South Africa's HIV prevention jab has reached 71,000 people. It needs to reach a million a year.

Johannesburg — Four months after South Africa began offering lenacapavir, an HIV prevention injection given twice a year, 71,000 people have received it, researchers write in the Mail & Guardian. Ending AIDS as a public health threat by 2043 would take between one and two million people a year.

The injection is almost 100% effective at preventing HIV infection. The rollout began in June at 360 government clinics. The figure of 71,000 is as of 5 October.

The researchers argue that the medicine alone is not enough, and draw six lessons from the country's experience with daily prevention pills. By June 2026 only 2.3 million people had ever taken those pills, and a 2022 survey found that only a third of sexually active South Africans knew they existed.

What worked with the pills

Their study followed 1,038 young people starting HIV prevention medication.

• People must be told deliberately. Forty-six percent had learned about prevention through targeted efforts and 35% through their social networks.
• The messenger matters. Community outreach with peer educators led 46% to 50% of people to start immediately, against 21% to 34% without them.
• Delays lose people. Peer navigators who went with people to the clinic turned awareness into use.
• Mass media does little. Only 5% heard about prevention from television, radio or billboards. Eighty-four percent heard through personal contact.
• Demand has to be paid for. Outreach made up between 14% and 40% of the cost of each visit.
• Measure it. Track which campaigns actually lead people at high risk to start.

The government's plan

The health department intends to promote the injection through clinic campaigns, community discussions, media coverage, radio, peer educators and social media.

The article notes that the research was funded by the Gates Foundation.

This report is based on an article by Refiloe Motaung and colleagues in the Mail & Guardian.