HIV, or human immunodeficiency virus, weakens the body’s immune system, leaving it vulnerable to illness. 

Without treatment, HIV can progress to a severe, life-threatening disease called acquired immunodeficiency syndrome or Aids. There is no cure, but with regular treatment, the virus can be suppressed to undetectable levels in the blood, meaning it cannot be passed on. 

HIV is treated with ARVs, usually taken daily as tablets. South Africa has both the largest number of people living with HIV in the world and the biggest ARV programme. By 2024, about 6.3-million people were on treatment.

The scale of South Africa’s ARV programme means researchers need to monitor the possible effects of these drugs on humans and the environment. This is where the 2020 report comes in.

Researchers from South Africa’s North-West University (NWU) began the report in 2016. The findings are detailed across two extensive volumes and were submitted to the state-funded Water Research Commission. 

The researchers tested water sources in the Gauteng and North West provinces. They found traces of several ARVs in rivers both upstream and downstream of wastewater treatment plants, with smaller concentrations present in some drinking water samples collected near these rivers. 

The ARVs were not found in fish caught in the same water. However, lab tests on freshwater snails and microscopic organisms suggested these drugs might negatively affect the water environment in which they were found. 

While the report did not find evidence of harm to humans, this detail was often lost in some of the news coverage, which also made other crucial errors. 

Africa Check has previously written about “churnalism”. It often leads to misleading coverage.

In this case, much of the coverage of the 2020 report drew heavily on an article published on the university’s website, with little context added. It’s common for journalists to use press releases or other secondary sources as a starting point for reporting, but simply quoting or rephrasing often leaves out vital information.

For example, none of the news articles we reviewed mentioned that the report was published in 2020 or that the samples were collected between October 2017 and October 2018. 

This doesn’t mean the research is irrelevant. Studies like this take time and can guide future research, legislation and public debate. But it’s important to note that the landscape has changed since the samples were taken. 

As Bhekisisa points out in their article, South Africa’s entry-level ARV regimen is now different. At least one of the drugs (efivarenz) the researchers found is no longer as widely prescribed, and a new drug, dolutegravir, has been introduced. 

There are also more South Africans taking ARV medication in 2025 than in 2016. This means that the types and concentrations of ARVs in South African water sources are likely to have changed significantly since the research was done.

Context like this is essential in science reporting. Rachel Zamzow, managing editor of The Open Notebook, an organisation providing science journalism advice and training, told Africa Check: “When the research that reporters cover intersects with public health, medicine, or the environment, misleading or sensationalised science coverage can have very real consequences.” 

In this case, poor reporting about the research could make people doubt whether tap water is safe to drink, or even convince some people taking ARVs that they could skip doses and get treatment from the water. 

So what can you do to stay well-informed about scientific research, and how can journalists ensure they report scientific findings accurately? For readers, the key is knowing how to recognise misleading reporting.

1. Read beyond the headline

Some social media reactions seemed to misunderstand key details that could be clarified by reading almost any reporting on the topic.

At the extreme end, some posts claimed that powerful groups had deliberately added ARVs to water sources to cause harm. These echo well-known and widely mocked falsehoods pushed by conspiracy theorists, such as disgraced US radio host Alex Jones. 

But even those who didn’t seem to think there were bad intentions behind it sometimes said that ARVs were deliberately “put” in drinking water to stop HIV.

There is no credible evidence to suggest that this was deliberate. It’s also unclear what purpose this would have – as Bhekisisa explains, the ARV levels found in water sources, especially tap water, were far too low to affect HIV in people. 

Instead, the report suggested that most ARVs enter water sources through wastewater. Traces of the drugs leave the body in waste, and unused medication can also end up in sewage systems. Although treatment plants clean water, they aren’t designed to filter out smaller chemicals like ARVs, so they stay in the water system.

The report’s authors told Africa Check that pharmaceuticals in water are not unique to South Africa. “It's a growing global concern, including in developed nations.” 

The report builds on years of extensive research into this issue.

While there may be cause for concern about ARVs in water sources, the report only found evidence of possible harm to the environment, not to humans. Some reporting did mention that the risks to humans were currently unknown, but often buried it in the text, not in the headline. Reading beyond the headline would have cleared up this and other concerns voiced on social media. 

But if a news article itself is inaccurate or lacking context, even a careful reader can be misled. 

2. Watch out for sensational language

If an article uses dramatic or sensational language, you might want to dig deeper. Zamzow suggested key terms to look out for: “‘Cure,’ ‘groundbreaking,’ and ‘breakthrough’ are signs of over-hyped coverage.”

According to The Open Notebook, in science, “true ‘breakthroughs’ are rare”. Science usually advances slowly, through trial and error. Most findings add small pieces to a much bigger puzzle. Big discoveries do happen, but you should be wary of extraordinary claims.

