South Africa’s AIDS Epidemic Peaked in 2002; Number of New Infections Expected to Level Off, Study Says
South Africa's HIV/AIDS epidemic peaked in 2002 with 4.69 million HIV-positive people, and the epidemic is expected to level off as fewer new infections are reported, according to a study published in the current issue of the African Journal of AIDS Research, Reuters reports (Quinn, Reuters, 10/20). Thomas Rehle, an independent consultant in international health and disease control, and Olive Shisana of South Africa's Human Sciences Research Council developed a statistical model to project future epidemiological trends and the demographic impact of HIV/AIDS in South Africa using data from the Department of Health's National Antenatal HIV Prevalence Survey and the 2002 Nelson Mandela/HSRC Study of HIV/AIDS (HSRC release, 10/20). The study is the first to use data from the Mandela/HSRC survey. According to the model, the number of new infections among people ages 15 to 49 -- a "leading indicator" of the progression of the epidemic -- decreased from 4.2% in 1997 to 1.7% in 2003, according to Reuters. In addition, overall HIV prevalence in the same age group was projected to decline from 17.3% in 2001 to 15.2% in 2010. Also, the researchers projected that the annual number of deaths from AIDS-related illnesses in South Africa will peak in 2008 with 487,320 deaths and will decline to 470,000 deaths by 2010 (Reuters, 10/20). However, the researchers said that HIV prevalence will remain "roughly constant" in the "immediate future" and average life expectancy will continue to drop over the next ten years, according to BBC News (BBC News, 10/21).
More Research Needed
The study attributes the decrease in HIV prevalence to several factors including an increase in the number of HIV/AIDS-related deaths and changes in sexual behavior following the introduction of HIV prevention programs. In addition, the study says that there is still "much uncertainty" surrounding the future of the epidemic in South Africa, according to an HSRC release. The researchers said that additional data from future national surveys are needed to substantiate the study's projections (HSRC release, 10/20). The authors also caution that policy changes, such as the government's recent decision to expand access to treatment by providing antiretroviral drugs through the public health system, could have a "profound" impact on the course of the epidemic, according to Reuters.
Earlier studies of South African's HIV/AIDS epidemic had projected much higher HIV prevalence and mortality rates, according to Reuters. A report by the U.S. Census Bureau projected that as many as 37.9% of sexually active adult South Africans could be HIV-positive by 2010, when there could be as many as 900,000 AIDS-related deaths each year. Despite the new study's lower estimates, the researchers caution that they should not be taken as a sign that the seriousness of the epidemic has been exaggerated (Reuters, 10/20). "Although our projections of the future HIV/AIDS burden in South Africa are relatively moderate compared to the projections made by various other researchers, the projected morbidity and mortality due to HIV/AIDS underscore nonetheless the same conclusion: the importance of acting now to fight the epidemic with an increased commitment from all levels of society," the study says (HSRC release, 10/20). Rehle added, "Five million infections is still a huge burden for any country. If there is a message here it is to stop fiddling with the numbers and get serious" (Reuters, 10/20).