Summary

Approximately 36.7 million people worldwide are living with the Human Immunodeficiency Virus (HIV). Almost 20 percent of South Africa’s adult population (aged fifteen to forty-nine) is HIV-positive, and about one in every five people living with HIV worldwide is in South Africa. The pandemic, and the political controversies it elicited, have come to define both local and global understandings of the post-apartheid nation. The history of HIV in South Africa begins in the 1980s during an era of heightened repression by the apartheid state, in which discriminatory laws and fearful public responses tapped into broader prejudices relating to race and sexuality. During the 1990s, as South Africa transitioned to democracy and as rates of HIV reached pandemic levels, partnerships were built between civil society and state actors to confront the many challenges that the HIV epidemic presented. However, from the late 1990s, corruption and the abuse of political power within the Department of Health, together with the government’s refusal to provide life-saving antiretroviral treatment (ART), ignited a new era in health advocacy. While the HIV-treatment activist movement won the struggle for public access to treatment, Jacob Zuma’s succession to President Thabo Mbeki heralded a new era of political controversies in the state’s HIV response. A copious historiography on the HIV epidemic in South Africa maps the contemporary chronology and evolution of the disease, including a focus on changing public understandings and responses