South Africa (SA) now accounts for more than 50% of newly reported HIV cases in sub-Saharan Africa annually. In 1993, approximately 90% of those reported as HIV positive in SA were of African descent. This paper examines sociological factors in the spread of HIV in SA through the application of Lalonde's (1974) Health Field Concept. SA's emerging District Health System (DHS) is discussed, as well as barriers to effective implementation and recommendations. Through Lalonde's sociopolitical view of health, a coordinated and multisectorial approach to HIV/AIDS in SA can be established. Without this approach, health care interventions will fail to target the population effectively, thereby reducing effectiveness and sustainability.

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