Let Communites Lead The Fight Against AIDS

By Sinazo Mkoko

The world can end AIDS, with communities leading. This was the key message for the 2023 World AIDS Day, celebrated globally on December 1. The day was celebrated under the theme “Let Communities Lead”, as the world came together to show support for people living with HIV and to remember those who have lost their lives from AIDS-related illnesses.

Where does South AfrIca Stand?

The percentage of people living with HIV in South Africa decreased from 14.0% in 2017 to 12.7% in 2022. This is according to the Sixth South African National HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI), conducted by the Human Sciences Research Council (HSRC) in collaboration with its partners. The survey’s key findings, announced on Tuesday, November 28, emphasise progress towards eradicating HIV in South Africa, the country with the world’s largest HIV pandemic. The HSRC stated that the latest figure translates to approximately 7.8 million people living with HIV in South Africa in 2022, compared to 7.9 million in 2017.

According to Professor Khangelani Zuma, Divisional Executive of the Public Health, Societies, and Belonging Division of the HSRC and the overall Principal Investigator of the survey, a number of factors contribute to HIV prevalence. “These factors include fewer people getting infected with HIV, more children born HIV-negative, AIDS-related mortality, and people ageing and dying from natural causes. The increase in the population (birth of HIV-negative babies) would also increase the denominator of HIV-negative people in the country. The epidemic curve also shows an ageing population of people living with HIV who are living longer as the epidemic stabilises,” said Professor Zuma. 

According to the 2022 survey, South Africa has made significant progress towards the UNAIDS 95-95-95 targets, which call for 95% of all people living with HIV to be aware of their HIV status by 2025, 95% of those aware of their status to be on antiretroviral treatment (ART), and 95% of those on ART who are also aware that they are living with HIV to achieve viral load suppression. SABSSM VI revealed that in 2022, 90% of people aged 15 and older living with HIV in South Africa were aware of their status, 91% of those aware were on ART, and 94% of those on ART were virally suppressed.

The survey also shows that in 2022, 81% of people aged 15 and older living with HIV in South Africa were virally suppressed (less than 1000 copies/mL), up from 62% in 2017. Viral suppression was higher (83%) in women than in men (79%) and lower (70%) in young adults (15–24 years). Men aged 25–34 had the lowest proportion of viral load suppression (66%).


“The 2022 survey also shows gaps that remain in addressing the HIV epidemic in South Africa. Among people aged 15 years and older, the impact of the HIV epidemic in South Africa is unequal across geographic regions and populations, particularly affecting black Africans, women, and young people. HIV prevalence varied geographically, ranging from 8% in the Western Cape Province to 22% in KwaZulu-Natal Province.

“Furthermore, HIV prevalence was nearly twice as high among women (20%) compared to men (12%). By race, HIV prevalence was the highest among black Africans (20%), followed by Coloureds (5%), and lowest among Whites and Indian/ Asian people (1% each).” – HSRC. Delivering his keynote address in his capacity as the Chairperson of the South African National AIDS Council (SANAC), Deputy President Paul Mashatile called on communities to actively participate in interventions to combat “stigma, discrimination, and human rights violations affecting individuals infected and affected by HIV/AIDS.”

“History demonstrates that when communities unite, any challenge can be overcome. Our combined strengths can help us achieve the goal of eliminating HIV/AIDS and tuberculosis as public health threats,” he said. Hon. Mashatile added that the participation of civil society has been crucial in the HIV response globally and in South Africa, “leading to significant progress in areas like access to prevention, treatment, care, and support, as well as outreach for vulnerable populations.” Touching on the SABSSM VI survey, Hon. Mashatile said that while the results show that the prevalence of HIV is declining, there are some concerning patterns regarding the age group between the ages of 25 and 49 years.

“Among females, HIV prevalence was highest in ages 35 to 39 years at 34.2%, whereas among males, HIV prevalence was highest in ages 45 to 49 years at 27.1%. “Furthermore, there is reason for concern about the increased incidence of HIV infection among adolescent girls aged 15 to 19, since it is an indication that men engage in unprotected sexual activities with girls and young women. “We must take extraordinary measures as a society to protect kids against immoral predators. We must ensure that children have a safe environment to discuss the issues influencing their sexual conduct and the pressures they are under. We must stand with them and educate them about their rights and sexual health.” Hon. Paul Mashatile.

All relevant documents, including the presentation and summary sheet about SABSSM VI, can be viewed here.

Sources: SAMRC|SAGov|HSRC| The Presidency

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