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Introduction

Despite earlier controversies, the South African government acknowledges that the human immunodeficiency virus (HIV) is the cause of Acquired Immune Deficiency Syndrome (Aids).

“In conducting [the HIV/Aids and STI Strategic Plan for South Africa, 2000 – 2005], government’s starting point is based on the premise that HIV causes Aids,” the South African Cabinet said in a statement on their meeting of 17 April 2002. “It is also critical for us, as a nation, to note that there is no cure for Aids.”

When Aids was first identified in the early 1980s it was seen as an immediate death sentence. Since then, advances in treatment means a significant number of those infected with the virus live healthily for many years without succumbing to full-blown Aids. For that reason it is often journalistic practice in South Africa to refer to “HIV and Aids” rather than “HIV/Aids”, to distinguish the lives, experience and challenges of those who are HIV-positive and healthy from those who are seriously ill with Aids. But for reasons of brevity, this article uses the term “HIV/Aids”.

Infection rates

South Africa has one of the fastest HIV-infection rates in the world. Statistics South Africa’s 2007 population estimates put the South Africa’s overall HIV-prevalence rate at about 11%, much higher than that of sub-Saharan Africa as a whole, and among the highest in the world. Others put the figure higher; UNAids estimates South Africa’s HIV/Aids prevalence rate to be 18% to 19% (18.8% in 2005 and 18.3% in 2006), significantly higher than the rate in sub-Saharan Africa (5.9%) and the world (1%).

In 2006, an estimated 350 000 South Africans died of HIV/Aids – nearly half of all deaths for that year, and the leading cause of death for the country’s adult population. Between 1997 and 2004 death rates from all causes increased by about 80%, largely due to HIV/Aids. Some 290 000 South African children were estimated to be living with HIV/Aids in 2006, and the country has more than 1-million Aids orphans.

The Department of Health, in collaboration with UNAids, the World Health Organisation and other groups in South Africa, have undertaken mathematical modelling to estimate the HIV prevalence in the general population. Using the spectrum model, the number of South Africans estimated to be HIV-positive some 5.41-million (5.3-million according to according to Statistics South Africa). This estimate is lower than the 2005 estimate of 5.54-million.

But HIV prevalence in South Africa may be beginning a downward trend. This has been predicted in the UNAids spectrum model, as well as by independent South African models.