HIV Prevalence Has ‘Leveled Off’ in South Africa, Health Ministry Says
The rate of HIV prevalence in South Africa appears to have "leveled off" at 25% of the adult population, according to a new survey by the South African Health Ministry, the New York Times reports. "We can confidently say that the prevalence rate has stabilized," Health Minister Manto Tshabalala-Msimang said yesterday (Cauvin, New York Times, 6/11). The survey, titled "The 12th National HIV and Syphilis Sero-Prevalence Survey," gauges the total number of South Africans who are infected with HIV but is not considered a "reliable indicator" of the rate of new HIV infections (Xinhua News, 6/10). The survey evaluated 16,730 pregnant women who sought care at public health clinics because pregnant women are considered to provide "the most reliable" cross-section of social and income groups and are considered the most likely population to seek health care (New York Times, 6/11). The study states that 24.8% of pregnant women in South Africa were infected with HIV in 2001, up from 24.5% in 2000. This rise is "a far lower rate of increase than in previous years," Agence France-Presse reports (Agence France-Presse, 6/10). The survey states that HIV prevalence among younger pregnant women has declined, dropping from 16.1% in 2000 to 15.4% in 2001 among women under 20 and from 29.1% in 2000 to 28.4% in 2001 among women ages 20 to 24. Tshabalala-Msimang said that this decline indicates that HIV prevention messages are successfully reaching young people (New York Times, 6/11). "We can attribute this positive outcome to the hard work that has been put into prevention campaigns aimed at encouraging safe sexual behavior among the youth," she said (Agence France-Presse, 6/10). The survey found that HIV prevalence among older women is rising, increasing from 23.3% in 2000 to 25.6% in 2001 among pregnant women ages 30 to 34 and from 15.8% to 19.3% among women ages 35 to 39. This increase "more than offset" the decline in infections among younger women, Tshabalala-Msimang said. Epidemiologists estimate that of South Africa's population of 44 million people, 4.74 million are currently infected with HIV, which means that the country has the highest number of HIV-positive adults in the world.
Questioning the Results
Dr. Bernhard Schwartlander, director of HIV/AIDS programs at the World Health Organization, said that although the declining number of HIV infections among young people is "encouraging," the country can "hardly afford to level off with roughly a quarter of the adult population HIV-positive." He said that a "plateau in prevalence is inevitable, as infections eventually reach a saturation point." Dr. Salim Abdool Karim, deputy vice chancellor for research at the University of Natal, said that because more people are dying of AIDS-related causes, the rate of new HIV infections must be increasing to keep the prevalence rate stable. "The high number of new infections is hidden by the large number of people who are dying," he said (New York Times, 6/11). The Democratic Alliance, the South African opposition party, also questioned the study, stating that "with 6,000 [AIDS-related] deaths a week, South Africa had yet to see the full effect" of the epidemic. Democratic Alliance spokesperson Sandy Kalyan said that the government must provide medication for people already infected with HIV in order to ensure social and economic stability (Agence France-Presse, 6/10). According to Reuters, Statistics South Africa plans to produce the "first reliable data on the magnitude and impact of the HIV/AIDS epidemic" in South Africa in time for a Cabinet policy review in July (Chege, Reuters, 6/10).