Aids in SA 'starting to level off'
1 December 2005
HIV prevalence among South Africans aged between 15 and 49 increased only slightly from 2002 to 2005, suggesting that the epidemic in South Africa may have started levelling off, according to a major new study by the Human Sciences Research Council (HSRC).
Things we should know
The HSRC study makes a number of findings South Africans should know about, including how pregnancy and male circumcision can affect transmission, and the importance of getting tested. But the key finding is this: if you think that you, or your children, are not at risk of contracting HIV, chances are you're wrong.
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However, the study - which estimates that 10.8% of South Africans are HIV-positive - found that young South African women, and people in poorer communities, are particularly vulnerable to HIV/Aids, and that South Africans in general suffer from a "false sense of security" when it comes to the epidemic.
The HSRC released the results of its 2005 national household survey on HIV prevalence, incidence, behaviour and communication on Wednesday ahead of World Aids Day on 1 December.
The report was commissioned by the Nelson Mandela Foundation and conducted by the HSRC in partnership with the Medical Research Council and the Centre for Aids Development, Research and Evaluation.
10.8% of South Africans HIV-positive
The survey, which excludes children under two years of age, found that an estimated 4.8-million South Africans, or 10.8% of the population, are living
with HIV. This figure aligns broadly with the 11.4% estimated by the HSRC in 2002, and the 11.3% estimate for 2005 published by the Actuarial Society of SA earlier this week.
Comparing the 2002 with the 2005 survey, the study found a similar HIV prevalence among South Africans in the 15-49 age group, up slightly from 15.6% in 2002 to 16.2% in 2005. Among adults of 25 years and older, HIV prevalance was almost the same at 15.6% in 2005 compared to 15.5% in 2002.
However, the survey found increased HIV prevalence among young South Africans aged between 15 and 24 (10.3% in 2005 versus 9.3% in 2002).
And while a substantially lower HIV prevalence was recorded among children aged 2-14 (3.3% in 2005 compared to 5.6% in 2002), the epidemic remained "significant" among South African children, with an estimated 5.1% of children aged 2-4 and 4.4% of children aged 5-9 living with HIV.
Women, poor hit hardest
The survey also found that
South African women are more likely to be living with HIV than men, and that this proportion has increased over time, with young women aged 15-24 almost four times more likely to be HIV-positive than men in the same age-group.
The largest increase in prevalence between 2002 and 2005 was found among women aged 15-24, up from 12% to 16.9% (compared with a 4.4% prevalance rate for men in the same age-group). Overall, HIV prevalence among females was estimated to be 13.3%, compared to 8.2% among males.
The study findings also reflected the socio-economic inequalities that increase vulnerability to HIV, with South Africans living in informal settlements found to have by far the highest HIV prevalence - 25.8% in the 15-49 age-group, compared to 17.3% in rural informal areas and 13.9% in formal (urban and rural) areas.
KwaZulu-Natal was the province hardest hit by the epidemic, with an estimated 16.5% HIV prevalence, followed by Mpumalanga at 15.2% and Free State at
12.6%.
Among people aged 15-49, HIV prevalence was highest in Mpumalanga (23.1%) and Kwazulu-Natal (21.9%).
2005 estimates 'more robust'
Dr Olive Shisana, principal investigator and CEO of the HSRC, said a larger sample size made the 2005 estimates more robust than those of 2002. In 2005, 23 275 people took part in the survey and 15 851 respondents agreed to be tested for HIV, compared to 2002, when 9 963 people took part in the survey and 8 428 agreed to be tested.
Professor Thomas Rehle, a co-principal investigator of the report, said technological developments had allowed new biological tests to be conducted on samples gathered in the survey. One of the hallmarks of the 2005 survey, he said, was the availability of nationally representative estimates of annual new infections, or incidence rates.
"The addition of HIV incidence testing into the survey protocol allows a simultaneous analysis of HIV prevalence and incidence that will
significantly improve our understanding of the current dynamics of HIV transmission in South Africa," Rehle said.
Such information was vital to informing interventions and systems of support, he said, adding that the analysis would also help improve models for projecting future HIV/Aids trends.
John Samuel, chief executive of the Nelson Mandela Foundation, said the 2002 study, the first to demonstrate levels of infection in South Africa by age, gender, location and race, had received international acclaim and influenced government policy on treatment.
"The second study has allowed us to assess trends in infection and knowledge of HIV between 2002 and 2005," Samuel said. "It enables us to probe behaviour, communication and perceptions around treatment, mental health, and vaccine development. It also provides critical insights into contextual, structural and political factors for HIV."
He said the foundation would discuss the latest figures with the government
to help inform the national plan for the prevention, treatment, care and management of HIV/Aids.
SouthAfrica.info reporter
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