There are a number of complex reasons explaining why South Africa's black population has been disproportionately affected by AIDS. The history of apartheid is undoubtedly one factor. Throughout the early part of the AIDS epidemic, apartheid was still in effect. Black areas received fewer health services and educational materials than other areas. As a result, the disease spread faster in black communities.
Even today, the legacy of apartheid fuels this problem. Most private hospitals, as well as better equipped and staffed public ones, are located in urban centers. Much of the black South African population still resides in Bantustans, far from these services. Receiving access to drugs and treatment remains difficult for much of the black population in these more rural areas. Even urban blacks have fewer good choices for health services. Hospitals in black residential neighborhoods tend to be overcrowded, understaffed, and underfunded. As more and more people are infected by AIDS/HIV, this problem is compounded. The legacy of apartheid is largely to blame for this, as it concentrated populations by race and disproportionately delivered public funding and resources.
This unequal distribution of health resources is part of the long legacy of the apartheid system. So is a black population that is typically less wealthy than the white population. With fewer financial resources, many South African blacks cannot afford the private health services that are often better able to handle AIDS/HIV treatment and prevention.