Prevention fatigue and the normalization of HIV among South African youth: A crisis of complacency

Despite decades of investment in HIV prevention, South Africa continues to experience high rates of new infections among youth aged 15 to 24. This integrative literature review study explores how prevention fatigue and the normalization of HIV have contributed to a growing crisis of complacency among young people, leading to emotional disengagement and declining participation in prevention efforts. Guided by social constructivism, the Health Belief Model (HBM), and the concept of prevention fatigue, the study systematically reviewed peer-reviewed literature, national policy documents, and program evaluations published between 2010 and 2024. Thematic analysis revealed three key findings: a diminished perception of HIV risk due to normalization; emotional burnout and desensitization stemming from repetitive prevention messaging; and a disconnection between traditional HIV communication strategies and the lived digital, cultural, and social realities of youth. The study argues that knowledge alone is insufficient to sustain behavior change and calls for a fundamental shift in prevention strategy design. Recommendations include the use of emotionally intelligent messaging, digital innovation, and youth-led content creation to re-energize prevention efforts. This study contributes to the discourse by reframing youth disengagement not as ignorance, but as a product of systemic oversaturation and social repositioning of HIV in the post-crisis era. Key Words:Youth;, HIV, AIDS, Prevention, Fatique, HIV Normalization