Objectives

The aim of this study examines the HIV prevalence and associated factors orphaned adolescents and youth in South Africa using the 2017 population based national survey.

Results

Of 1 978 orphaned participants aged 12–24 years. The overall HIV prevalence was 7.8%(95% CI: 6.3–9.6). HIV was higher among females (9.2%) compared to males (6.4%). HIV prevalence was significantly (p< 0.05) higher among Black Africans than other race groups (8.2% versus 1.4%), unemployed compared to those who are employed (8.2% versus 1.3%), no condom use at last sex act (13.8% versus 5.8% who used a condom), had high self-perceived risk of HIV infection (11.4% versus 5.7% with low perception), and those who ever had an HIV test (9.5% versus 5.3% never tested). In the final multivariate model, the odds of HIV infection were significantly higher among female than males [AOR= 2.9 (95% CI: 1.1–7.8), p= 0.032] and those residing in rural informal/tribal areas than urban areas [AOR= 2.9 (05% CI: 1.1–7.7), p= 0.031]. The findings suggest a need for intervention to create employment opportunities, promote protective sex, address perceived susceptibility to HIV and encourage routine testing. Prioritising orphaned female adolescents and youth and those residing in rural informal/tribal areas.