HIV/AIDS in South Africa

HIV prevalence does not indicate that a country has an AIDS crisis, as HIV and AIDS are separate conditions. HIV prevalence, instead, indicates that people remain alive despite the infection. South Africa has the largest HIV treatment programme in the world. World Bank Open data explains the data it publishes on HIV prevalence as follows: South Africa's HIV treatment programme was launched in earnest in 2005. The trend in South Africa's HIV and AIDS statistics has changed significantly in the years since then. == Latest data on HIV prevalence in South Africa ==

The World Bank and United Nations source their data on HIV prevalence from Statistics South Africa. According to Statistics South Africa's mid-year population estimates for 2018, the total HIV prevalence rate for the country is 13.1%. The HIV prevalence rate for all adults aged 15 to 49 is 19.0%.Statistics South Africa estimates the number of deaths attributable to AIDS in 2017 as 126,755 or 25.03% of all South African deaths. == Other statistics ==

By race A 2008 study revealed that HIV/AIDS infection in South Africa was distinctly divided along racial lines: 13.6% of Black Africans in South Africa are HIV-positive, whereas only 0.3% of Whites living in South Africa have the disease. False traditional beliefs about HIV/AIDS, which contribute to the spread of the disease, persist in townships due to the lack of education and awareness programmes in these regions. Sexual violence and local attitudes toward HIV/AIDS have also amplified the epidemic. By gender HIV/AIDS is more prevalent among females, especially those under the age of 40. Women made up roughly 4 in every 5 people with HIV/AIDS aged 20–24, and 2 out of 3 of those aged 25–29. Although prevalence is higher among women in general, only 1 in every 6 HIV/AIDS infected people with multiple sex partners is a woman. Young boys and girls in South Africa are both highly affected by intimate partner violence and HIV/AIDS. Research has found links between the two, as well as a relationship with drug use. It was found that problem drinking and cannabis use are mediating variables in the relationship between men who experienced childhood sexual abuse and who engage in HIV sexual risk behaviors. One 2006 study also noted that alcohol and increased HIV risk are linked to gender-based violence in two specific ways: one being that the consumption of alcohol might lead to increased sexual violence against women who refuse sex, and that women may be abused for disclosing their positive status to their partner. Furthermore, women and men both experience difficulty disclosing their HIV positive status for various reasons, the most common of which being that women fear abandonment or retaliative violence, while men fear embarrassment and shame. By pregnant women HIV prevalence among pregnant women is highest in the populous KwaZulu-Natal province (37%), and lowest in the Western Cape (13%), Northern Cape (16%), and Limpopo (18%) provinces. In the five other provinces (Eastern Cape, Free State, Gauteng, Mpumalanga, and North West), at least 26% of women attending antenatal clinics in 2006 tested HIV-positive. The latest HIV data collected at antenatal clinics suggest that HIV infection levels might be levelling off, with HIV prevalence in pregnant women at 30% in 2007, 29% in 2006, and 28% in 2005. The decrease in the percentage of young pregnant women (15–24 years) found to be infected with HIV can be extrapolated to suggest a possible decline in the annual number of new infections. By age Between 2005 and 2008, the number of older teenagers with HIV/AIDS nearly halved. Between 2002 and 2008, prevalence among South Africans over 20 years old increased. Between 2005 and 2008, the total number of people infected with HIV/AIDS increased in all of South Africa's provinces except KwaZulu-Natal and Gauteng. Nevertheless, KwaZulu-Natal still has the highest infection rate at 15.5%. In the province with the lowest infection rate, the Western Cape, the total number of people with HIV/AIDS doubled between 2005 and 2008. • KwaZulu-Natal: 27.0% • Mpumalanga: 22.8% • Free State: 25.5% • North West: 22.7% • Gauteng: 17.6% • Eastern Cape: 25.2% • Limpopo: 17.2% • Northern Cape: 13.9% • Western Cape: 12.6% == Awareness campaigns ==

