South Africa's HIV Prevalence Drops to 12.7%: New Survey Highlights Progress

In terms of treatment, the survey highlights a significant increase in antiretroviral treatment (ART) coverage, rising from 63.7% in 2017 to 80.9% in 2022.

The latest findings from the sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) reveal a notable decrease in HIV prevalence across the country, dropping from 14% in 2017 to 12.7% in 2022. This decline represents a reduction in the number of people living with HIV from 7.9 million to 7.8 million.

Released by the Human Sciences Research Council (HSRC) at the 2024 International AIDS Conference, the survey indicates that while HIV prevalence has decreased across all age groups, women continue to be disproportionately affected. The prevalence rate for females stands at 16.4%, compared to 8.8% for males. The highest prevalence is seen among females aged 35 to 39 years (34.2%), and males aged 45 to 49 years (27.1%).

HIV incidence in 2022 was 0.44% across all ages, equating to 232,400 new infections. The incidence rates varied by age group: 0.60% among adults aged 15 and older, 0.39% among youth aged 15 to 24, and 0.72% among adults aged 15 to 49. The survey also noted that HIV incidence rates were consistently higher in females compared to males across all age categories.

In terms of treatment, the survey highlights a significant increase in antiretroviral treatment (ART) coverage, rising from 63.7% in 2017 to 80.9% in 2022. This means approximately 5.7 million people living with HIV are now on ART, an increase from 4.5 million in 2017. Of those on ART, 83.2% are females and 76.2% are males. HIV viral load suppression stands at 81.4% across all ages.

The SABSSM VI survey, conducted between 2022 and 2023, assesses progress towards the South African national HIV and AIDS, STI, and TB Strategic Plan, as well as monitoring HIV indicators for national and international reporting. It also evaluates progress towards the 2030 UNAIDS 95-95-95 targets, which aim for 95% of people living with HIV to know their status, 95% of those diagnosed to receive continuous treatment, and 95% of those on treatment to achieve viral suppression by 2025.

Progress towards these targets is promising, with 89.6% of people living with HIV aware of their status, 90.7% of those aware being on treatment, and 93.9% of those on treatment achieving viral suppression. Improvement in these indicators has been more pronounced among males compared to females.

Despite these advances, challenges remain. The survey reveals that 73.1% of youth aged 15 to 24 are aware of their HIV status, with key drivers of HIV including early sexual debut, age-disparate relationships, multiple sexual partners, and low condom use. HIV-related stigma continues to be a significant issue, though most respondents hold positive attitudes towards people living with HIV.

The survey achieved a household response rate of 80% and an individual interview response rate of 94.1%, with 47,766 participants providing blood specimens for testing.

Professor Khangelani Zuma, the principal investigator, highlighted that while the survey indicates significant progress, there is still work to be done. Recommendations include continuing intensive programs to reduce new infections among adolescent girls and young women, and enhancing prevention efforts targeting groups disproportionately affected by HIV.

The findings underscore the need for ongoing efforts to combat the HIV epidemic and address the factors driving new infections, with the aim of mitigating the public health threat by 2030.