The Nelson Mandela Foundation (NMF) commissioned the first national, household sero-prevalence survey of HIV/AIDS in 2002. That study had significant impact nationally, in the sub-region and internationally. The report received widespread attention, has been used to build the capacity of other Southern African Development Community (SADC) countries in implementing similar studies, and has impacted on policy, strategy and practice in the area of HIV/AIDS in South Africa. Statistics South Africa currently uses the 2002 household survey to estimate the magnitude of the HIV/AIDS situation in the country. Since 2002, significant shifts have occurred and South Africa has made great strides: the roll out of a comprehensive programme for the care and treatment of HIV-infected individuals has begun and investment in mass media campaigns aimed at preventing new infections is at an all-time high. The NMF realised that it was important to assess the extent to which these policies and practices had changed the shape of the pandemic in South Africa by following up on the first survey. This report on the second national survey of HIV/AIDS reveals a number of key issues, such as: South Africans are increasingly being tested to find out their HIV status; more people, including older South Africans, are using condoms at higher rates than before; and, more care and support is being provided to people living with and affected by HIV/AIDS. The report brings home the reality that the HIV prevalence in South Africa among persons aged 2 years and older at 10.8 per cent translates to 4.8 million people living with HIV/AIDS in 2005. Factors underpinning continued high HIV prevalence are partly illustrated by the finding that half of the respondents in this study who were found to be HIV positive did not think they were at risk of HIV infection. It considers HIV/AIDS stigma, the integration of family planning and HIV/AIDS service, and the existing HIV/AIDS communication campaigns. The findings and recommendations of the report will be invaluable to policy-makers and strategic planners, health and other professionals, the media, researchers and academics.