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South Africa is currently experiencing one of the most severe HIV epidemics in the world. By the end of 2005, there were five and a half million people living with HIV in South Africa, and almost 1,000 AIDS deaths occurring every day, according to UNAIDS estimates.¹ A survey published in 2004 found that South Africans spent more time at funerals than they did having their hair cut, shopping or having barbecues. It also found that more than twice as many people had been to a funeral in the past month than had been to a wedding.²

A number of factors have been blamed for the rapid rise in HIV prevalence in South Africa, and debate has raged about whether the Government’s response to the epidemic has been sufficient. This page aims to examine the effect that AIDS has had on the country, the measures that have been taken to prevent it, and the current attitudes and viewpoints that surround the crisis.

To find out more about the number of people that have been affected by HIV and AIDS in South Africa, visit our South Africa statistics page.

History

South Africa has had a turbulent past, and this history is relevant to the explosive spread of HIV in the country.

1980s - In 1985, a State of Emergency was declared in South Africa that would last for five years. This was a result of riots and unrest that had arisen in response to Apartheid, the system of racial segregation that had been in place since the 1950s. Apartheid prohibited mixed-race marriages and sex between different ethnic groups, and categorised separate areas in which different races lived. In the same year, the Government set up the country’s first AIDS Advisory Group in response to the increasingly apparent presence of HIV amongst South Africans. The first recorded case of AIDS in South Africa was diagnosed in 1982, and although initially HIV infections seemed mainly to be occurring amongst gay men, by 1985 it was clear that other sectors of society were also affected. Towards the end of the decade, as the abolition of Apartheid began, an increasing amount of attention was paid to the AIDS crisis.

1990 - The first national antenatal survey to test for HIV found that 0.8% of pregnant women were HIV positive³. It was estimated that there were between 74,000 and 120,000 people in South Africa living with HIV. Antenatal surveys have subsequently been carried out annually.

1991 - The number of diagnosed heterosexually transmitted HIV infections equalled the number transmitted through sex between men. Since this point, heterosexually acquired infections have dominated the epidemic. Several AIDS information, training and counselling centres were established during the year.

1992 - The Government’s first significant response to AIDS came when Nelson Mandela addressed the newly-formed National AIDS Convention of South Africa (NACOSA), although there was little action from the Government in the following few years. The purpose of NACOSA was to begin developing a national strategy to cope with AIDS. The free National AIDS Helpline was founded.

1993 - The National Health Department reported that the number of recorded HIV infections had increased by 60% in the previous two years and the number was expected to double in 1993. The HIV prevalence rate among pregnant women was 4.3%.

1994 - The Minister for Health accepted the basis of the NACOSA strategy as the foundation of the Government's AIDS plan. There was criticism that the plan, however well intended, was poorly thought-out and disorganised. The South African organisation Soul City was formed, with the aim of developing media productions to educate people about health issues, including HIV/AIDS.

1995 - The International Conference for People Living with HIV and AIDS was held in South Africa, the first time that the annual conference had been held in Africa. The then Deputy President, Thabo Mbeki, acknowledged the seriousness of the epidemic, and the South African Ministry of Health announced that some 850,000 people - 2.1% of the total population - were believed to be HIV positive.⁴

1996 - The HIV prevalence rate among pregnant women was 12.2%.

1997 - The HIV prevalence rate among pregnant women was 17.0%. A national review of South Africa's AIDS response to the epidemic found that there was a lack of political leadership.

1998 - The pressure group Treatment Action Campaign (TAC) was founded, to advocate for the rights of people living with HIV/AIDS and to demand a national treatment plan for those who were infected. Deputy President Thabo Mbeki launched the Partnership Against AIDS, admitting that 1,500 HIV infections were occurring every day.

1999 - The HIV prevalence rate among pregnant women was 22.4%.

2000 - The Department of Health outlined a five-year plan to combat AIDS, HIV and STIs.⁵ A National AIDS Council was set up to oversee these developments. At the International AIDS Conference in Durban, the new South African President Thabo Mbeki made a speech that avoided reference to HIV and instead focused on the problem of poverty, fuelling suspicions that he saw poverty, rather than HIV, as the main cause of AIDS. President Mbeki consulted a number of ‘dissident’ scientists who rejected the link between HIV and AIDS.

2001 - The HIV prevalence rate among pregnant women was 24.8%.

