South Africa is home to 7.5 million people living with HIV. Despite the large burden, the country has made progress, reducing both new infections and deaths from HIV by 50% and 73% from 2010 levels, respectively, by 2021.1 By the end of 2021, the country had managed to ensure that 94% of all people living with HIV (PLHIV) knew their HIV status and 74% of those who knew their HIV positive status had initiated antiretroviral treatment (ART) with the majority virally suppressed.1 Children living with HIV (CLHIV) have, however, lagged, with 52% of them on ART and their viral suppression rates lower than that of adults.2 Strengthening the prevention of mother-to-child transmission of HIV (PMTCT) is necessary to reduce the burden of HIV among children.
The antenatal care HIV sentinel surveillance surveys have been conducted in the country annually since 1990 and biannually since 2015. The survey’s primary objectives are to estimate overall HIV prevalence and to determine trends over time and across geographic locations (province or district) and age among pregnant women attending antenatal care at 1,589 sentinel surveillance sites in all 52 districts and nine provinces of South Africa. Since 20173, several secondary objectives have been included to evaluate the performance of the country’s PMTCT programme concerning all four programme pillars.