The Sixth South African HIV Prevalence, Incidence and Behaviour Survey (SABSSM VI) for Limpopo has found that the province had one of the lowest HIV prevalence levels among all provinces in 2022, at 8.9%, down from 10.1% in 2017.
This translates to an estimated 570 000 people living with HIV (PLHIV) in Limpopo, a 2% decrease from the 580 000 reported in 2017.
The data is based on the Human Sciences Research Council (HSRC) which released the key findings of the SABSSM VI for Limpopo.
The findings were released at the Meropa Hotel in Polokwane on Tuesday.
The survey found that in 2022, HIV prevalence in the province was disproportionately higher among the 25 to 49 year old age group, with females recording a prevalence of 22.3% and males 17%.
"Moreover, HIV prevalence was high, 7.4% among individuals living in rural formal or farm areas. Notably, females consistently showed a higher HIV prevalence across all selected demographic variables compared to their male counterparts," the data revealed.
According to the overall principal investigator of the study, the HSRC's Professor Khangelani Zuma, the survey revealed that the HIV epidemic profile peaked at an HIV prevalence of 29.4% among people aged between 50 and 54 in 2022, down from a peak of 36.9% in 2017 among those aged 40 to 44.
"There was a decrease in HIV prevalence in 2022, except among those zero to 14 years, 35 to 39 years, and 50 to 54 years, compared to 2017," Zuma noted.
The data presented was for three Limpopo districts - namely Vhembe, Capricorn, and Mopani.
Among the three districts, the highest HIV prevalence was found in Mopani at 9%.
The SABSSM VI survey, conducted between 2022 and 2023, aimed to maintain surveillance of HIV infection and behaviours in South Africa, evaluate the progress of the South African national HIV and AIDS, STI and TB Strategic Plan, and monitor HIV indicators for national and international reporting.
Antiretroviral treatment
Shifting the focus to antiretroviral treatment (ART) coverage, the HSRC said the estimates closely mirror the national outlook, increasing to 80.8% in 2022 from 62.8% in 2017.
This translates to an estimated 430 000 PLHIV in the province receiving treatment in 2022, up from 290 000 in 2017.
ART use among all people living with HIV in the province was 80.8%, with males (73.1%) having lower coverage than females (84%).
Additionally, ART coverage was lower among those residing in urban areas (79.7%) than in other localities.
The lowest ART use was reported in Vhembe (76.4%), followed by Capricorn (80.8%).
Viral load suppression
The survey further revealed that in 2022, among all provinces, Limpopo had one of the lowest proportions of PLHIV who achieved viral load suppression (VLS) at 77.0%, up from 60.8% in 2017.
VLS was slightly lower among females (76.6%) than males (77.8%), with a more significant disparity in rural informal or tribal areas, where females achieved VLS at a rate of 75.2% compared to males at 83.9%.
"Low levels of VLS are concerning in that there is a high risk of HIV transmission during unprotected sexual acts with a person who is virally unsuppressed."
Knowledge of HIV status
Meanwhile, Zuma expressed concern that people living with HIV aged 25 to 49 make up the majority of those in Limpopo who are unaware of their HIV status (65.0%), aware but not on ART (63.3%), and on ART but not virally suppressed (65.9%).
However, he noted that adolescents and youth aged 15 to 24 disproportionately contribute to gaps in treatment, comprising only 4.8% of all people living with HIV, yet accounting for 15% of those unaware of their status, 13.3% of those aware but not on ART, and 11.4% of those on ART but not virally suppressed.
Among females, those aged 15 to 24 years account for a minority of female people living with HIV (4%).
Sex debut
Regarding the key drivers of the HIV pandemic, the Professor noted that the proportion of adolescents and youth aged 15 to 24 who reported having sex before the age of 15 years decreased to 8.7% in 2022 from 13.5% in 2017.
In 2022, the percentage of adolescents and youth aged 15 to 24 who had their sexual debut before the age of 15 years was higher among males (14%) compared to females (3.1%).
"This percentage varied by district, with the lowest rate in Capricorn (4.8%) and the highest rate in Vhembe (12.9%)."
Multiple partners
The survey revealed that in Limpopo, 11.4% of people aged 15 and older reported having multiple sexual partners in 2022, a decrease from 12% in 2017.
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Notably, males (18.5%) were 3.7 times more likely to report having multiple sexual partners than females (5%).
The highest proportion of multiple sexual partners was found among those aged 15 to 24 (15.8%), compared to other age groups.
Condoms
Regarding condom use, the survey found that in Limpopo, 29.8% of people reported using a condom with their most recent sexual partner in 2022, a decline of 11.8% from 41.6% in 2017.
Condom use was lower among certain groups, including those aged 25 to 49 (28.7%) and females (25.4%).
In Limpopo, a higher proportion (53%) reported never using a condom with their most recent sexual partner, while only 4.4% reported using a condom almost every time.
"The consistency of condom uses with the most recent sexual partner among people aged 15 and older in the province was higher among adolescents and youth aged 15 to 24 (31.7%) compared to those aged 25 to 49 (19%).
"However, nearly 60% of adolescents and youth aged 15 to 24 reported using condoms only sometimes or never," noted the report.
