The legal framework
South Africa introduced free school-based HPV vaccination for grade five girls in 2014 and has achieved reasonable coverage. Adult screening, by contrast, has been limited: national policy has long provided a small number of free cytology tests from age 30 at long intervals, which is far less than most comparable countries, although HPV testing is being introduced.
South Africa runs a free school-based HPV vaccination programme for girls in Grade 5, and has had a national cervical screening policy since 2000. The burden is compounded by HIV: women living with HIV have a much higher risk that an HPV infection persists and progresses, which is why screening intervals for them are shorter.
Key points
| School programme | Free for grade five girls since 2014 |
|---|---|
| Boys | Not included in the public programme |
| Screening policy | A small number of free cytology tests from age 30, at long intervals |
| HPV testing | Being introduced, including for women living with HIV |
| Women living with HIV | Screened more frequently, given substantially higher risk |
| Burden | Cervical cancer is a leading cause of cancer death in women |
| Cost | Free in the public sector within the policy limits |
In practice
- If you are living with HIV, ask for more frequent screening: the policy provides for it and the risk is much higher.
- Do not wait for an invitation: there is no call and recall system.
- Ask whether HPV testing is available at your facility.
- Bleeding after sex needs examination without delay.
Cost and coverage
Vaccination and screening within policy limits are free in the public sector.
Where to go
- Public clinics and community health centres.
- Cancer Association of South Africa.
- HIV clinics, which increasingly integrate cervical screening.
Worth knowing
Women living with HIV have a far higher risk of cervical cancer and are entitled to more frequent screening. That entitlement is frequently not offered — ask for it explicitly.
Frequently asked questions
How does HIV change the screening advice?
Women living with HIV should be screened more frequently, because HPV infection is more likely to persist and progress to cancer. South African guidelines set shorter intervals for them. If you are living with HIV, ask specifically — the standard interval is not the one that applies to you.
Why vaccinate boys as well as girls?
Because HPV causes cancers of the penis, anus and throat as well as the cervix, and genital warts in both sexes — and because high coverage in both sexes cuts transmission for everyone far faster than vaccinating girls alone. Programmes that include boys reach population-level protection years earlier, which is why almost every country that started with girls has since extended it.
Official sources and links
- gov.za — official government portal
- South African Human Rights Commission — constitutional rights body