By Mohale Moloi, Yolanda Mdzeke, Jessica Pitchford
- South Africa’s medicines regulator, the South African Health Products Regulatory Authority (Sahpra), has approved a two-monthly anti-HIV injection. At the Emavundleni Prevention Research Centre in Nyanga outside Cape Town, more than 200 women have been taking the jab as part of a clinical trial.
- The shot almost entirely cancels people’s chances of contracting HIV through sex. It’s also easier to stick to than the daily HIV prevention pill because it only has to be taken once every two months.
- Our reporters travelled to Cape Town and spoke to three women who’ve become HIV prevention advocates in their communities. Watch the video to find out why they’re worried about getting the virus. They also tell us how the injection, called CAB-LA, has changed their lives.
An anti-HIV injection called CAB-LA has just been approved by South Africa’s medicines regulator, and the health department says it could be in clinics by August 2023 — but only if the price is right. In Cape Town, more than 200 women have been using the two-monthly jab as part of a study. We spoke to three of them.
A two-monthly anti-HIV injection has been a game changer for the Cape Town women who got access to it through a clinical trial known as HPTN084. The jab, called CAB-LA, practically nullifies people’s chances of contracting HIV, partly because it’s so much easier to take than a daily oral pill.
It can be hard to stick to a daily regimen, says Amanda Roberts, one of 200 women who took part in the open-label arm of the study at the Emavundleni Research Centre in Nyanga. “Some days I’m not at home, I’m having fun, and I don’t have my pills on me. I used to think: I’m going to take tablets to a party? No way.”
In an open-label study both the researchers and participants know which drug trial participants receive.
The injection isn’t only convenient, it’s empowering too, says Boleka Ntshintshi. “You know men don’t want to use condoms,” she says, but with CAB-LA it’s become easier for Ntshintshi to protect herself. “It isn’t about what your partner says. It’s all about you.”
Ntshintshi concludes: “I’ve regained my dignity. I feel powerful.”
Sinethemba Kolisile says the jab has given her peace of mind. “The times we’re living in are dangerous. There are a lot of rapes. You don’t know whether your rapist is HIV positive.”
The three women want the injection to be available for everyone.
Studies show the shot can prevent up to a quarter of South Africa’s new annual infections (52 000 out of 200 000).
South Africa’s medicines regulator the South African Health Products Regulatory Authority (Sahpra) approved the jab on 2 December, and the health department told Bhekisisa it could be in clinics by August 2023 — as long as it’s affordable.
Watch the full video to find out how CAB-LA works to prevent HIV from entering people’s cells.
If you leave the Cape Town CBD via the N2 highway, in about 20 km you’ll get to the township of Nyanga.
It was once named South Africa’s murder capital.
While crime – and its accompanying social ills – are something Amanda Roberts has learnt to live with around here, she’s grateful that she doesn’t also have to live with HIV.
It took her mother’s life in 2016.
AMANDA ROBERTS, CAB-LA study participant
“My mom’s twin also has HIV. That’s why I decided to join the study. Because I didn’t want to go the same route they had to go.”
Amanda is part of a clinical trial, which has been ongoing for the past 5 years.
About 200 young women have chosen to get a new injection every two months.
The shot contains a drug called cabotegravir or CAB-LA for short. It virtually wipes out their chances of contracting HIV through sex.
They get the jab here at the Emavundleni clinic in a part of Nyanga called Crossroads.
For Amanda, the injection has replaced a daily HIV prevention pill she used to take. She struggled to take it regularly.
AMANDA ROBERTS, CAB-LA study participant
“Some days I’m not at home, I’m having fun, so I don’t have my tablets with me – you understand? Because I used to think ‘I’m going to carry tablets to a party? No way’. That’s when the problem started because I used to skip maybe a day, without taking them.”
For Boleka Ntshintshi, the injection is not only more convenient, it’s empowering. This form of HIV prevention is also called PrEP. She says PrEP gives her more control over her life.
BOLEKA NTSHINTSHI, CAB-LA study participant
“It’s important to tell yourself, ‘this is my responsibility to protect myself.’ Because you know men don’t want to use condoms. So, it isn’t about what your partner says, it’s all about you taking responsibility over your life.”
Studies show the injection works better to prevent HIV infection than the daily pill — likely because it’s easier to adhere to.
22-year-old Sinethemba Kolisile says her community needs CAB-LA because of sexual violence.
SINETHEMBA KOLISILE, CAB-LA study participant
“The times we live in are dangerous, and there are a lot of rapes, like within one year there are too many that occur, and you don’t know whether or not your rapist is HIV positive.”
Steven Innes heads the clinical trial unit at Emavundleni.
He says HIV enters the cells in our bodies and makes copies of itself that look like our DNA …
STEVEN INNES, Clinical research leader
“That’s why HIV can’t be cured. Once it’s integrated, once its part of your cells, you can’t get rid of it. Cabotegravir is able to prevent HIV from integrating its DNA into the cell’s DNA. In other words, it prevents the cell from becoming infected in the first place.”
There were 200 000 new HIV infections in South Africa last year, CAB-LA can help to stop this.
But while it may be a game changer there’s a cost factor.
In the United States CAB-LA sells for R54 000 a pop.
ViiV Healthcare, which makes the injection, says they will lower the price for African countries.
But they haven’t yet announced how much it will cost.
Amanda, Boleka and Sinethemba hope their friends and loved ones can one day get the same protection as them – from a pandemic that has taken millions of lives.
This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.