Journalists depend on HIV/AIDS statistics to contextualise stories. Statistics tell the reader or viewer why your story is important. Although estimates vary between agencies, even the lowest estimates are frightening reminders of the extent of the HIV/AIDS epidemic.
This factsheet examines global and South African statistics with a focus on HIV infection and mortality and on funding for HIV/AIDS-related issues.
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation:
| Global Summary of the AIDS epidemic (December 2005) | |
| Number of people living with HIV in 2005 worldwide | 40.3-million |
| Adults | 38-million |
| Women | 17.5-million |
| Children under 15 years | 2.3-million |
| People newly infected with HIV in 2005 worldwide | 4.9-million |
| Adults | 4.2-million |
| Children under 15 years | 700 000 |
| AIDS deaths in 2005 worldwide | 3.1-million |
| Adults | 2.6-million |
| Children under 15 years | 570 000 |
Source:  AIDS Epidemic Update: December 2005 |
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According to the UNAIDS/WHO AIDS Epidemic Update 2005
+25 million Number of people who had died of AIDS globally since the first cases of HIV/AIDS were identified in 1981.
Source: UNAIDS/WHO, 2005
| Regional HIV/AIDS Statistics (End of 2004) | ||||
| Adults and children living with HIV | Adults and children newly infected with HIV in 2004 | Adult Prevalence | Adult and child deaths due to AIDS | |
| Sub-Saharan Africa | 25,800,000 | 3,200,000 | 7.2% | 2,400,000 |
| North Africa and Middle East |
510,000 |
67,000 |
0.2% |
58,000 |
| South and South-East Asia |
7,400,000 |
990,000 |
0.7% |
480,000 |
| East Asia |
870,000 |
140,000 |
0.1% |
41,000 |
| Oceania |
74,000 |
8,200 |
0.5% |
3,600 |
| Latin America |
1,800,000 |
200,000 |
0.6% |
66,000 |
| Caribbean |
300,000 |
30,000 |
1.6% |
24,000 |
| Eastern Europe and Central Asia |
1,600,000 |
270,000 |
0.9% |
62,000 |
| Western and Central Europe |
720,000 |
22,000 |
0.3% |
12,000 |
| North America |
1,200,000 |
43,000 |
0.7% |
18,000 |
| TOTAL |
40,300,000 |
4,900,000 |
1.1% |
3,100,000 |
| Source: AIDS Epidemic Update: December 2005 | ||||
According to UNAIDS:
10% Percentage of world's population living in Sub-Saharan Africa
60% Percentage of all people living with HIV l Sub-Saharan Africa
Source: UNAIDS, 2004
"Sub-Saharan Africa has just over 10% of the world's population, but is home to more than 60% of all people living with HIV — some 25.4 million. In 2004, an estimated 3.1 million people in the region became newly infected, while 2.3 million died of AIDS. Among young people aged 15-24 years, an estimated 6.9% of women and 2.2% of men were living with HIV at the end of 2004.
2.4-million Number of people in Sub-Saharan Africa who died of AIDS in 2005
Source: UNAIDS, 2005
However, it is much too early to claim that these recent declines herald a definitive reversal in these countries' epidemics and, furthermore, the need for treatment, care and support will continue to increase for years to come."
The SA National Department of Health conducts an annual survey among pregnant women attending antenatal care at selected sites in all nine provinces of the country. Although an antenatal survey should be scrutinised because it may be unrepresentative of the entire population, it does give a good indication of the trend of the epidemic.
