A new health survey shows that while South Africa’s overall HIV rate has dropped slightly, prevalence remains dangerously high in several provinces. 

The 2022 South African National HIV Survey found that about 7.8 million people in the country are HIV positive. That’s down 1.3% from 7.9 million in 2017.

“The percentage of all people living with HIV in South Africa has decreased,” said Khangelani Zuma, head of the Human Sciences Research Council, which conducted the study.

But provinces like KwaZulu-Natal and the Free State still have sky-high infection rates up to 21.8%, while the Western Cape and Northern Cape are lower from 8-11%. 

“KZN is still leading on the prevalence of HIV, and of course, we need to understand this in relation to the intervention and the programme,” Zuma explained. 

Several factors drive prevalence – from people living longer with HIV to more children being born without it. “These all contribute to the denominator of HIV-negative people,” he said.

Worryingly, young women face double the infection rates of men  20.3% versus 11.5% among males. 

While the slight national decline is welcome news, much more work is needed to curb new transmissions and help those living with HIV across South Africa. Tougher action and targeted programmes for provincial hotspots could prove vital next steps.