Millions on HIV treatment — but alarming gaps remain, new SA data shows
Despite South Africa making world-leading strides for HIV testing rates, new data reveals that tens of thousands of people still begin treatment dangerously late
Image: Supplied
Despite South Africa making world-leading strides for HIV testing rates, new data reveals that tens of thousands of people still begin treatment dangerously late — and over a million have stopped taking their life-saving medication altogether.
This is according to the latest estimates from Thembisa 4.7, South Africa's most sophisticated HIV modelling tool.
Thembisa 4.7 synthesises multiple data sources including Stats SA's 2022 Census and the HSRC's latest national HIV survey.
To understand the numbers, we need to understand what viral suppression is and what it means for South Africans. What is viral suppression?
When someone living with HIV takes their medication regularly, the amount of virus in their blood can drop so low that it's undetectable. This is known as 'viral suppression.' This is a good thing, as it keeps people healthy and prevents the virus from spreading to others.
Are South Africans on ART reaching viral suppression?
According to the data, in South Africa, viral suppression varies by province and by person.
Researchers used patient data from a global HIV research network called IeDEA, as well as South Africa's own TIER health system, to understand how well antiretroviral therapy (ART) is working in different provinces.
However, not everyone had their viral load (amount of virus in the blood) measured and recorded. So scientists used a method called Bayesian analysis to fill in the blanks based on patterns they saw in the data they did have.
Scientists found that viral suppression rates dropped after 2009, but have been improving since 2013.
According to the data, women tend to have better suppression rates than men and older adults (age 50 and above) are doing better than younger people.
They also found that those who started treatment earlier — when their immune systems were still strong — had better outcomes.
The study indicates that the Western Cape and Free State are performing better than average, while other provinces, like Limpopo and Eastern Cape, are lagging behind.
For example, in Limpopo, patients had 46% lower odds of viral suppression compared to the reference group. Meanwhile, the Western Cape had 22% higher odds than average.
Video Player is loading.
Play Video
Play
Unmute
Current Time
0:00
/
Duration
-:-
Loaded :
0%
Stream Type LIVE
Seek to live, currently behind live
LIVE
Remaining Time
-
0:00
This is a modal window.
Beginning of dialog window. Escape will cancel and close the window.
Text Color White Black Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Transparent Semi-Transparent Opaque
Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps
Reset
restore all settings to the default values Done
Close Modal Dialog
End of dialog window.
Advertisement
Next
Stay
Close ✕
What about missing data?
As mentioned previously, not everyone had their viral load measured and recorded, which could make the official numbers look better or worse than they really are.
To deal with this, the researchers estimated what might be happening with patients who didn't have test results. On average, people without a recorded viral load were slightly less likely to be virally suppressed — but not always by much. Alarming statistics
In 2023, an estimated 7.8 million people — or 12.6% of the population — were living with HIV in South Africa. Of those, 5.9 million were on ART, leaving roughly 2 million untreated. Worryingly, about 1 million of the untreated population had previously started treatment but later disengaged, signalling deep cracks in the country's treatment retention strategy.
Over 46,000 adults only started ART in 2023 after their CD4 counts had fallen below 200, a level that reflects advanced immune suppression and significantly increases the risk of life-threatening illnesses like tuberculosis. SA's progress on global 95-95-95 HIV targets
South Africa has made notable progress toward the global 95-95-95 HIV targets. The targets aim to ensure that by 2025, 95% of people living with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those on treatment are virally suppressed. The country has already met the first goal, with 95.4% of people living with HIV diagnosed.
However, only 78.7% of diagnosed individuals are currently on ART — far short of the second goal.
Of those on treatment, 91.3% have achieved viral suppression, indicating strong medication efficacy — but when assessed across all people living with HIV, only 68.6% are virally suppressed. New infections are outpacing deaths
There were 149,000 new HIV infections in 2023, down from over 500,000 annually in the early 2000s. Yet, with only 50,000 HIV-related deaths, the overall number of people living with HIV continues to climb — and is expected to rise for several years.