Prevalence of HIV Among Antenatal Care Attendees in South Africa, 1990-2004. Credit: SA National Department of Health. National HIV and Syphilis Antenatal Sero-Prevalence Survey in South Africa, 2004. Enlarge image
According to the National HIV and Syphilis Antenatal Sero-Prevalence Survey in South Africa, 2004:
| HIV Prevalence By Province Among Antenatal Clinic Attendees, South Africa: 2001 — 2004 | |||
| Province | 2002 | 2003 | 2004 |
| KwaZulu-Natal | 36.5% | 37.5% | 40.7% |
| Mpumalanga | 28.6% | 32.6% | 30.8% |
| Free State | 28.8% | 30.1% | 29.5% |
| North West | 26.2% | 29.9% | 26.7% |
| Gauteng | 31.6% | 29.6% | 33.1% |
| Eastern Cape | 23.6% | 27.1% | 28.0% |
| Limpopo | 15.6% | 17.5% | 19.3% |
| Northern Cape | 15.1% | 16.7% | 17.6% |
| Western Cape | 12.4% | 13.1% | 15.4% |
| South Africa | 26.5% | 27.9% | 29.5% |
|
Source: SA National Department of Health. National HIV and Syphilis Antenatal Sero-Prevalence Survey in South Africa, 2004. Note: These values fall within a 95% confidence interval. |
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The SA National Department of Health study cited above extrapolated that 5.6-million South Africans were HIV-positive by the end of 2003, including:
But this was a survey of pregnant women who attend ante-natal clinics. Although this is not a representative sample of all South Africans, researchers can extrapolate this information and estimate how many people in South Africa have HIV/AIDS. In 2003, the researchers acknowledged four assumptions:
The South African National HIV Prevalence, Behavioural Risks and Mass Media Household Survey was conducted in 2002 by the Human Sciences Research Council (HSRC), Medical Research Council (MRC), Centre for AIDS Development Research and Evaluation (CADRE) and Agence Nationale de Recherches sur le Sida (National French Agency for AIDS Research or ANRS).
The survey sampled people living in households and hostels throughout South Africa and provides detailed information on HIV infection rates by age, race, sex, province and locality-type as well as information on knowledge, attitudes and behaviours.
Estimates for the entire population are based on applying findings to the census. The wide confidence intervals indicate that in some cases the sample sizes were quite small. The Actuarial Society of South Africa cautioned that this may have resulted in bias in relation to prevalence rates relating to province, race and amongst children aged 2-14 (AIDS Analysis Africa, 2003).
In 2005, the second in this series of national surveys was conducted, the South African National HIV Prevalence Incidence Behaviour and Communication Survey, 2005. Although the survey questionnaire was similar to the 2002 study, a number of indicators were modified based on the 2002 study and a number of new indicators and modules were added. Below is a comparison of the key findings between the 2002 and 2005 studies.
| Comparison of Key Findings between 2002 and 2005 household prevalence studies | ||
| Category | 2002 | 2005 |
| Overall prevalence (2 years and older) | 11.4% (pg 58) | 10.8% (pg 77) |
| Males | 9.5% | 8.2% |
| Females | 12.8% | 13.3% |
| Total living with HIV/AIDS | 4.5-million | |
| Estimated HIV prevalence per age group | (pg 59) | (pg 77) |
| Children 2-14 | 5.6% | 3.3% |
| Persons aged 15-24 | 9.3% | 10.3% |
| Adults 25+ | 15.5% | 15.6% |
| Overall HIV prevalence per province (2 years and older) | (pg 58) | (pg 79) |
| KwaZulu-Natal | 11.7% | 16.5% |
| Gauteng | 14.7% | 10.8% |
| Free State | 14.9% | 12.6% |
| Mpumalanga | 14.1% | 15.2% |
| North West | 10.3% | 10.9% |
| Eastern Cape | 6.6% | 8.9% |
| Limpopo | 9.8% | 8.0% |
| Northern Cape | 8.4% | 5.4% |
| Western Cape | 10.7% | 1.9% |
| HIV prevalence by race in SA (2 years and older) | (pg 60) | (pg 80) |
| Total | 11.4% | 10.8% |
| African | 12.9% | 13.3% |
| White | 6.2% | 0.6% |
| Coloured | 6.1% | 1.9% |
| Indian | 1.6% | 1.6% |
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Sources: |
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Graphic: Distribution of deaths by age and year of death, 1997-2002. Between 1997 and 2003, the number of deaths among people aged 20-49 has been rising steadily. AIDS-related deaths are the likely cause for most of the increase.
Source: Statistics South Africa. Mortality and causes of death in South Africa, 1997–2003. Enlarge image
Statistics South Africa. Mortality and causes of death in South Africa, 1997-2003
It is difficult to get accurate estimates of AIDS mortality in South Africa because often the death isn't registered as HIV/AIDS-related on the death certificate. But the rising number of recorded deaths in South Africa, as well as the noted causes of death, do give us an indication of the effect HIV/AIDS is having on mortality.
The study, published in 2005, found that the number of registered adult deaths in South Africa increased 63% from 272,221 in 1997, to 441,029 in 2002. The major cause of these increases is likely to be HIV/AIDS.