The four main HIV/AIDS awareness campaigns in South Africa are Khomanani (funded by the government), LoveLife (primarily privately funded), Soul City (a television drama for adults) and Soul Buddyz (a television series for teenagers). Soul City and Soul Buddyz are the most successful campaigns, although both experienced a slight decline in effectiveness between 2005 and 2008. Khomanani is the least successful campaign, although its effectiveness has increased by more than 50% between 2005 and 2008. The dubious quality of the condoms distributed is a setback to these efforts. In 2007, the government recalled more than 20 million locally manufactured condoms due to defects. Some of the contraceptive devices given away at the ANC's centenary celebrations in 2012 failed a water test conducted by the Treatment Action Campaign. == Co-infection with tuberculosis ==

In 2007, it was estimated that one-third of HIV infected people would develop TB (tuberculosis) in their lifetimes. In 2006, 40% of TB patients were tested for HIV. It has been the government policy since 2002 to cross-check all new cases of TB for HIV infection. Although STI prevention is part of the government's HIV/AIDS programmes, as is that of most countries, in South Africa, HIV/AIDS prevention is done in conjunction with TB prevention. Tuberculosis remains the leading cause of death among people living with HIV in South Africa, and most patients who die from HIV-related causes die from TB or similar opportunistic infections. In fact, the Health Department's prevention program is called the “National HIV and AIDS and TB Programme”. In line with United Nations requirements, South Africa has also drawn up an "HIV & AIDS and STI Strategic Plan". == History ==

In 1983, AIDS was diagnosed for the first time in two patients in South Africa. The first recorded AIDS-related death occurred in the same year. The project was dogged by controversy and was finally shelved in 1996. From 6 to 10 March 1995, the 7th International Conference for People Living with HIV and AIDS was held in Cape Town, South Africa. The conference was opened by then-Deputy President Thabo Mbeki. In January 1996, it was decided that South Africa's national soccer team, Bafana Bafana, would contribute to the AIDS Awareness Campaign by wearing red ribbons to all their public appearances during the Africa Nations Cup. On 5 July 1996, South Africa's Health Minister, Nkosazana Dlamini-Zuma, spoke at the 11th International Conference on AIDS in Vancouver. She said: In February 1997, the South African government's Health Department defended its support for the controversial AIDS drug Virodene by stating that "the 'cocktails' that are available [for the treatment of HIV/AIDS] are way beyond the means of most patients [even from developed countries]". Parliament had previously launched an investigation into the procedural soundness of the clinical trials for the drug. In 1999, the South African HIV prevention campaign LoveLife was founded. 2000s In 2000, the Department of Health outlined a five-year plan to combat AIDS, HIV, and STIs. A National AIDS Council (SANAC) was set up to oversee these developments. The South African government successfully defended against a legal action brought by transnational pharmaceutical companies in April 2001, challenging a law that would allow the importation of cheaper, locally produced medicines, including anti-retrovirals. However, the government's rollout of anti-retrovirals remained generally slow. Also in 2001, Right to Care, an NGO dedicated to the prevention and treatment of HIV and associated diseases, was founded. Using USAID's PEPFAR funding, the organisation expanded rapidly and after ten years (2011) had over 125,000 HIV-positive patients in clinical care. In 2002, South Africa's Constitutional Court ordered the government to remove restrictions on the drug nevirapine and make it available to pregnant women in all state hospitals and clinics to help prevent mother-to-child transmission of HIV, following a court challenge by Treatment Action Campaign and others. In 2007, Anand Reddi and colleagues at the PEPFAR funded Sinikithemba HIV/AIDS clinic at McCord Zulu Hospital in KwaZulu-Natal, South Africa published the first report demonstrating paediatric antiretroviral therapy can be effective despite the challenges of a resource-limited setting. Notably, the model at Sinikithemba HIV/AIDS clinic demonstrated the benefits of a family centred model of care and data suggests that an HIV-positive primary caregiver was found to be protective against paediatric mortality. 2020s In 2025, President of the United States, Donald Trump, cut foreign aid funding to numerous countries, directly impacting a major HIV research project in South Africa In July 2025, South Africa secured R520 million (approximately USD 29 million) in funding from the Global Fund to Fight AIDS, TB, and Malaria. The funding will be used to purchase the biannual anti-HIV injection, lenacapavir, manufactured by Gilead Sciences. Research has shown that lenacapavir, an antiretroviral medication, could work towards ending HIV/AIDS in South Africa. == Demographics ==