On a positive note, more people are starting treatment than becoming newly infected. In 2023, 237,000 individuals began ART, creating a 1.6:1 ratio of treatment starts to new infections. But this ratio has declined from over 2:1 in the 2010s, suggesting momentum is slowing.
Life expectancy continues to rise. After dropping to 53.6 years in 2004 at the height of the AIDS crisis, it has now climbed to 65.9 years in 2023 — 62.3 for men and 69.7 for women — largely due to ART scale-up.
IOL

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

IOL News
38 minutes ago
- IOL News
5 Surprising health benefits of cold weather
I'll be honest: when winter rolls in, I'm usually the first to wrap myself in a thick blanket and daydream about Cape summers. But what if I told you that embracing the chill could actually transform your wellbeing? It's a mindset that's gaining traction globally and South Africans are uniquely positioned to reap these rewards. When we think of winter in South Africa, we conjure up images of misty mornings in the Cape, frost-tipped lawns in our homes, and those endless, blue-sky days that beg for a mug of rooibos. But beneath the surface discomfort, science reveals a hidden treasure trove of health benefits in the cold. 1. Sharper minds in chilly weather It sounds counterintuitive, but studies have found our brains operate faster at colder temperatures. A 2017 study in the journal Thinking & Reasoning found that people performed better with mental tasks in cool environments, linking brisk air to improved concentration and cognitive speed. Next time you're stuck in a winter work slump, try a brisk walk outside, science is on your side. 2. Nature's detox, clearing out the lungs Here's something rarely discussed: cold air is a natural cleanser for your respiratory system. According to the Vhdehi Institute of Medical Sciences and Research, inhaling crisp air helps clear mucus from your lungs and nasal passages by triggering your body's vasoconstriction response. This reduces inflammation and can even help stave off infection - a natural immune boost you won't find in a pill. 3. Burn more calories effortlessly Winter is not just for comfort food. Research from Harvard Health shows that our bodies expend more energy to keep warm, which means you're burning extra calories just by being outside. In other words: that evening stroll through your neighbourhood, bundled up in your favourite beanie, is doing double duty for your waistline. 4. Sleep better, stress less There's a reason animals hibernate. Cold weather nudges us toward deeper sleep, giving our bodies time to repair and reset. Sleep scientists at the Sleep Foundation have found that lower bedroom temperatures can improve both the quality and length of your rest. Pair that with the slower pace of winter life, and you've got a recipe for lower stress and improved mental health. 5. Cleaner air, fewer allergies Winter in South Africa brings a drop in pollen counts and fewer pesky insects. With less dust and allergens swirling around, you're less likely to suffer sneezing fits or allergic reactions. Take advantage of this "clean air season" by heading outdoors, whether for a hike or a simple wander through your local park.


The Citizen
2 hours ago
- The Citizen
Strawberry moon: When would be the best time for Lowvelders to gaze up to the sky?
Strawberry moon: When would be the best time for Lowvelders to gaze up to the sky? If you miss out on tomorrow night's spectacular in the sky, you will have to wait another 18 years to experience it. On June 11 at 09:43, the strawberry moon will be the lowest moon in the sky in 19 years, and according to Project Nightfall's Facebook page, it will only be this low again in 2043. This will occur in the daytime, so the best time for South Africans to view the lunar spectacle will be shortly after sunset, today, June 10. The full strawberry moon will grace the night sky, producing a stunning show as the fully-lit disk of Earth's natural satellite will ride low over the south-eastern horizon. ALSO READ: How to make moon sand According to the website a full moon occurs every month when the moon is positioned opposite the sun in the Earth's sky. 'It allows the lunar disk to be fully lit from our perspective. June's full moon is commonly referred to as the strawberry moon in the United States, but the nickname isn't a reference to its colour, though there's a decent chance it will take on a yellow-orange hue when near the horizon due to the atmosphere's habit of scattering certain wavelengths of light. Rather, the evocative name is thought to have been coined by the Native American Algonquian tribes in reference to the short strawberry harvesting season that falls around this time of year, according to the Old Farmers Almanac. Other cultures have dubbed the event the blooming moon, green corn moon, birth moon and hatching moon, to name a few,' according to ALSO READ: FOTO'S: 'Once in a blue moon' hemelsig laat die lense fokus When to watch: Full moon will be at 09:43 on June 11, but best viewing will be on the evening of June 10 as the moon rises at dusk. Check your local moon-rise time for the exact moment! Don't miss this rare celestial night-sky show! At Caxton, we employ humans to generate daily fresh news, not AI intervention. Happy reading! Stay in the know. Download the Caxton Local News Network App Stay in the know. Download the Caxton Local News Network App here


