The findings came from a recent study that analyzed various water sources across the country. It revealed that small amounts of ARVs—commonly used in HIV treatment—are entering the water system through municipal wastewater facilities. The drugs most often detected were lopinavir and efavirenz, with some concentrations found to be higher than recommended international levels.

The study also pointed out that most current wastewater treatment plants are not equipped to filter out these types of pharmaceutical compounds. As a result, ARVs were found in higher concentrations downstream from these facilities, suggesting that the treatment systems are failing to adequately remove them.

Despite these discoveries, officials maintain that the levels found in drinking water are very low and not harmful. The Department of Water and Sanitation emphasized that while the presence of ARVs is not ideal, the drugs themselves do not transmit diseases—they are used to treat them. That means there is no risk of contracting HIV from drinking water containing trace amounts of ARVs.

Experts have acknowledged the need for more research into the long-term impact of pharmaceutical residues in water, including the potential for antimicrobial resistance and environmental harm. However, there is currently no evidence suggesting ARVs in water affect aquatic life or pose an immediate threat to human health.

Globally, the issue of pharmaceutical contamination in water is gaining attention, with many countries facing similar challenges. These substances are typically found in extremely small quantities—measured in nanograms—and are not yet fully regulated due to the complexity of monitoring and removing them.

The government continues to investigate the matter and encourages the development of more advanced water treatment technologies to address these emerging concerns.

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Before her clinic shut down, Gugu was fortunate to receive a nine-month supply of antiretroviral drugs (ARVs)—a critical medication that helps suppress the virus and prevent transmission. Her current supply will run out in September, after which she hopes to access medication at a local public hospital.

Her journey with HIV began a decade ago after a persistent chest infection led her to seek testing. Though she suspected the diagnosis, confirmation brought clarity and a commitment to treatment. Today, Gugu works as a project coordinator with an NGO that supports pregnant sex workers, helping them access treatment to protect their unborn children from infection.

Many women like Gugu now find themselves in limbo. The clinics they once trusted have disappeared, leaving public hospitals as the only remaining option—facilities that are often overstretched and under-resourced. For those still engaged in sex work or facing stigma, navigating these public systems can be especially difficult.

Global health experts have raised concerns over the fallout from recent aid reductions. A new report highlights that progress against HIV is in jeopardy, with millions of lives potentially at risk if funding shortfalls aren’t addressed. Despite major gains over the past two decades—including millions of lives saved and infections prevented—activists and healthcare workers warn that such progress could be undone.

Gugu fears that many women may now avoid seeking care altogether, a dangerous step backward in a country that has long fought to turn the tide on HIV.

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