Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 1;39(12):1839-1841.
doi: 10.1097/QAD.0000000000004281. Epub 2025 Aug 28.

Under-reporting of HIV and AIDS as an underlying cause of death in South Africa

Pam Groenewald  1 , Tracy Glass  1 , Natasha Kallis  1 , Chantelle Holmgren  1 , B Nojilana  1 , Monique Maqungo  1 , Mireille Cheyip  2 , Diane Morof  2 , Nadine Nannan  1 , Debbie Bradshaw  1
Affiliations

Under-reporting of HIV and AIDS as an underlying cause of death in South Africa

Pam Groenewald et al. AIDS. .

Abstract

Under-reporting of HIV-related and AIDS-related deaths is a major problem in South Africa, with only 27.9% of documented HIV-related deaths in medical records reported as such in the official cause of death data. The legacy of AIDS denialism in South Africa, confidentiality concerns, and anticipated stigma appear to have created a culture of not recording HIV as an underlying cause on the official medical certificate of death. Inaccurate statistics could affect resource allocation for the epidemic.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Underlying cause of death from death notifications for HIV/AIDS deaths based on medical records, South African national cause of death validation study 2017/2018 (N = 2749).
See this image and copyright information in PMC

References

    1. Bradshaw D, Msemburi W, Dorrington R, Pillay-van Wyk V, Laubscher R, Groenewald P. on behalf of the South African National Burden of Disease Study team. HIV/AIDS in South Africa: how many people died from the disease between 1997 and 2010?. AIDS 2016; 30:771–778. - PubMed
    1. Paula AA, Chequer P, Pires DRF, Lemos KRV, Barone LG, Veloso VG, Pacheco AG. Assessing the underreporting of deaths among people living with HIV in Rio de Janeiro, Brazil, from 2014 to 2019. Cad Saude Publica 2022; 38:e00081821. - PubMed
    1. Dorrington RE, Moultrie TA, Laubscher R, Groenewald P, Bradshaw D. Rapid mortality surveillance using a national population register to monitor excess deaths during SARS-CoV-2 pandemic in South Africa. Genus 2021; 77:19. - PMC - PubMed
    1. Nadine N, Debbie B, Ria L, Mikateko M, Tshifhiwa N, Ian N, et al.; the Strengthening Mortality Surveillance project team. Rapid assessment of cause-of-death data collection and public health use in South Africa. Cape Town: South African Medical Research Council. 2023.
    1. Bradshaw D, Dorrington RE, Laubscher R. Rapid mortality surveillance report 2011. Cape Town: South African Medical Research Council, 2012.