The Citizen
4 hours ago
- The Citizen
CANSA launches online support network for cancer survivors
Each June, global attention turns to the impact of cancer on survivors, their caregivers, loved ones, families, and others within their support circle. Often, these individuals simply need someone to talk to about their cancer journey. The Cancer Association of South Africa (Cansa) has launched a new online platform, offering yet another way to connect people to caring cancer communities. This month, people around the world honour those facing cancer and recognise the importance of a supportive community. 'Many cancer survivors report feeling isolated from the moment they are diagnosed,' said Gretchen Minnaar, Cansa's services manager: psychosocial support. 'They often find that friends, colleagues, and even some family members avoid them, rather than offering comfort or simply being present.' Furthermore, a survivor's need for support does not end with a clean bill of health. Many face long-term challenges, including fear of recurrence, depression, pain, memory problems, changes in bodily functions, and relationship issues. Cansa provides extensive support to survivors and others affected by this devastating disease—and the need is significant. Each year, over 115 000 South Africans are diagnosed with cancer, according to the South African National Cancer Registry. Many more cases go unreported or unregistered. To help meet this growing need, Cansa has launched a virtual support group to expand the reach of its existing services, which include face-to-face support groups as well as Facebook and WhatsApp support groups across South Africa. ALSO CHECK: DEMS intensifies winter safety awareness across Ekurhuleni The new virtual support group, launched on May 24, is facilitated by Cansa and held monthly via Zoom. Managed by trained counsellors, each session covers different topics in a relaxed, supportive environment that encourages engagement and input from survivors. Cansa's WhatsApp support groups operate both nationally and regionally. Regional groups are limited to patients in specific areas, while national groups cater to bereavement, caregiver, and newly diagnosed patient support. Additional groups are available for women survivors, men survivors, ostomy patients, and teens aged 13 to 17. On Facebook, Cansa runs three support groups: * Cancer Survivors – Champions of Hope (for cancer survivors in treatment or remission) * Caring for the Caregivers (for caregivers of cancer patients) * TLC – Childhood Cancer Support (for children and their parents/guardians affected by cancer) * Survivor Wendy de Rooij noted that more treatment facilities should inform patients about Cansa's support groups. 'I would not have found my amazing group if it weren't for a desperate late-night Google search,' she said. 'These people have given me far more practical information than any other healthcare group I've encountered since my cancer journey began.' The support groups encourage members to share their stories. 'Interacting with people who understand your lived experience is an invaluable form of support. It's so beneficial to hear about the coping strategies of someone who has been—or is currently—in the same situation as you,' added Minnaar. ALSO CHECK: Germiston audience inspired by blind man's Kilimanjaro climb Ovarian cancer survivor Rina van der Merwe shared that during her treatment and recovery, Cansa's support groups always gave her a safe space to talk. 'And reading about other warriors' journeys also helped me a lot,' she said. Cancer patients, survivors, caregivers, family members, and others affected by cancer can join one of these groups by completing a form on Cansa's website at Support is currently available in English, Afrikaans, isiXhosa, and isiZulu. The organisation remains committed to connecting people facing cancer with vital information, day-to-day assistance, and emotional support—ensuring no one has to face cancer alone. Please note: • Patients, survivors, and others affected by cancer must contact Cansa directly for support. • Cansa is not informed of patient treatment by medical centres and requires patient permission to make contact. • Cansa does not provide treatment. • Cansa is not authorised to prescribe or supply medication. • Cansa's clinical specialist nurse offers free advice on managing cancer, pain, and treatment side effects. For more information or to seek support, visit At Caxton, we employ humans to generate daily fresh news, not AI intervention. Happy reading!