Countries with the Greatest HIV/AIDS Incidence in Africa in 2025
In Southern Africa, the HIV epidemic continues to be a significant public health challenge. According to recent data, several countries in the region are among the top ten African nations with the highest adult HIV prevalence.
Eswatini, a small kingdom in Southern Africa, has the world's highest adult HIV prevalence, with approximately 27.5% of its population living with the virus, amounting to around 230,000 people. neighbouring South Africa follows closely, with over 7.7 million adults living with HIV and an adult prevalence rate of 16.6%.
Uganda, with an adult HIV prevalence of 5.6% and approximately 1.5 million people living with the virus, is another country struggling with the epidemic. Zambia and Zimbabwe, both with adult HIV prevalence rates of 11% and approximately 1.3 million people living with HIV each, are also among the hardest hit. Malawi, with an adult HIV prevalence of 7.6% and nearly 980,000 people living with the virus, and Lesotho, with an estimated 270,000 people infected and a prevalence rate of 20.5%, complete the list of countries with high HIV prevalence in the region.
Mozambique, with about 2.4 million people living with HIV and a prevalence rate of 11.8%, faces additional challenges such as poor literacy rates, high levels of gender inequality, and one of the lowest healthcare worker-to-patient ratios on the continent.
Botswana, despite its high HIV prevalence rate of 19.7%, has made remarkable strides in its response to the epidemic. The country has reduced AIDS-related deaths through consistent public awareness campaigns and the early adoption of free antiretroviral therapy. South Africa, being one of the first African nations to adopt injectable PrEP and self-testing kits nationwide, is also a leader in the region's HIV response, running the world's largest publicly funded ART program.
However, challenges remain. Lesotho's health system still suffers from a shortage of trained workers and inconsistent drug supply chains, hindering long-term viral suppression and treatment continuity. Key populations in Zambia, including sex workers and men who have sex with men, face high levels of discrimination. The Copperbelt and Lusaka regions in Zambia are among the most affected by the HIV epidemic.
International organisations such as the World Health Organization (WHO), UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and PEPFAR (The U.S. President's Emergency Plan for AIDS Relief) currently support the antiretroviral therapy rollout in Eswatini. The future of the HIV response in these countries will require continued international support and a commitment to addressing the underlying social and economic factors driving the epidemic.
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