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At a glance: HIV in South Africa

The biggest HIV epidemic in the world 

Key statistics

In 2020:

  • 7.8 million people with HIV 
  • 19.1% adult HIV prevalence 
  • 230,000 new HIV infections 
  • 83,000 AIDS-related deaths 
  • 72% 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.

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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.

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. 

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, with almost 5.1 million adults (aged 15 years and older) receiving treatment in 2020. 

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 a prevalence of 21.5% compared to 13.1% in men. Around one-third of women are likely to experience intimate partner violence in South Africa. This is a huge issue, which can prevent women from testing for HIV, 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 therapy. 

It is estimated that 57.7% of sex workers have HIV. Female sex workers with HIV are consistently less likely to know their HIV status than adult women overall. 

Gay men and other men who have sex with men with HIV are much less likely to know their HIV status compared with the overall adult male population with HIV. 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. 

Next: At a glance: HIV in Uganda

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