2002 - South Africa's High Court ordered the Government to make the drug nevirapine available to pregnant women to help prevent the transmission of HIV to their babies. Despite international drug companies offering free or cheap antiretroviral drugs,⁶ the Health Ministry remained hesitant about providing treatment for people living with HIV.

2003 - In November, the Government finally approved a plan to make antiretroviral treatment publicly available. The HIV prevalence rate among pregnant women was 27.9%.

2004 - The rollout of antiretroviral drugs began in Gauteng in March, followed shortly afterwards by other provinces.

2005 - At least one service point for AIDS related care and treatment had been established in all of the 53 districts in the country by March, meeting the Government’s 2003 target. However, it was clear that the number of people receiving antiretroviral drugs was well behind initial targets.

Why did the HIV epidemic go unchecked for so long?

The most rapid increase in South Africa’s HIV prevalence took place between 1993 and 2000, during which time the country was distracted by major political changes. While the attention of the South African people and the world's media was focused on the political and social changes occurring in the country, HIV was silently gaining a foothold. Although the results of these political changes were positive, the spread of the virus was not given the attention that it deserved, and people did not realise the impact of the epidemic in South Africa until prevalence rates had begun to accelerate rapidly. It is likely that the severity of the epidemic could have been lessened by prompt action at this time.

Treatment

While richer countries began to use a combination of antiretroviral drugs (ARVs) to effectively treat HIV in 1996, this treatment was for a long time only available to a small minority of South Africans who could afford to pay for private healthcare.

The Treatment Action Campaign (TAC) – an organisation led by Zackie Achmat, who would later become a Nobel Peace Prize nominee for his campaigning – was started in 1998 with the aim of putting pressure on the Government to increase public access to ARVs. Achmat, himself HIV positive, publicised the situation by refusing to take ARVs until they were available to all South Africans. He argued that the cost of providing treatment and preventive education was ultimately less expensive than the economic impact of an unchecked AIDS epidemic.

In March 2003, the TAC laid culpable homicide charges against the Health Minister and her trade and industry colleague, claiming that the pair were responsible for the deaths of 600 HIV-positive people a day in South Africa who had no access to ARV drugs. By this time many poorer African countries were already implementing public treatment programmes, including Uganda, Nigeria and Zambia. South Africa's neighbour Botswana had started providing ARVs in early 2002.

The Government eventually approved plans to provide public access to the drugs in November 2003, in the form of the Operational Plan for Comprehensive Care and Treatment for People Living With HIV and AIDS. This followed years of debate in South Africa about the cost of implementing such a scheme and the effectiveness of antiretroviral drugs; the Government had frequently argued that an increase in access to antiretroviral treatment was not necessarily the best way to stop the AIDS epidemic, and that other treatment options needed to be considered. The Government’s change in attitude towards ARVs was partly a result of a court battle in which GlaxoSmithKline and other pharmaceutical companies agreed to allow low-cost generic versions of their drugs to be produced in South Africa. This made South Africa one of the first African countries to produce its own AIDS drugs.

While the decision to start an ARV program was widely commended, many have since expressed dismay at the slow pace at which treatment is being made available. Although the Government’s 2003 plan aimed to have 381,177 people on Government-funded ARVs by 2005-2006, only 85,000 people in the public sector were receiving treatment by September 2005⁷. UNAIDS estimated that at least 79% of South Africans who needed ARVs were not receiving them at the end of 2005⁸. In April 2006, a representative of the TAC said on the subject of access to ARVs:

“It is improving – slowly. It’s also patchy. Some places, like Khayelitsha, are doing well. In many parts of the country, the rollout is pitiful, such as Limpopo and Mpumalanga provinces. These areas are less urban and less wealthy.” ⁹

Debate has also focused on access to treatment in South Africa’s prisons, which are believed to have an extremely high prevalence of HIV. Since prisons are not accredited ARV sites they cannot distribute drugs directly. HIV positive prisoners have to be provided with transport and security to visit accredited sites and often have to pay for identity documents before they are allowed to access treatment, which most cannot afford. In March 2006, 242 inmates at Durban’s Westville prison initiated a hunger strike in protest at the lack of ARVs available to them, and the following month fifteen of those prisoners took the Government to court in an attempt to force them to provide the drugs directly through the prison system. In June, they won their case - the Government was ordered to ensure that the prisoners at Westville and "anybody else in a similar situation" be provided with treatment.¹⁰ There is hope that this ruling will force the Government to improve ARV access in other prisons as well, but for the moment there are still large numbers of HIV positive inmates who are not recieving treatment. The Government is currently planning a survey to establish the level of HIV infection amongst prisoners in South Africa, since the precise number affected is currently unknown. An study in 2004 suggested that around 41% of prisoners were HIV positive.¹¹

