OPINION: Gauteng’s Lenacapavir story is bigger than a new injection

When Lenacapavir was introduced in Gauteng in June, the province anticipated its impact but underestimated the swift community response. Within weeks, thousands of eligible clients flocked to the designated facilities to access this innovative HIV prevention option. By the end of July, 17,937 eligible clients had already been initiated on Lenacapavir. Gauteng has since received additional initiation packs, with a total of 57,231 packs allocated for initiating 114,160 eligible clients between June 2026 and March 2027.

This surge in demand is more than a mere statistic; it reflects the eagerness of Gauteng residents to protect themselves against HIV and their willingness to embrace new prevention methods. While there have been instances of facilities running low on Lenacapavir, those shortages were swiftly addressed, demonstrating the community's commitment to accessing the new prevention option.

However, it is crucial to acknowledge the reasons behind these shortages. In some facilities, demand exceeded initial projections, underscoring the importance of accurate planning and the need for the health system to adapt to real-world situations. The government is taking note of this demand and strengthening its planning to ensure a responsive health system.

Lenacapavir, administered twice a year, offers eligible HIV-negative individuals another prevention choice, complementing existing methods such as condoms, HIV testing, and STI screening. It does not replace these services but provides an additional option for those seeking protection. The message to young people is clear: protection of oneself and future plans should always be the primary focus.

Abstinence remains a viable choice, but it is essential to address the realities faced by young people in the community, including peer pressure, sexual violence, and emotional readiness in relationships.

Addressing teenage pregnancy and HIV among young people requires comprehensive sexual and reproductive health education. Parents, guardians, schools, and communities must support young people, providing them with accurate information and safe spaces to seek care without fear or judgment. While celebrating the strong response to Lenacapavir, it is equally important to emphasize that prevention must remain comprehensive.

Condoms continue to play a vital role in preventing HIV, pregnancy, and other sexually transmitted infections, alongside testing and STI screening.

Efforts to reach underserved communities, such as those undertaken by the Johannesburg Wellness Centre, which offers services to the LGBTI+ community, are vital. Effective public health responses must be inclusive and not discriminate or stigmatize any group. Collaboration between civil society organizations, NGOs, and traditional health practitioners is crucial in reaching every community with the necessary information, support, and services.

As we commemorate African Traditional Medicine Week, it is essential to recognize the invaluable role of Traditional Health Practitioners (THP’s) in the fight against HIV. These practitioners often serve as trusted voices in their communities and can play a significant role in educating clients about HIV prevention and referring them to public health facilities when needed.

The success of the Lenacapavir program in Gauteng offers encouragement but also highlights our responsibility. The province's commitment to HIV prevention must remain steadfast, and we must continue to work together, ensuring that no community is left behind in the pursuit of ending AIDS as a public health threat by 2030.