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At a glance: HIV in South Africa

The biggest HIV epidemic in the world

Key statistics: 2021

  • 7.5 million people with HIV
  • 18.3% adult HIV prevalence
  • 210,000 new HIV infections
  • 51,000 AIDS-related deaths
  • 5.5 million people on antiretroviral treatment

Progress towards targets

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

In 2021 in South Africa:

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Did you know?

South Africa has made huge improvements in getting people to test for HIV in recent years and met the 2020 target of 90% of people with HIV knowing their status in 2018. But it is behind on increasing access to HIV treatment, hampered by the need to provide HIV treatment for more people than any other country in the world.

Prevention

Preventing HIV in South Africa focuses on:

  • prevention of mother-to-child transmission
  • distributing condoms, including male and female condoms
  • voluntary medical male circumcision
  • PrEP – a daily pill that can prevent HIV (vaginal ring and injectable being trialled)
  • management of sexually transmitted infections, including partner infections
  • linking closely to HIV testing services.

Did you know?

South Africa was the first country in sub-Saharan Africa to fully approve PrEP, which is now being made available to people at high risk of infection, such as sex workers. The country has remained focused on increasing PrEP access in recent years by introducing things such as mobile PrEP clinics, despite the challenges of the COVID-19 pandemic.

Testing

Testing for HIV is lower among:

  • men
  • people with a lower socio-economic background
  • people living in rural areas.

Did you know?

It is possible to self-test for HIV at home in South Africa, which is popular among young people and people from key affected populations.

Treatment

Treatment for HIV is:

  • free 
  • started as soon as someone tests positive 
  • usually a three-in-one tablet 
  • received by more people with HIV than any other country in the world.

Did you know?

The South African government changed the usual first-line treatment regimen it offers in 2017, to a Dolutegravir-containing fixed dose combination, which has been found to have fewer side effects.

Local context

Women continue to bear a disproportionate burden of the HIV epidemic, with women twice as likely to have HIV than men. Around one-third of women are likely to experience intimate partner violence in South Africa – and this has increased in recent years, linked to the fallout of the COVID-19 pandemic. Violence against women and girls is a huge issue, and can prevent women from testing for HIV and starting and staying on treatment. It also helps drive transmission.

Men in South Africa are less likely than women to use HIV services, including HIV testing and starting and staying on antiretroviral treatment.

It is estimated that around 58% of sex workers have HIV. Female sex workers with HIV are consistently less likely to know their HIV status than other adult women.

Gay men and other men who have sex with men with HIV are much less likely to know their HIV status compared with other men. However, when they do know their HIV status, they are more likely to receive HIV treatment and be virally suppressed.

HIV-related stigma remains an issue – around 17% of people hold discriminatory attitudes towards people with HIV, according to UNAIDS data. But this is lower compared to other countries in the region.

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  • Last updated: 31 March 2023
  • Last full review: 01 March 2025
  • Next full review: 01 March 2025
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