As reported by the City of Cape Town, it has achieved significant improvements in HIV treatment and prevention rates over the past year, despite facing substantial challenges from reduced international funding that led to staffing cuts across City health facilities.
The progress comes as the City’s efforts aligned closely with South Africa’s national Close the Gap Campaign, which officially concludes on World AIDS Day, the City stated in a media release on World AIDS Day on 1 December.
The campaign aimed to strengthen HIV and tuberculosis services whilst re-engaging more than 70 000 people living with HIV in the Cape Town Metro who are currently not receiving antiretroviral therapy (ART) care, the City states.
However, the year proved particularly challenging due to the impact of the USAID stop work order, which resulted in reduced partner support and fewer counsellors, nurses and clerks in City Health facilities, according to the statement.
To address these setbacks, City Health reports that 18 high-burden facilities were identified where teams focused on improving access, strengthening systems, and providing enhanced support to clients living with HIV.
Adapting to staff shortages
With counsellors playing a vital role in HIV testing, patient education and support, the City moved to ensure continuity of care after losing NGO support staff, says a City Health spokesperson.
A series of HIV testing and counselling workshops were organised for clinicians, equipping them to take on these additional responsibilities.
The counselling workshops, emphasised the need for high-quality, patient-centred counselling that supports clients in problem-solving and helps them identify solutions to potential barriers to care. A key counselling message highlighted was U=U (Undetectable = Untransmittable) — the evidence-based reassurance that people living with HIV who maintain an undetectable viral load cannot transmit the virus to their sexual partners.
In November, the City hosted a webinar featuring a representative from the South African National AIDS Council (SANAC) to strengthen staff understanding of the science behind this important public health message.
Expanding treatment options
Another major focus has been expanding access to Six-Month Multi-Month Dispensing (6MMD) through ART Clubs at selected facilities, with further roll-out planned.
“This model allows stable patients to collect a six-month supply of medication in a single visit, reducing the need for frequent clinic attendance. This not only makes treatment more convenient for patients, but also helps decongest facilities and supports long-term adherence,” says Mayco member for community services and health Francine Higham.
According to Higham more than 90 000 people receive ART at City Health facilities, nearly 50 000 through the ART Club system.
The numbers show significant progress.
By June 2026, it is projected that 58% of ART patients at City facilities will be accessing services at a site offering 6MMD.
Furthermore, the City continues to offer and scale up the distribution of HIV self-screening kits, focusing primarily on pregnant women and their partners to broaden access and reduce barriers to testing, according to the statement.
Prevention efforts show promise
Preventing new HIV infections remains a priority for the City, says Higham, as it continues to provide oral Pre-exposure prophylaxis (PrEP), and the introduction of six-monthly injectable PrEP Lenacapavir at selected facilities next year that will offer an additional, long-acting prevention option to help curb new infections. The numbers show significant progress, according to Higham. At the end of June 2024, City clinics had 37 357 clients remaining on PrEP; that figure increased to 51 277 by June 2025.
“As we commemorate World AIDS Day, the City reaffirms its commitment to supporting resilient health services, empowering communities, and ensuring that every person living with HIV can access the treatment, care and dignity they deserve. The City also extends sincere thanks to all staff working across its HIV programme, including their work and dedication to the National Close the Gap Campaign,” Higham concluded.
