National youth programme begins implementation across OR Tambo District, coinciding with the introduction of Lenacapavir, the twice-yearly injectable PrEP option.
CAPE TOWN, SOUTH AFRICA: 1 APRIL 2026: TB HIV Care (THC), is among the South African partners implementing the My Journey Youth Programme across 19 sub-districts in 11 districts spanning eight of South Africa’s nine provinces. In the Eastern Cape, THC in collaboration with Community-Based Organisations, health facilities, and schools, will be delivering free, confidential HIV prevention, sexual and reproductive health, and human rights services to adolescent girls and young women (15–24). Funded as an implementing partner for NACOSA, which has been appointed as the principal recipient by the Global Fund, the programme launches in the OR Tambo District as part of a national effort, its largest to date, aiming to reach over 380,000 young women across eight provinces between December 2025 and March 2028.
“My Journey is designed to meet young women exactly where they are, without judgement, and to walk alongside them as they make choices about their health”, said Prof. Harry Hausler, Chief Executive Officer of TB HIV Care. “We are proud to anchor this programme in the Eastern Cape, and we are committed to ensuring that it is delivered with the quality, dignity, and respect that every young woman deserves”, Hausler emphasised.
In South Africa, as of 2024, an estimated 8 million people are living with HIV, representing approximately 13% of the global total, of whom 5.2 million are women.(1) Despite significant progress in treatment coverage and a 53% reduction in new infections since 2010, the country recorded approximately 170,000 new HIV infections in 2024 alone, the highest annual total globally.(2) At the centre of this crisis are adolescent girls and young women (AGYW). In South Africa, AGYW aged 15 to 24 account for approximately 25% of all new HIV infections, despite comprising a fraction of the overall population.(3) Each week, an estimated 1,000 AGYW in South Africa are newly infected with HIV.(4) The gender disparity is stark: HIV prevalence among women aged 20 to 24 is 15.6%, more than three times the 4.8% recorded among their male peers in the same age group.(5)
THC will deliver services across the OR Tambo District through 27 health facilities and more than 34 schools and colleges across the Nyandeni and Port St Johns Local Municipalities. Services are delivered through an integrated model encompassing health facilities, places of learning, mobile clinical units, and community safe spaces, ensuring that care reaches young women where they live, learn, and gather. Research in OR Tambo and Chris Hani Districts has recorded antenatal HIV prevalence as high as 38.2% in some rural communities, with HIV prevalence increasing significantly with age and gravidity in younger women.(6) A 2024 study in the Nyandeni Local Municipality, within OR Tambo District, confirmed that HIV disproportionately affects AGYW in this specific geography, compounded by age-disparate sex, transactional relationships, poverty, unemployment, and entrenched gender power imbalances.(7) Despite being the population most urgently in need of HIV prevention, many remain unreached.
A watershed moment…
The launch of My Journey in the Eastern Cape coincides with a noteworthy moment in global HIV prevention. In 2025, the South African Health Products Regulatory Authority (SAHPRA) approved Lenacapavir, a twice-yearly injectable pre-exposure prophylaxis (PrEP) option, for use in HIV-negative individuals at risk of HIV infection. The approval is underpinned by landmark clinical trial evidence.
“We are entering a genuinely transformative period in HIV prevention”, said Jennifer Mcloughlin, Programme Director: Prevention in Priority Populations, TB HIV Care. “The evidence for Lenacapavir is extraordinary, 100% efficacy in young women in South Africa is not a number we have ever seen before in prevention science”, Mcloughlin highlighted.
For adolescent girls and young women, the population for whom daily oral PrEP adherence has historically been difficult to sustain, Lenacapavir represents a potential paradigm shift. South Africa, which already accounts for approximately 20% of global oral PrEP initiations, is positioned to become an early-adopter country for Lenacapavir rollout, integrated into existing HIV prevention programmes including My Journey.(8) Lenacapavir will be offered on a phased basis through public health facilities providing PrEP. It is available only to individuals who test HIV-negative, and is administered as two subcutaneous injections in the abdomen every six months, accompanied by a two day oral loading dose provided on the first visit.
“My Journey is ideally positioned to translate this science into practice. We reach adolescent girls and young women in communities where HIV incidence is among the highest in the world, we offer non-judgemental services, and we provide the individualised support that makes adherence possible. Integrating Lenacapavir into our prevention package gives young women a meaningful choice, a choice that could protect them for six months at a time, and change the trajectory of their lives”, Mcloughlin concluded.
The South African National Department of Health has developed implementation guidelines to support the safe, effective, and equitable rollout of Lenacapavir as an additional, not replacement, HIV prevention option alongside oral PrEP, condoms, and PEP.
References:
- Johnson, L.F. (2025) Thembisa model version 4.8: estimates of HIV prevalence and incidence in South Africa. Cape Town: University of Cape Town Centre for Infectious Disease Epidemiology and Research.
- UNAIDS (2025) HIV data and statistics: South Africa. Geneva: Joint United Nations Programme on HIV/AIDS.
- Mntonintshi-Mketo, L.N. and Netangaheni, R.T. (2024) ‘HIV and sexual risk behaviours by 18-25-year-old youth at Nyandeni Municipality in the Eastern Cape’, Health SA Gesondheid, 29, article 2541.
- United Nations in South Africa (2023) The link to schooling and HIV infection rate is clear – and teenage girls are most vulnerable. Pretoria: United Nations South Africa.
- Abdullah, F. et al. (2019), cited in: Mntonintshi-Mketo, L.N. and Netangaheni, R.T. (2024) ‘HIV and sexual risk behaviours by 18-25-year-old youth at Nyandeni Municipality in the Eastern Cape’, Health SA Gesondheid, 29, article 2541.
- Madiba, S. and Mokgatle, M. (2021) ‘Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa’s Eastern Cape province’, PLOS ONE, 16(1), e0244581.
- Mntonintshi-Mketo, L.N. and Netangaheni, R.T. (2024) ‘HIV and sexual risk behaviours by 18-25-year-old youth at Nyandeni Municipality in the Eastern Cape’, Health SA Gesondheid, 29, article 2541.
- Meyer-Rath, G. et al. (2025) ‘Taking injectable PrEP to scale: optimising the value of Lenacapavir for South Africa’s HIV response’, medRxiv [preprint], 14 December 2025.
Issued by:
- Aziel Gangerdine
- TB HIV Care, Spokesperson
- E-mail: aziel@tbhivcare.org
- Cell: +27 (0) 66 545 6053
ENDS.
TB HIV Care
TB HIV Care is a registered non-profit company (NPC) that puts integrated care at the heart of responding to TB, HIV, and other major diseases. We work to prevent, find and treat TB and HIV in South Africa as well as targeting our interventions to address the needs of populations most at risk, including underserved communities, adolescent girls and young women, inmates in correctional centres, sex workers and people who inject drugs.
