10 December 2012

South Africa: Govt Making Inroads in Fight Against HIV

Pretoria — The HIV epidemic in South Africa has continued to stabilise over the past six years, with KwaZulu-Natal having recorded a notable decline in 2011.

According to the 2011 National Antenatal Sentinel HIV Prevalence Survey, released on Monday by Health Minister Dr Aaron Motsoaledi, the HIV epidemic has in the last six years shown signs of stabilisation, particularly among antenatal care first time bookers in public health sector clinics.

A total of 33 446 first time antenatal care attendees participated in the survey conducted in October 2011 at all 52 health districts.

The primary objective of the survey was to assess the HIV status among women attending public sector antenatal clinics, and for the department to use the data for the estimation of HIV sero-prevalence trends, and the burden of AIDS in the general population.

KwaZulu-Natal has recorded a notable decrease in HIV prevalence, with an estimated prevalence rate of 37.4% for 2011. The upper limit of the 2011 confidence interval (an interval in which a measurement or trial falls corresponding to a given probability) was lower than the 2009 and 2010 estimates of 39.5%, indicating a decline of 2.1%.

Motsoaledi attributed the decline in KZN to the hard work of the provincial branch of the National AIDS Council. The council includes key role players such as district mayors, who report on matters of maternal and child mortality; the success of the HIV Counselling and Testing (HCT) campaign and the circumcision campaign.

"When the district mayor [gives the report], the Premier then asks the Health Department if it has any corrections or anything to add to what the mayor recorded. [The mayor then] gives the responsibility to the leaders so that they don't regard only the health [system] or doctors as the ones who must deal with this," Motsoaledi noted.

Another advantage for the province, Motsoaledi said, was that Premier Zweli Mkhize was deeply involved in the fight against AIDS. Mkhize was at some point the Health MEC and he went into his position as Premier with the knowledge of what needed to be done to turn the situation around.

In Gauteng, the prevalence rate decreased from 30.4% in 2010 to 28.7% in 2011; Eastern Cape recorded a prevalence rate of 29.3% in 2011, whilst the Northern Cape and Western Cape were the only provinces that had prevalence rates below 20.0%. The Northern Cape recorded 17.0% and Western Cape recorded 18.2% for 2011.

On the other hand, Mpumalanga has recorded an increase in the prevalence rate of 2.0%, from 34.7% in 2009, 35.1% in 2010 to 36.7% in 2011.

Motsoaledi said the increase in the Gert Sibande District in Mpumalanga was not surprising but very worrying as 40% of the country's energy supply came from there.

"[Gert Sibande] needs a massive circumcision campaign, which they have not launched," he said, adding that the situation needed to be looked into.

The prevalence in the Free State also increased from 30.6% in 2010 to 32.5% in 2011; North West went up from 29.6% in 2010 to 30.2% in 2011, with Limpopo showing an increase from 21.4% in 2009 to 22.1% in 2011.

Encouraging results were also noted in the age group 15-24 years, which showed a decrease from 21.8% in 2010 to 20.5% in 2011 -- a decline of 1.3%. Another decrease was among the 15-19 year olds from 14% in 2010 to 12.7% in 2011.

The HIV prevalence, however, among women in age group 30-34 years remained the highest, increasing from 41.5% in 2009 to 42.2% in 2011. Among the 35-39 year-olds, the prevalence rate has increased from 35.4% in 2009 to 39.4% in 2011.

Explaining the increase in the older age groups, Motsoaledi said individuals in these age groups got infected earlier in their lives, and were now moving into a higher age group, pushing up the prevalence rates.

"The good news is that we have broken down the upward movement in the 15-19 years group, meaning that prevention is starting to work..." Motsoaledi said.

However, he warned that the country should not rest on its laurels and push harder to achieve the AIDS Millennium Development Goals (MDG) target.

"... Our focus must be on teenage pregnancies, reproductive health rights amongst school kids and the integrated school health programme is going to help us to do that... We have three years to reach the United Nations target of 5.3% and the jury is out on how hard we work as a country," Motsoaledi said.

The minister said the 2011 report had also shown syphilis infections had gone down.

"In the next year, we will do Hepatitis B prevalence and HIV infection, which is closely associated with HIV and AIDS," Motsoaledi said.

From 2013, the survey will be conducted on a monthly basis instead of only in October. Motsoaledi said this was because it was hard to include pregnant teens in the survey in October because of the final school exams.

"... Our target is to test 400 000 pregnant women of all ages annually and this result will be reported in 2014... If we do it on a monthly basis, we would have conducted the study on 400 000 women [in a year] and that is very significant," said the minister.

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