Although improved death registration and South Africa's population growth may have partly helped raise the figures, the uneven rises in deaths per age group has the signature of AIDS-related deaths. For instance, deaths among those aged 25-49, a high risk group for HIV/AIDS, more than doubled from 92,479 in 1997 to 199,485 in 2002, an increase of about 116%. (source)
A normal mortality graph should generally rise with age. In South Africa, mortality peaks at 30-34, and then drops again.
After studying the causes of death in the Statistics SA report, the Treatment Action Campaign found:
63% rise in registered adult deaths in South Africa from 1997 to 2002.
Source: Statistics SA, 2005
"Adding the largest causes of death most frequently associated with AIDS (tuberculosis, influenza and pneumonia, intestinal infections, HIV, immune disorders), the number of such deaths rose by 244% from 45 978 in 1997 to 170 531 in 2002. Obviously not all of these deaths are due to HIV. Likewise, these are not the only HIV-related deaths. However, after correcting for population growth and improved registration, most of the 244% increase can be assigned to HIV."
After analysing age of death distribution patterns, the Medical Research Council estimated that 61% of deaths relating to HIV had been wrongly attributed to other causes of death. According to the MRC results, HIV caused 112, 630 adult deaths (15-59yrs), and 40,727 child deaths (0-5yrs) in the year 2000-2001. (source)
The Actuarial Society of South Africa has released an often-cited model which projects AIDS infection, mortality and a range of other indicators. The ASSA2002 revised the projections of the ASSA2000 model, based on better epidemiological data. The revised model also incorporates several interventions, including antiretroviral treatment, and their likely effect on the epidemic.
In November 2005, the ASSA released ASSA2003, which for the first time took the government's Comprehensive Plan for HIV and AIDS into account at a provincial level.
In November 2005, the ASSA released the ASSA2003 model, which revised ASSA2002's projections and took into account differing government and private sector interventions at a provincial level. This allows for accurate provincial projections.
Key findings of ASSA2003 model:
Total HIV |
Total HIV prevalence | 15-49 HIV prevalence | Life expectancy | |
| KwaZulu-Natal | 1 520 000 | 16% | 26% | 43.3 |
| Gauteng | 1 370 000 | 14% | 22% | 52.4 |
| Free State | 380 000 | 14% | 22% | 47.2 |
| Mpumalanga | 440 000 | 13% | 22% | 46.5 |
| North West | 470 000 | 12% | 20% | 50.7 |
| Eastern Cape | 630 000 | 9% | 17% | 49.4 |
| Limpopo | 380 000 | 7% | 12% | 56.4 |
| Northern Cape | 60 000 | 7% | 11% | 57.8 |
| Western Cape | 250 000 | 5% | 8% | 61.8 |
| South Africa | 5 200 000 | 11% | 18% | 51.0 |
The ASSA2003 model makes projections up to 2025. The full model is available for download from the ASSA website after free registration. Below are projections on key HIV/AIDS indicators for 2006, 2007, 2010 and 2015, using the ASSA default assumptions and rounded to the nearest whole number.
| Calendar Year starting 1 July | 2006 | 2007 | 2010 | 2015 |
| Total population | 47,866,985 | 48,218,209 | 49,147,178 | 50,328,901 |
| Total HIV infections | 5,372,474 | 5,511,749 | 5,813,088 | 6,027,508 |
| Births infected perinatally | 38,429 | 38,592 | 38,504 | 37,416 |
| Babies newly infected by mother's milk | 25,624 | 25,786 | 25,816 | 25,134 |
| AIDS sick | ||||
| New AIDS sick (over the past year ending on 30 June) | 465,126 | 492,779 | 524,857 | 490,175 |
| Total AIDS sick (in the middle of year) | 599,298 | 633,931 | 701,508 | 797,003 |
| Adults on ART | 200,457 | 313,420 | 709,021 | 1,126,299 |
| Adults with AIDS, not on ART | 510,804 | 510,514 | 456,452 | 426,352 |
| Children on ART | 25,318 | 38,069 | 81,980 | 111,168 |
| Children with AIDS, not on ART | 26,955 | 27,289 | 26,807 | 25,432 |
| Deaths: | ||||
| Male AIDS deaths (in the year starting 1 July) | 163,016 | 167,357 | 175,358 | 187,217 |
| Female AIDS deaths (in the year starting 1 July) | 191,363 | 199,643 | 218,420 | 242,645 |
| AIDS deaths (in the year starting 1 July) | 354,379 | 367,000 | 393,777 | 429,862 |
