Antenatal HIV prevalence up

The 2010 National Antenatal Sentinel HIV & Syphilis Prevalence Survey, conducted annually by the department for the past 21 years, was released on Tuesday, 29 November, by Health Minister Dr Aaron Motsoaledi, just days ahead of World Aids on 1 December.

The report showed that HIV prevalence among antenatal women was 30.2% in 2010, compared with 29.4% in 2009. The study was conducted among a sample of 32 225 first time antenatal care attendees last year, with 32 861 having participated in 2009.

Speaking at the release of the survey, Motsoaledi said the figures showed the country was "just holding back the tsunami" in the battle against HIV.

"At the moment we are stable, but we think the war still has to be won... We need to fight the war."

The WHO/UNAIDS estimates the number of people living with HIV in SA for 2010 at 5.575 million. Of these, 518 000 were children under 15 years, while 2.95 million were adult females over the age of 15.

The highest provincial HIV prevalence was recorded in KwaZulu-Natal, which increased from 38.7% in 2008 to 39.5% in 2009 and stabilised at 39.5% in 2010.

Other provinces with a "higher" HIV prevalence estimates compared to 2009 were: Eastern Cape (29.9%), Gauteng (30.4%), Limpopo (21.9%), Mpumalanga (35.1%), Northern Cape (18.4%) and the Western Cape (18.5%).

The North West and the Free State had 'lower' HIV prevalence estimates, with 29.6% and 30.6% respectively.

The study reflected that the peak in HIV prevalence (from 2007 - 2010) was now occurring in the 30 - 34 years age category.

"The HIV prevalence in this group increased from 41.5% in 2009 to 42.6% in 2010," said the survey.

The study said this could be partly explained by ART use. The encouraging finding was the decline in the prevalence rate in the 15 - 24 years age group, which went from 23.1% in 2001, to 21.8% in 2010.

"Prevalence in the young group (15 - 24) is declining and we suspect that our prevention methods in messages are reaching where they need to reach," said Motsoaledi.

Of concern, however, was the teenage pregnancy rate revealed by a Department of Education sanctioned study spanning from 200 - 2008.

It showed that teenage pregnancy was more prevalent in KZN, with 15 027 cases, Eastern Cape 11 852 and Limpopo 12 848. The findings of the Health Department's survey showed that of 121 10 - 14 year olds that participated in the 2010 antenatal HIV survey, 11 of them (9.4%) were HIV positive, which is an increase from the 7.3% recorded in 2008.

"...In all our prevention programmes, we need to include young children and work together with the Department of Social Development and Basic Education," said Motsoaledi.

He said the hostility shown to the department regarding the testing of children in schools was misplaced, adding that there was an urgent need to finalise the school health programme.

"When the health workers visit the schools, they will also do sexual reproductive [health] so as not to confuse people."

On the interventions to address the high prevalence in older age group, Motsoaledi said they would revisit the message of 'Abstain, Be faithful and Condomise' and check which part was working.

"Faithfulness is the main message. It's a difficult issue but not impossible... We need to target men and concentrate on those responsible for spreading the disease.

"The issue has been discussed with men's groups. We need to ask nurses to sit down with married couples, including in churches, to speak about the issue of faithfulness. Through medical male circumcision, men are also being counselled on men's responsibilities," Motsoaledi said.

Research Director at the Human Science and Research Council, Dr Khangelani Zuma, noted that the decline in the prevalence in the 15 - 24 age group was encouraging, but that more had to be done for the older age group.

"The higher prevalence in older age group could be partly explained by ART use. We need to look at the cause," said Zuma.