Peter Piot (1997), the executive director of UNAIDS, states that the South African government estimated in 1997 that 2.4 million South Africans were living with HIV. UNAIDS estimates in AIDS Epidemic Update that in 2006, 24.7 million adults and children in sub-Saharan Africa were infected. The national prevalence rates (the number of cases of the disease present in a specified population at a given time) of HIV infection among adults vary widely. Some West African countries report relatively low rates of infection, whereas others in the southern portion of the continent experience much higher rates. Even though there are indications that some of the HIV epidemics in this region have already peaked and are diminishing, there is actually an equilibrium--32% of people with HIV globally live in Southern Africa and 34% of AIDS global deaths occur in this region. Similarly, an unfortunate equilibrium exists between the number of people newly infected with HIV and the number of people dying of AIDS.

Because heterosexual transmission is the predominant mode of transmission in Africa, men and women have been almost equally infected. However, in 2006 more women than men were infected with HIV, and they were also more likely to be the ones caring for others infected with HIV or suffering from AIDS. Paid sex workers and their customers play a significant role in the spread of HIV in many countries. In some African cities the risk of contracting HIV infection approaches 50%.

John D. Stratigos and Evangelia Tzala indicate in ''Global Epidemiology of HIV Infection and AIDS'' (Clinics in Dermatology, vol. 18, no. 4, July-August 2000) that in the late 1990s four out of five HIV-positive women in the world lived in Africa, as did 87% of children who lived with HIV. There are several reasons for this. The female childbearing population is larger in Africa than in any other place, and African women generally have more children than women in other parts of the world. This means that one woman can pass the virus on to more children. Furthermore, nearly all children in Africa are breastfed, and breastfeeding is responsible for more than one-third of mother-to-child transmissions of HIV. Even though there are drugs available to sharply reduce mother-to-child transmission, they are expensive, and women in developing countries generally cannot afford them.

In AIDS Epidemic Update, UNAIDS notes that HIV infection rates in South African pregnant women have continued to rise, from 22.4% in 1999 to 30.2% in 2005. Even though there are some indications that the prevalence of HIV infection among young people may be stabilizing, women remain disproportionately affected. In 2005 young women aged fifteen to twenty-four were four times more likely to be HIV infected than young men.

UNAIDS notes that even though recent data confirm that nearly two-thirds of all HIV-infected people live in sub-Saharan Africa, some data from Zimbabwe paint a more optimistic picture. Both the incidence and prevalence of HIV infection are declining in Zimbabwe, and the infection levels among pregnant women, which ranged from 30% to 32% in the early 2000s, dropped to 24% in 2004. The decrease in infection rates among pregnant women was dramatic in Zimbabwe's capital, Harare, where HIV infection in pregnant women declined from 36% in 1996 and to 24% in 2004.

In response to routine screening of donated blood and the more careful use of blood for procedures such as transfusions, the role of transmission through HIV-infected blood has diminished considerably over the past several years, accounting for less than 10% of the total reported HIV infections.

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