HIV and TB Overview: South Africa

Background

CDC began collaborating with South African non-governmental and community-based organizations in 1989 to address the country’s growing HIV epidemic. In 1995, CDC-South Africa strengthened its support and began working with the Government of South Africa. The partnership led to the development of national HIV guidelines and HIV and tuberculosis (TB) service delivery programs.

When the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launch in 2003, this support rapidly expanded. Today, priorities include:

• HIV treatment and prevention.
• Integration of HIV and TB in clinical services.
• Strong laboratory systems.
• Robust health information systems.
• Disease surveillance and response systems.
• Public health workforce capacity, placement, and retention.

HIV and TB data

HIV/AIDS

Tuberculosis (TB)

Key activities and accomplishments

Strengthening HIV treatment and prevention

HIV and TB

CDC supported comprehensive HIV and TB prevention, care, and treatment services. This initiative reached 144,121 people at higher risk in FY 2022 (PEPFAR FY21 APR performance data).

Packages of services were tailored to the needs of people at higher risk, including:

• Female sex workers.
• Men who have sex with men.
• Transgender people.
• People who inject drugs.
• People who are incarcerated.

Antiretroviral therapy (ART)

In fiscal year (FY) 2022, CDC supported ART services for over 2 million people living with HIV (PLHIV). This accounted for 39 percent of the 5.1 million people who are on ART in South Africa (PEPFAR FY21 APR performance data).

Additionally, in the districts supported by CDC-South Africa, 90% of TB patients were tested for HIV in 2022. Of those TB patients, 57 percent were HIV co-infected. 90% of the co-infected patients received ART in addition to TB treatment (PEPFAR FY21 APR performance data).

By the end of September 2022, an estimated 95% of PLHIV knew their status and 76 percent were receiving ART. Of those on treatment who had a viral load (VL) test, 93 percent achieved VL suppression below 1,000 copies/mL. Among children younger than 15 years old, 80 percent are estimated to know their status. Of those that know their status, 71% are receiving ART and 69% are virally suppressed.

Voluntary medical male circumcision (VMMC)

CDC supports efforts aimed at increasing the uptake of VMMC for men 15 years and older. CDC supported 192,792 medical male circumcisions in 2022.

Prevention of mother-to-child transmission (PMTCT)

CDC-supported implementing partners are committed to eliminating mother-to-child transmission of HIV in South Africa. CDC PEPFAR data showed reduced mother-to-child transmission rates of less than 1 percent at six weeks gestational age. In FY2022, maternal HIV testing coverage was 99 percent, and maternal ART coverage was 100 percent (PEPFAR FY22 APR performance data).

DREAMS

CDC focuses support on programs designed for adolescent girls aged 15 to 19 and young women aged 20 to 24. One of these programs is the Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) program. CDC uses evidence-based interventions to address factors that increase girls’ and young women’s HIV risk. These interventions include post-violence care, parenting/caregiver programs, and facilitating access to resources such as cash transfers and education subsidies.

Strengthening laboratory systems

CDC supports national programs that increase laboratory diagnostic quality and public health laboratory service. These programs support quality laboratory systems and clinical use of results through accreditation. They also help with the management of laboratory results and ensuring that facilities can access laboratory information systems. This allows timely result delivery and proper documentation in patient charts and health information management systems.

Strengthening health information systems and surveillance

CDC supports the National Department of Health to assess, enhance, and use existing information systems across the South African Government. This support helps the government plan human resources for health based on community needs, disease burden, and individual health facilities' characteristics.

CDC also supports local implementing partners, including the:

• Human Sciences Resource Council.
• National Institute for Communicable Diseases.
• South African Medical Research Council.

CDC and partners work to conduct disease surveillance and research that informs South Africa’s HIV response and program implementation.

This research includes population surveys to understand:

• HIV prevalence and incidence.
• Enhanced antenatal surveys in pregnant women.
• Surveillance of recent HIV infections.
• HIV drug resistance surveillance.
• HIV mortality surveillance.

Additionally, CDC supports bio-behavioral surveys of groups of people that are at higher risk.

Resources

Our success is built on the backbone of science and strong partnerships.