There has been some tension in South Africa between the methods used by different medical practices to treat HIV. Around 80% of people living in African countries consult traditional African healers and use traditional African remedies,¹² even if they use conventional medicines as well, and some of these traditional methods of treatment are potentially harmful to people living with HIV. For instance, some people (such as the Health Minister, Manto Tshabalala-Msimang) claim that African potato boosts the immune system and thereby helps to fight off AIDS. Yet a recent study shows that people taking ARVs should not eat African potato, because it lowers the level of antiretroviral chemicals in the body and increases the likelihood of HIV developing resistance to the drugs.¹³

At the same time, some traditional medicines and practices have been shown to be beneficial in the treatment of HIV. Traditional healers are treated with respect in South African society, and in 2004 the Traditional Health Practitioners Bill was passed to formally recognise and regulate their legitimacy. Many such practitioners recognise the benefits of ARVs, and counsel people living with HIV to continue with antiretroviral treatment. The TAC argues that traditional healers have an important role to play in the treatment of HIV:

“Their cultural importance combined with their close involvement within communities puts traditional healers in a unique position to help fight HIV.” - Zach Rosner, TAC. ¹⁴

AVERT.org has more information about which people around the world are able to access ARV medication.

HIV prevention

South Africa has a highly diverse population, divided by deeply rooted social inequalities. South Africans have a mixture of ethnic backgrounds: black people account for 75% of the population, whites make up around 13%, Asians make up about 3%, and other people of mixed racial heritages account for about 9%. There are 11 official languages and many dialects. Around 86% of the population is literate.¹⁵ Some live in large, crowded cities, while others live in sparsely populated rural areas, many of which are isolated, underdeveloped and lacking infrastructure. This diversity has made it very difficult to carry out AIDS awareness campaigns that actually influence people’s behaviour.

Voluntary counselling and testing

Voluntary counselling and testing (VCT) is an important part of South Africa’s HIV prevention strategy. Once an individual knows that they are HIV positive, they can modify their sexual behaviour to prevent further infections occurring, and can be directed towards treatment. A number of VCT services have appeared in South Africa in recent years, catering for different groups such as pregnant mothers and young people.

Although the expansion of VCT schemes in recent years has been encouraging, a regional study carried out in 2005 suggested that men are much less likely to access VCT services than women in South Africa. Researchers believe that this is due to fears among men that their HIV positive status will be disclosed through testing, and that stigmatisation will follow. The survey also suggested that some men see no value in knowing their HIV status, viewing such knowledge as a burden.¹⁶

Mother-to-child transmission

In 2000, the Department of Health announced plans to provide two prevention of mother-to-child transmission (PMTCT) sites in each province of South Africa. There was still, however, discontent about the lack of antiretroviral drugs available to pregnant women with HIV.

The following year, the TAC took the Government to court, seeking an order to make nevirapine (an antiretroviral drug proven to be effective and economical in reducing the transmission of HIV from mothers to their babies) available in all state hospitals and clinics. Many health care professionals had become frustrated by the Government's lack of progress in supplying the drug, which, the Government argued, was due to questions about its toxicity. Doctors had started applying to NGOs for grants to pay for nevirapine, and in some cases used their own money to buy the drug. Official policy stated that the doctors were forbidden to provide nevirapine, and those who did so risked being disciplined or sacked.

Later that year, the High Court ruled against the Government, ordering that nevirapine be made available to all pregnant women with HIV. A subsequent Government appeal was overturned, but they continued to display reluctance about distributing the drug, and even threatened to revoke its approval in 2003 unless the company that produced it (Boehringer Ingelheim) could provide additional data proving that it was safe. The Department of Health has continued to question its safety, in spite of the consensus medical opinion.

Pregnant women with HIV can now access nevirapine at almost every hospital, health centre and clinic in the country. This is a huge progression from the original eighteen PMTCT sites set up in 2000. The Government estimates that in 2004, 78.7% of pregnant women who were HIV positive received nevirapine.¹⁷ However, the Government has been accused of failing to monitor the programme accurately, and there are concerns that many pregnant women are still unable to access the drug.

