infection from sex by approximately 99 percent when used as prescribed, according to a 2022 meta-analysis.

Men who have sex with men are up to 26 times more likely to acquire HIV than the general population, according to the World Health Organisation. South Africa became the first country in Africa to start rolling out oral PrEP in 2016. The initial strategic focus of the programme was on key populations including sex workers, men who have sex with men, transgender persons, people who inject drugs, and people in prisons.

Key populations and their sexual partners accounted for roughly 39 percent of new HIV infections in Sub-Saharan Africa in 2020, according to UNAIDS. Two million new HIV infections occurred in South Africa, according to a 2024 paper in Frontiers in Reproductive Health.