LEN won’t sell itself: 6 lessons from HIV prevention pills

South Africa is rolling out lenacapavir (LEN), an HIV prevention injection that lasts six months — but people first need to know about it and want it.

There’s a warning from HIV prevention pills: despite being free and stocked at almost all government clinics, uptake has been far lower than the number of people who could benefit.

Wits University’s Health Economics and Epidemiology Office, HE 2 RO, found that personal contact worked particularly well: in one project using community outreach and peer navigators, 46–50% of people started prevention medication immediately after hearing about it.

The lesson for LEN? Use trusted messengers, make the jab easy to get once people want it, budget for creating demand — and don’t promote it where clinics don’t have enough stock.

In today’s newsletter , Refiloe Motaung from the Wits Health Economics and Epidemiology Research Office explains why LEN won’t sell itself.

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COMMENT South Africa now has one of the most effective HIV prevention medicines , in the form of a twice-yearly injection, ever developed.

But there’s a catch: people have to want it — and know where to get it.

Lenacapavir, or LEN, protects HIV-negative people against getting the virus for six months at a time and is almost 100% effective.

South Africa started rolling it out at 360 government clinics in June , but next year, when generics become available the country will start rolling the medicine much more widely.

Analysis of Wits University’s Health Economics and Epidemiology Office , HE 2 RO, shows that if between one and two million people take LEN each year between now and 2043, South Africa will be able to prevent enough new HIV infections to end Aids as a public health threat within the next 17 years.

We’ll have a lot of catching up to do from 2027 onwards, because we’re still far from reaching those numbers.

By 5 October, just over 71 000 people in the country had taken LEN, health department figures show.

But the experience of daily, equally effective HIV prevention pills, which the government started to roll out widely in 2020, should serve as a warning: an excellent medicine, even when it is free, does not necessarily sell itself.