Lindiwe Mqatazana is not taking any chances with her health, or with that of her unborn child. <\/p>\n
\u201cThere are a lot of guys who won\u2019t tell you they are HIV-positive. I have to protect myself,\u201d said the 25-year-old municipal worker, a resident in Cape Town\u2019s Gugulethu township. She is among the first cohort of South Africans to start using Lenacapavir, the twice-yearly HIV prevention shot which became available at select public clinics in June<\/a>.<\/p>\n Optimism about Lenacapavir is running high as clinical trials found it provided users with almost complete protection against HIV infection. However, global supplies are severely constrained, forcing the health department to ration the limited stock it has on hand. <\/p>\n Mqatazana is one of the lucky ones. She previously took oral pre-exposure prophylaxis (PrEp), a daily pill to protect her against HIV infection, but struggled with the nausea and headaches it triggered. On a recent visit to Vuyani Clinic, she confirmed her pregnancy and received her first dose of Lenacapavir \u2015 two subcutaneous shots in the buttocks with two pills, followed by a second round of pills she took at home 24 hours later. Aside from some mild pain at the injection sites, she\u2019s had no side-effects and has been assured the drug is safe for her baby.<\/p>\n South Africa has the world\u2019s worst HIV burden, with almost 8-million people living with the disease, according to the latest Tembisa model<\/a>. It estimated there were 140,000 new infections last year, or more than 380 a day.<\/p>\n Stopping the epidemic in its tracks by virtually eliminating transmission is possible with well-established tools such as antiretroviral treatment and oral PrEp. But that would take decades, said modellers. <\/p>\n Adding Lenacapavir to the mix could dramatically reduce the time to achieve the goal, particularly if the shot was prioritised for people at greatest risk of infection, according to a study<\/a> led by the Wits Health Economics and Epidemiology Research Office (HER2O).<\/p>\n But the numbers are huge: reducing HIV incidence in South Africa to less than 0.1% a year by 2039 would require providing Lenacapavir to 2.9-million people a year. If a more modest target of 1.7-million people a year was reached, it would take until 2043 to end the epidemic, said the study\u2019s lead author, Lise Jamieson, a senior researcher at HE2RO. <\/p>\n Oral PrEp has been available in South Africa since 2016, and though about 600,000 people start each year, many struggle to stick with it. Dimpho Tsotetsi, a transgender activist from Gauteng, started using oral PrEp in 2017 but said she often missed a day or two, reducing its efficacy. She jumped at the offer of Lenacapavir.<\/p>\n \u201cGetting a shot every six months is transfabulous. Anything to make my life convenient, make my life simpler,\u201d she said. <\/p>\n Lenacapavir triggered surprisingly painful lumps at the injection sites on her abdomen, but it hasn\u2019t put her off. \u201cIt hurt so much for the first two weeks I couldn\u2019t laugh [or] do anything that required me to use my stomach muscles. But I\u2019m definitely going for my second dose,\u201d she said. <\/p>\n