| Accumulated Aids Deaths (to middle of the year) | 1,814,457 | 2,168,835 | 3,293,012 | 5,351,660 |
| Adult AIDS deaths (15+) | 309,715 | 320,893 | 341,106 | 373,145 |
| Child AIDS deaths (0-14) | 44,663 | 46,107 | 52,671 | 56,717 |
| Prevalence rates | ||||
| Antenatal clinics | 28.3% | 28.7% | 29.2% | 29.1% |
| Youth aged 15-24 | 10.4% | 10.4% | 10.5% | 10.4% |
| Male population | 10.1% | 10.2% | 10.5% | 10.7% |
| Female population | 12.3% | 12.6% | 13.1% | 13.2% |
| Total population | 11.2% | 11.4% | 11.8% | 12.0% |
| Incidence rates | ||||
| Women aged 15 — 19 | 4.23% | 4.22% | 4.20% | 4.22% |
| Youth 15-24 | 2.85% | 2.85% | 2.84% | 2.86% |
| Adults (ages 20 — 64) | 1.68% | 1.63% | 1.49% | 1.38% |
| Total population | 1.23% | 1.20% | 1.14% | 1.09% |
| Total new infections (in the year starting 1 July) | 521,607 | 512,931 | 492,244 | 481,471 |
| Life expectancy at birth | 50.7 | 50.5 | 50.4 | 50.3 |
HIV Prevalence
Caption: Projections of HIV-infected in 2004 made by different organisations range from 3.8-million to 5.6-million.
Source: Dorrington RE, Bradshaw D, Johnson L, Budlender D. The Demographic Impact of HIV/AIDS in South Africa. National Indicators for 2004. Enlarge image
"HIV prevalence" refers to the estimated percentage of the adult population living with HIV at a specific time, regardless of when infection occurred. It describes the HIV trends in terms of time, place (province) and age. National level prevalence surveys are usually conducted using pregnant women attending antenatal clinics as the sample population. However, they can be conducted amongst a sample of the general population (for example, as was done in the Nelson Mandela/HSRC Survey), but also in workplaces, in specific communities, or amongst particular populations (for example sex workers, or truck drivers).
Prevalence is expressed as a percentage of a particular population — for example, "20% of women attending public sector antenatal clinics were HIV-positive".
HIV Incidence
"HIV incidence" is the number of new infections occurring over a given time among previously uninfected people. This is usually expressed as a number of a particular population — for example, it is estimated that there are 600 new infections occurring per day. HIV Incidence statistics have been recorded in the latest national household survey in South Africa ( South African National HIV Prevalence Incidence Behaviour and Communication Survey, 2005).
Measuring new infections is a complex process and is usually estimated rather than being measured directly.
Estimates are usually derived from antenatal prevalence surveys, by estimating incidence using prevalence rates amongst young people (e.g. 15-19 year olds) as it is more likely that any infections in this group will have taken place quite recently. Although there are limitations to this approach, changes in HIV prevalence amongst younger age groups may reflect important new trends in the epidemic.
Confidence Interval
The term "confidence interval (CI)" is often used in HIV prevalence and behavioural surveys. Confidence intervals show how precise an estimate is. For example, the HIV prevalence of 15-19 year olds might be estimated to be 13% — but we need to know how precise that estimate is. A 95% CI shows that the level of confidence that is influenced by the number of observations of HIV infection — so for example, the sample size might have been too small to make a very accurate estimate, and what is then given is the likely range of the estimate. In the case of the example, the researchers would say that they believe that the rate is 13%, but because of the limitations of their sample, this might range from 10% to 16%, with a 95% likelihood that it is 13.
Narrower CI ranges indicate a higher level of sampling efficiency — so a CI range of 12%-14% is better than a range of 10%-16%, for example.
Global Statistics
Funding for AIDSAccess to HIV Treatment and CareWomen and AIDS — A Growing ChallengeSouth African Statistics
National HIV and Syphilis Antenatal Sero-Prevalence Survey in South Africa, 2004 South African National HIV Prevalence, Behavioural Risks and Mass Media Household SurveyMortality and causes of death in South Africa, 1997-2003 The Demographic Impact of HIV/AIDS in South Africa. National Indicators for 2004. 
