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South Africa reports ‘significant’ progress in fight against HIV


But funding crunch means programmes need to become more targeted to sustain momentum, expert says

South Africa is making headway in its fight against HIV/Aids, new national data shows.

But the number of people living with HIV in South Africa—an estimated 7.8 million—and shrinking HIV/Aids budgets mean the data needs to be used to target the areas of greatest need to ensure these gains continue, an expert has said.

“We’ve made a lot of progress,” says Tarrylee Reddy, a specialist statistician in the South African Medical Research Council’s Biostatistics Research Unit, who worked on the survey. "But we have to continue and intensify [our work]."

‘Significant’ gains

The Sixth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey released its summary findings on 28 November. It shows that South Africa has made headway on the global 95-95-95 target, which states that by 2025, 95 per cent of all people living with HIV should know their status, that 95 per cent of those should be on antiretroviral treatment, and that 95 per cent of those on treatment should be virally suppressed.

In 2022, 90 per cent of South Africans living with HIV knew their status. Of them, 91 per cent were on treatment, and 94 per cent of those on treatment were virally suppressed.

This is a “significant improvement” from the last time this data was gathered, in 2017, when those proportions were 85 per cent, 71 per cent and 87 per cent, the survey team said.

The data also show that many inequalities remain in South Africa’s HIV epidemic. Women are almost twice as likely as men to have HIV, while Black people are nearly twenty times more likely to live with HIV than white people.

Geographically, HIV prevalence remains much higher in the east of the country than in the west, with KwaZulu-Natal having the highest overall prevalence, with 22 per cent of people aged 15 or over living with HIV.

Vital for planning

More detailed data on infection rates and socioeconomic factors that influence the HIV epidemic are due to be released next April, Reddy says. These will be vital to inform South Africa’s HIV/Aids response going forward, she adds—especially as HIV budgets are tight.

In October, the government’s mid-term budget proposed a 4 per cent, or R1 billion, cut to the country’s HIV/Aids funding in the current financial year. Section 27, a non-profit advocacy body, warned that this “may regress” progress on putting more people on antiretroviral treatment. 

“We’re dealing with a lot of uncertainty at the moment,” Reddy says. A more targeted approach, informed by district-level data identifying trends and hotspots, will help allocate limited funds effectively, Reddy says.