Young people

Young people are the age group most severely affected by AIDS in South Africa, with the largest proportion of HIV infections in the country occurring amongst people between the ages of 15 and 24. LoveLife, the most prominent HIV prevention campaign to be carried out in South Africa, has targeted this age group specifically and attempted to integrate HIV prevention messages into their culture. It was launched in 1999, with the aim of reducing rates of teenage pregnancy, HIV and sexually transmitted infections among young South Africans. The campaign attempts to market sexual responsibility through the media as if it were a brand. It also operates a network of telephone lines, clinics and youth centres that provide sexual health facilities, as well as an outreach service that travels to remote rural areas, to reach young people who are not in the educational system. In terms of funding, loveLife has become the largest campaign aimed at HIV prevention in the world.

LoveLife has been criticised in some circles for sexualising the epidemic, and, although it may have been very effective, the actual difference it has made to reductions in new HIV infections is very difficult to measure. Some AIDS activists feel that the campaign is poorly targeted and ineffective.¹⁸ In December 2005, loveLife suffered a major set back when the Global Fund, one of its main financial backers, withdrew funding, stating that the campaign ‘was deemed to not have sufficiently addressed weaknesses in its implementation’.¹⁹

Men who have sex with men

Although heterosexual sex is the most common route of HIV transmission in South Africa, the rate of infection amongst men who have sex with men is rising. While homosexuality has become much more acceptable in South Africa in recent years, the subject is still taboo in most communities and discrimination is common.

The first gay men’s association in South Africa was GASA 6010, which later became the Triangle Project. In 1984, a counselling and medical service run by this organisation began to carry out AIDS prevention initiatives in bars and clubs. Groups such as the AIDS Support and Education Trust (ASET) in Cape Town continue to target gay men with AIDS prevention campaigns, but there is still a lack of information available in gay communities. The Government has been accused of failing to address the impact of HIV among gay men, and nationwide prevention schemes such as loveLife have been criticised for not including any information about sex between men in their campaigns. Medical clinics and school prevention programmes have also failed to provide information on this issue.

The Government has argued that existing national prevention schemes are relevant to people of all sexual orientations. But many non-Governmental organisations (NGOs) argue that they have been unfairly left with the task of providing gay men with information about HIV prevention, without any support from the Government.

The Triangle Project estimated in 2003 that between 12 and 30 percent of homosexual men in South Africa were living with HIV.²⁰

Other prevention initiatives

In 2001 the Government set up the AIDS Communications Team (ACT) to develop and implement a two-year media campaign intended to educate people about the dangers of HIV. The campaign was called 'Khomanani' which means 'caring together', and produced material in several languages.

Prior to ACT and loveLife, a number of other prevention campaigns were carried out. In 1994, ‘The Soul City Project’ was started by a number of different funders to educate people about HIV through radio, print and television, using dramas and soap operas to promote its message. Between 1998 and 2000, the ‘Beyond Awareness’ campaign concentrated on informing young people through the media.

‘Denialism’ and misinformation in South Africa

Many people argue that the response to HIV/AIDS in South Africa has been hampered by ‘AIDS denialism’, a minority scientific movement that refutes the orthodox idea that HIV causes AIDS. Some leading figures in South Africa have flirted with this school of thought, much to the dismay of AIDS activists. President Mbeki has consistently refused to acknowledge that HIV is the cause of AIDS; he argues that HIV is just one factor among many that might contribute to deaths resulting from immunodeficiency, alongside others such as poverty and poor nutrition:

“Does HIV Cause AIDS? Can a virus cause a syndrome? How? It can’t, because a syndrome is a group of diseases resulting from acquired immune deficiency. Indeed, HIV contributes, but other things contribute as well.” ²¹

Although Mbeki has never declared outright that he rejects the link between HIV and AIDS, he has continually inferred as much through statements such as this. He has also failed to publicly state that he believes HIV to be the cause of AIDS.

While international scientific consensus holds that antiretroviral medication is an effective treatment for HIV, Mbeki has claimed that it is harmful and unsafe. Drug companies, he argues, have exaggerated the importance of ARV treatment in order to further their profits.

In 2000 Mbeki included a number of ‘AIDS dissidents’, such as the controversial American scientist Peter Duesberg, in a committee set up to advise the Government on tackling the AIDS crisis²². In the same year, hundreds of delegates walked out of the International AIDS Conference in Durban in protest after Mbeki reiterated his view that HIV is not wholly responsible for AIDS.²³

In October 2000, Mbeki stated that he would withdraw from the public debate about whether HIV causes AIDS, after admitting that his stance had created confusion amongst the public. Since making this statement he has largely avoided the issue of what causes AIDS, but has repeatedly suggested that the impact of AIDS in South Africa may have been overstated.

