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By Ngaa Murombedzi, On behalf of AIDS Healthcare Foundation (AHF), Southern Africa Region (www.AIDSHealth.org). 

South Africa's introduction of long‑acting injectable HIV pre‑exposure prophylaxis (PrEP), Lenacapavir, is a welcome addition to the choices people have to protect against HIV. It signals scientific progress and renews hope in a country that remains at the heart of the global HIV epidemic. With approximately 7.8 million people living with HIV and an estimated 170 000 new infections recorded in 2024, our prevention response must be bold, people‑centred, and grounded in lived realities.

Lenacapavir offers particular promise for adolescent girls and young women, pregnant and breastfeeding mothers, and key and vulnerable populations who continue to face disproportionate HIV risk. For individuals who have struggled with daily oral PrEP adherence, a twice‑yearly injectable option could be life‑changing. Choice matters. Innovation matters. But innovation must never come at the expense of the fundamentals that have carried South Africa's HIV response forward for decades.

Lenacapavir is PrEP—but it is not comprehensive prevention. It protects against HIV, not against sexually transmitted infections (STIs) or unintended pregnancy. That distinction is not academic; it is critical in a country already burdened by some of the highest STI rates globally and persistently high levels of adolescent pregnancy. At this moment of biomedical progress, we must be clear: injectable PrEP does not replace condoms.

Condoms remain the only prevention tool that simultaneously protects against HIV, STIs, and unplanned pregnancy—and they remain the most cost‑effective intervention available to the public health system. Yet condom use, particularly among young women and within longer‑term or age‑disparate relationships, remains uneven. These patterns are not driven by lack of knowledge alone; they reflect entrenched gender norms, power imbalances, economic vulnerability, and limited negotiation autonomy. Any prevention strategy that ignores these demographic and social realities is destined to fall short.

This is why the rollout of Lenacapavir must strengthen—not weaken—condom promotion and access. In a context of constrained resources and competing health priorities, narrowing prevention messaging risks creating new pressures elsewhere in the system. Rising untreated STIs and ongoing high rates of teenage pregnancy are not side issues; they are core indicators of whether our HIV prevention approach is working.

Community engagement must therefore be non‑negotiable. Biomedical innovation does not succeed in isolation. Communities must fully understand what Lenacapavir is, how it works, how often it must be taken, and—crucially—what it does not protect against. We need ongoing, community‑led consultations that listen to people's experiences, from access barriers and service quality to perceptions of risk and protection. One‑off messaging is not enough. Listening must be continuous.

South Africa's progress against HIV has always been strongest when communities were not treated as passive recipients, but as drivers of change. We must return to that principle now. To stem the tide of HIV infections among key and vulnerable populations—while also reversing increases in STIs and teenage pregnancy—we need a deliberate behaviour shift anchored in co‑creation.

The ask is clear.

Government, donors, and implementing partners must:

• Position key and vulnerable populations as co‑creators of prevention messaging, not merely targets of it.
• Embed strong, visible condom promotion at every point of Lenacapavir rollout.
• Integrate routine STI screening and sexual health services into all HIV prevention encounters.
• Invest in peer‑led, community‑based education and distribution strategies that reflect real‑world relationships, risks, and constraints.
• Actively and consistently engage men and boys, recognizing that prevention responsibility cannot continue to rest disproportionately on women and girls.

We can welcome innovation without losing our foundations. Lenacapavir expands the prevention toolbox—but combination prevention remains the backbone of an effective response. Condoms, community leadership, and integrated sexual and reproductive health services are not optional add‑ons; they are essential.

As AIDS Healthcare Foundation in Southern Africa, we believe this moment can either strengthen our prevention architecture—or unintentionally weaken it. The difference lies in whether we choose to lead with communities, protect proven interventions, and balance biomedical ambition with social reality. If we do that, innovation will accelerate progress rather than compromise it—and South Africa will be closer to ending new HIV infections while safeguarding broader sexual and reproductive health for all.

Distributed by APO Group on behalf of AIDS Healthcare Foundation.

