This paper looks at the scope and nature of the HIV and AIDS epidemic in South Africa and follows trends from 1994 to 2008. It uses available and official reports and statistics, and focuses on a brief history of HIV and AIDS in South Africa, scope of the HIV and AIDS epidemic, nature and impact of the HIV and AIDS epidemic, responses to the HIV and AIDS epidemic and the demographic and population policy issues. The paper outlines HIV interventions and their impacts. It also highlights South Africa’s Population Policy concerns about human development, demographic and environmental issues, which lead to ten major concerns. Among them, challenges of (i) the high rates of infant and maternal mortality, linked to high-risk child bearing; (ii) the high rates of premature mortality attributable to preventable causes; and (iii) the rising incidence of sexually transmitted infections, especially HIV and AIDS, and (iv) the projected socio-economic impact of AIDS.