In 2002 the Cabinet issued a statement on their latest AIDS campaign, declaring:

“In conducting this campaign, Government’s starting point is based on the premise that HIV causes AIDS” ²⁴

While this remains the official stance of the Government, there is evidence that certain politicians continue to question scientific consensus on AIDS. President Mbeki has repeatedly stressed the importance of a good diet in halting the progression of AIDS, as has the Health Minister Manto Tshabalala-Msimang, who famously urged people to eat lots of beetroot and garlic to fight off the illness. While it is true that a good diet is an important part of treatment, it is certainly no substitute for antiretroviral medication, as she has suggested. Her stance has angered many, including the revered South African cleric Desmond Tutu:

"We are playing with the lives of people, with the lives of mothers who would not have died if they had had drugs. If people want garlic and potatoes let them have them, but let's not play games. Stop all this discussion about garlic." ²⁵

The Health Minister has also voiced support for the Dr Rath Health Foundation, an organisation that promotes vitamin supplements as a substitute for ARV drugs. The foundation has previously published adverts in South Africa claiming that antiretroviral drugs are toxic and cause AIDS. In August 2005, The Advertising Standards Authority ruled that such statements were a threat to public health, and that the organisation would not be allowed to make such claims in future adverts. Manto Tshabalala-Msimang later stated in newspapers that:

“No reason exists to criticise Rath, his treatments and his foundation” ²⁶

The Dr Rath Health Foundation continues to promote its ineffective vitamin treatment in South Africa despite widespread international condemnation. The organisation has been banned from almost all other countries in which it has tried to operate. The TAC, which recently won a court case to prevent the Rath Foundation from wrongly labelling them ‘a front for the pharmaceutical industry’, has strongly criticised the Government for failing to condemn the organisation.

The Health Minister continues to make statements that play down the importance of ARVs, and it is likely that the attitude towards the drugs taken by her and other politicians has been central to the slow rate of progress in providing access to treatment. Amongst the scientific community there is little doubt about the benefits of ARVs; a recent study in South Africa reported that 93% of HIV positive people surveyed were alive after one year of treatment.²⁷

Alongside AIDS denialism and misinformation about AIDS treatment, false beliefs about how HIV can be transmitted are also a concern. In April 2006, on trial for the alleged rape of a HIV positive woman, South Africa’s former Deputy-President Jacob Zuma was found not-guilty but confessed that he had had consensual sex with the woman despite being aware that she was HIV positive. He stated his belief that HIV was not easily transmitted from women to men, and that he had showered after sex in the belief that this would minimise his chances of contracting HIV. There was widespread dismay amongst the AIDS prevention community that a politician (particularly one who had once been head of the National AIDS Council) could display such ignorance, and a fear that his statement would cause confusion amongst the public, undermining years of AIDS prevention campaigns. The National AIDS Helpline was subsequently inundated by callers querying the validity of his statement.²⁸

Many people believe that the widely publicised views of politicians such as Mbeki, Tshabalala-Msimang and Zuma have added to the climate of misinformation that surrounds the problem of AIDS in South Africa. Zackie Achmat, leader of the TAC, argues that the real hindrance to antriretroviral drug provision in the country is not lack of funding, but the attitude of the Government:

“The biggest problem we have in South Africa is that we have a President who doesn’t believe that HIV causes AIDS.” ²⁹

To read more about the issue of whether HIV causes AIDS, see our evidence page.

Other major issues

Stigmatisation

The prevalence of misinformation about AIDS in South Africa has not only hampered efforts to increase access to treatment, but has also created a climate of confusion in which prejudice towards people living with HIV thrives.

HIV is sometimes seen as being a disease of the poor. In South Africa, there is some correlation between extreme poverty and high HIV prevalence, although the virus is prevalent across all sectors of society³⁰. By 1998, although people from more affluent, largely white society were starting to come out as being HIV positive, stigmatisation of the condition remained still deeply rooted in township areas. In October of that year, the then Deputy President Thabo Mbeki made the Declaration of Partnership Against AIDS, in which he called for an end to discrimination against people living with HIV.³¹ However, it was clear that there was a long way to go before this goal could be achieved; less than two months later, Gugu Dlamini, an AIDS activist in Durban, was beaten to death by her neighbours after declaring that she was HIV positive on World AIDS Day.