According to the National HIV and Syphilis Antenatal Sero-prevalence Survey of 2005 and 2007, the percentage of pregnant women with HIV per year was as follows: According to a 2006 study by the South African Department of Health, 13.3% of 9,950 Africans who were included in the poll had HIV. Out of 1,173 whites, 0.6% had HIV. These numbers are confirmed in a 2008 study by the Human Sciences Research Council that found a 13.6% infection rate among Africans, 1.7% among Coloureds, 0.3% among Indians, and 0.3% among Whites. In 2007, it was estimated that between 4.9 and 6.6 million of South Africa's 48 million people of all ages were infected with HIV, which is the virus that causes AIDS. == AIDS denialism under Thabo Mbeki ==

2000 On 9 July 2000, then President Thabo Mbeki opened the XIII International AIDS Conference in Durban with a speech not about HIV or AIDS but about extreme poverty in Africa. In the speech, he confirmed his belief that immune deficiency is a big problem in Africa, but that one can't possibly attribute all immune deficiency-related diseases to a single virus. On 4 September 2000, Thabo Mbeki acknowledged during an interview with Time magazine (South African edition) that HIV can cause AIDS but confirmed his opinion that HIV should not be regarded as the sole cause of immune deficiency. He said: On 20 September 2000, then-President Thabo Mbeki responded to a question in Parliament regarding his views. He said: 2001 In 2001, the government appointed a panel of scientists, including several AIDS denialists, to report back on the issue. The report suggested alternative treatments for HIV/AIDS, but the South African government responded that unless alternative scientific proof is obtained, it will continue to base its policy on the idea that the cause of AIDS is HIV. 2003 Despite international drug companies offering free or cheap antiretroviral drugs, the Health Ministry remained hesitant about providing treatment for people living with HIV. Only in November 2003 did the government approve a plan to make antiretroviral treatment publicly available. Before 2003, South Africans with HIV who used the public sector health system could get treatment for opportunistic infections but could not get anti-retrovirals. Although many scientists and political figures called for her removal, she was not removed from office until Mbeki himself was removed from office. These policies led to the deaths of over 300,000 South Africans. 2007 In August 2007, President Mbeki and Health Minister Tshabalala-Msimang dismissed Deputy Health Minister Nozizwe Madlala-Routledge. Madlala-Routledge has been widely credited by medical professionals and AIDS activists. Although she was officially dismissed for corruption, it was widely held that she was dismissed for her more mainstream beliefs about AIDS and its relation with HIV. == Role of the media in South Africa's epidemic ==

The South African press took a strong advocacy position during the denialism era under Thabo Mbeki. There are numerous examples of journalists taking the government to task for policy positions and public statements that were seen as irresponsible. outrage at Mbeki's statement that he never knew anyone who had died of AIDS, and coverage of the humiliating 2006 International AIDS Conference. It could be claimed that the news media have taken a less aggressive stance since the end of Mbeki's presidency and the death of Tshabalala Msimang. The emergence of Jacob Zuma as party and state leader heralded what the press saw as a new era of AIDS treatment. However, this also means that HIV is afforded less news coverage. A recent study by the HIV/AIDS and the Media Project has shown that the quantity of HIV-related news coverage has declined dramatically from 2002/3 (what could be considered the pinnacle of government AIDS denialism) to the more recent "conflict resolution" phase under Zuma. Perhaps HIV has fallen into the traditional categories of being impersonal, undramatic, "old" news. == See also ==