It’s also common to use emotive language to grab attention, but this can distort the research.

It’s easy to see why someone might worry after reading a headline like “A hidden threat: Dangerous levels of ARVs found in South Africa's water sources”. 

But, as the report’s authors told Africa Check: “There is no current evidence that drinking water containing trace amounts of ARVs at current levels poses immediate danger to human health.”

Good science journalism should explain why findings matter, and provide basic context, such as how the research was done and what remains unknown.

3. Try to find the original source

If all else fails, the best way to know what a study found is to read it yourself. Research papers can be dense, but you don’t need to be an expert to learn from them. Even just checking if a study is quoted correctly can reveal problems.

“If there isn't a study cited, or if the research cited seems questionable – perhaps due to a conflict of interest or the lack of peer-review – then the reporting might be misleading,” Zamzow said. (The 2020 report was not peer-reviewed, which doesn’t make it unreliable, but does mean that it should be read carefully.)

Most reporting we found did name the actual report. But comparing the coverage with the university’s article revealed signs of churnalism.

The Sunday Times, for example, incorrectly implied that a quote about ARVs in concentrations “far exceeding global norms” came from the report. But it was from the university’s article. This shows the importance of consulting the original source, as even institutional communications can be misleading.  

Reading scientific studies may seem daunting but, according to Zamzow, “many scientific papers follow a standard pattern, which means it's relatively easy to find key information you need”.

The Open Notebook’s guides to reading scientific papers and very long documents can help you break down complex research into clear takeaways.

For journalists, the goal should also be to go beyond the press release with original reporting.

1. Read the original study

As Africa Check has previously written, a journalist should always start by reading the original study. Press releases and other secondary sources can help, but relying on them alone risks misleading readers. 

Take, for example, the following paragraph from this IOL article:  

The presence of ARVs in water can be considered a hidden or latent risk. Humans are also exposed to these compounds via drinking water, and at concentrations exceeding calculated hazard quotients.

Here, sentences from different parts of the university’s article were pieced together in a way that misrepresents the report’s findings.

In the original report, the sentence suggesting ARVs could be a hidden risk was referring specifically to “environmental concerns” – not direct risks to humans. 

2. Think about your audience

It’s possible to overwhelm readers with too much detail. Most people won’t be interested in every step of the research and could be confused by scientific jargon. Journalists need to choose the most important information to share.

Zamzow advises tailoring your reporting to your audience. Ask questions like: “How might the research you're covering apply to their daily lives, and what key information do they need to know to make decisions?”

In the case of ARVs in South African water sources, relevant questions include:

• Is the tap water safe to drink?
• Should people on ARVs change their dosage?
• What knock-on effects could this have, for example, on the environment? 

Bhekisisa has answered some of these questions in their article.

But jargon can still get in the way. For example, a Mail & Guardian article quoted the line: “The consumption of any type of exogenous drug by any organism in sufficient quantities may intervene with the regulation of metabolic systems and bring about adverse effects.” This was also quoted in the university’s article.

While accurate, such wording is hard for a general audience to digest.

This could be simplified for the public by paraphrasing it to something like: “In large enough quantities, any drug could have harmful side effects.”

At its worst, jargon can actively mislead.

The same Mail & Guardian article also says that the report found some ARVs in “concentrations at some sites far exceeding global norms”. This is technically accurate, and appeared in the university’s article too, but phrases like “global norms” might imply that international standards limiting how much of these drugs may be present in water exist. 

The report’s authors told Africa Check that “there are no national or international guidelines for the amount of ARVs that may be present in water sources”, although they recommended conducting further work to establish at what levels these drugs might begin to affect the environment.

In this case, “global norms” just means that higher levels of ARVs were found in South African water sources than are typically found elsewhere.

3. Speak to an expert

Even the most experienced science journalists can’t be experts in every field. One of the most useful things you can do is to ask experts for their views.

“It's helpful to consult with both an author from the study and a relevant expert in the field, who can comment on the quality of the work from an outsider's perspective,” Zamzow told Africa Check.

An expert who is not involved in the research is more likely to spot possible flaws, while the researchers who conducted a study are best placed to explain its methods and findings. 

“Journalists should always contact the owner of the research, or the relevant media department, to facilitate communication between researchers and the media,” the researchers told Africa Check. 

Speaking to experts shouldn’t be the only step you take – the jargon-heavy Mail & Guardian article did interview the authors of the 2020 report, and things still got lost in translation. But experts can also provide important context and help ensure that you explain concepts in a way that is both accurate and understandable to a general audience.

“If you come up with a metaphor or analogy to explain a complex idea, consider running it by an expert to ensure you're representing the research accurately,” Zamzow said.

Experts and the organisations they work for are often eager to share their work with the public. NWU’s communications department told Africa Check: “Nothing is published on the NWU’s newsroom on which journalists may not further enquire.”