In 2000, Justice Edwin Cameron of the South African court announced in a speech that he was HIV positive. The public response to this declaration was, on the face of it, largely supportive. However, coming out as HIV positive can in many cases have a negative effect on employment and housing opportunities, as well as social relationships. A study in 2002 revealed that only one third of respondents who had revealed their HIV positive status were met with a positive response in their communities. One in ten said that they had been met with outright hostility and rejection.³²

When his son died of AIDS in 2005, Nelson Mandela publicised the cause of his death in an effort to challenge the stigma that surrounds HIV infection:

"Let us give publicity to HIV/AIDS and not hide it, because [that is] the only way to make it appear like a normal illness." ³³

Read more about HIV-related stigma and discrimination.

Gender inequality and sexual abuse

Although HIV prevention campaigns usually encourage people to use condoms and reduce their number of sexual partners, women and girls in South Africa are often unable to negotiate safer sex and are frequently involved with men who have a number of sexual partners. They are also particularly vulnerable to sexual abuse and rape, and are economically and socially subordinate to men. Police reports suggests that in 2004-2005 there were 55,114 cases of rape in South Africa³⁴, although the actual figure is undoubtedly larger than this since the majority of cases go unreported. This major problem plays a significant role in the high prevalence of HIV among women in South Africa.

Post-exposure prophylaxis (PEP, a treatment that has been shown to significantly reduce the chances of HIV infection when taken within 72 hours of sexual contact) has been made available to victims of rape in South Africa since December 2002. However, a recent study suggests that access to PEP is not uniform throughout the country, and some rape victims report that the treatment was not made available to them.³⁵

Women are likely to face more severe discrimination than men if they are known to be HIV positive. This can lead to physical abuse and the loss of economic stability if their partners leave them. Since antenatal testing gives them a greater chance of being identified as HIV positive, women are sometimes branded as ‘spreaders’ of infection.

The Government has acknowledged that many women face “triple oppression” in South African society - oppression on the grounds of race, class and gender – and has been making efforts to address this problem, through education and skills development schemes.³⁶ The social restrictions faced by women mean that they are often powerless to enforce behaviour change when it comes to sexual relationships, even when they are aware of the risks involved in unprotected sex.

AVERT.org has more information about women, HIV and AIDS.

Children living with HIV

The AIDS Law Project, an NGO based in Johannesburg, estimated that 50,000 children in South Africa were in need of ARVs at the beginning of 2006, but that only around 10,000 were receiving them.³⁷ UNAIDS estimates that at the end of 2005, children accounted for 8% of those receiving ARVs in South Africa.³⁸

Read more about children living with HIV.

AIDS orphans

As well as many children being infected with HIV in South Africa, many more are suffering from the loss of their parents and family members from AIDS. UNAIDS estimated that there were 1.2 million South African children living as orphans due to AIDS in 2005, compared to 780,000 in 2003.³⁹ Once orphaned, these children are then likely to face poverty, poor health and a lack of access to education.

AVERT.org has more information about AIDS orphans.

The way forward for South Africa

In recent years, antenatal survey results have led the South African Government to claim that the HIV epidemic is beginning to stabilise. The Democratic Alliance (the main opposition party in South Africa) argues that such claims detract from the seriousness of the country’s AIDS crisis. Even if the epidemic is stabilising, it is doing so at a very high level. Following the antenatal survey in 2004, Democratic Alliance health spokesman Ryan Coetzee stated:

“The figures continue to increase, and that is not 'stabilising'. The report proves the Government's prevention campaign is not succeeding” ⁴⁰

The high level of new HIV infections occurring in South Africa reflects the difficulties that have been faced by AIDS education and prevention campaigns. The social climate in South Africa has not proved accommodating to safe sex messages, and there is a continuing need to encourage real behaviour change as well as simple HIV awareness.

In terms of treatment, there is hope that the rate of AIDS deaths will begin to fall now that the Government has been pressured into taking a firmer stance on treatment access. There is still, however, a desperate need for the rollout of ARVs to occur more rapidly. Many people living with HIV still have no access to treatment, and many HIV positive women who are pregnant are not being provided with drugs that significantly reduce the chances of mother-to-child transmission.

In the face of such a terrible epidemic, there is a tendency for some people to adopt a fatalistic attitude. However, as Justice Cameron stated at the 2000 AIDS conference in Durban:

"We don't accept 'sad realities' in South Africa. If we accepted sad realities, we would still have a racist oligarchy here." ⁴¹

To learn more about what it is like to be living with HIV in South Africa, visit our township photo gallery.

Last updated June 23, 2006