By Bas Wijne, CEO, APO Group (https://APO-opa.com).

At last month's PRCA South Africa conference, the leading PR and communications forum in the region, I joined a panel on PR as a Strategic Advisor: Ethics, Sustainability and Boardroom Influence alongside Annaleigh Vallie (Executive Head of Integrated Communication, Nedbank), and Larry Khumalo-MacArthur (Managing Director and Market Lead, Weber Shandwick Africa). The discussion reinforced that when communications is excluded from the boardroom, decision-making breaks down between formation and execution. In complex organisations, executive decisions are often interpreted differently across stakeholders, leading to early misalignment.

The most effective leadership teams address this by involving communications when decisions are formed.

Without this, the same course of action fractures in execution across stakeholders. The issue is not variation in interpretation itself, but the absence of a structured way to account for it in advance.

Communications is a co-architect that belongs in the boardroom, shaping how intent becomes a decision and how a decision becomes reality. This is especially clear in African markets. Differences in regulatory environments, culture, and stakeholder expectations mean the same announcement can be interpreted in fundamentally different ways across jurisdictions. Consider a single boardroom decision. A multinational announces a restructuring across several African territories – typically involving changes to operating models, workforce alignment, cost structures, and local responsibilities.

In one country, the decision is seen as a move toward efficiency and long-term growth. In another, it signals contraction. In a third, it raises questions about market commitment. The underlying decision stays the same, but its meaning shifts depending on where it lands.

These differences affect how decisions are executed across markets. Alignment weakens, not from a flawed strategy, but from fragmented meaning.  

For a co-architect, this means stress-testing decisions before they are final. Advising and assessing how they will land in different markets. Working directly with leadership teams to adjust how decisions are framed, sequenced, and released so that intent translates across markets.

APO Group operates as an example of this co-architect model, serving as a strategic communications consultancy that integrates advisory and execution. We don't just execute communications - we consult and advise at the boardroom level. We apply this approach across multiple African markets. Africa-Newsroom.com, our pan-African newswire and the only platform of its kind on the continent, distributes to 250+ Africa-focused news sites and 450,000+ journalists in all 54 countries. The same infrastructure that delivers messaging across the continent gives us the monitoring data to test how it will be received before a single line is published. That is what stress-testing means in practice.

When a global Fortune 500 telecommunications operator with multi-market African operations needed transformation across six African countries, they consolidated nine agencies into one partner: APO Group. Before announcing the decision, it was tested in each market. We checked how it signalled efficiency, retreat, or questions about commitment.

That insight was fed directly back into how the announcement was structured, sequenced, and released.

Messaging was then executed through a single coordinated system across all markets, rather than multiple disconnected systems.

The result was a 573% increase in top-tier media placements for the programme across key African markets compared to the previous multi-agency model, driven by unified messaging and faster execution cycles.

For organisations operating across multiple African markets, fragmented communications create fragmented decisions. Integrated communications strengthen delivery. In this environment, communications is part of how leadership decisions hold their meaning as they move across borders.

The question for leadership teams is not whether communications supports decisions, but whether it is involved early enough to ensure those decisions hold their meaning as they move across markets.

And ultimately: is communications shaping the decision itself, or only being asked to manage its interpretation after it leaves the boardroom?

Distributed by APO Group on behalf of APO Group Insights.

Media Contact:
marie@apo-opa.com 

About APO Group:
Founded in 2007 by Nicolas Pompigne-Mognard, APO Group is the communications consultancy built for performance – combining strategic advisory, on-the-ground execution, and guaranteed visibility across all 54 African markets. Its owned newswire, Africa Newsroom, secures placement on 250+ Africa-focused news sites, connecting organisations directly with journalists, analysts, investors, and policymakers worldwide.

Recognised internationally for communications excellence including SABRE, Davos Communications, and World Business Outlook distinctions, APO Group partners with global and African organisations to deliver communications that perform. Clients include the African Development Bank Group, Africa CDC, Afreximbank, NFL, Nestlé, Emirates, Canon, Western Union, GITEX Global, and Cassava Technologies.