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HIV Rate Peaks at 40% in Rural South African Mothers
Mark Mascolini
2002-08-08

As many as 40% of rural South African mothers have HIV infection, as do 6% of their children. Testing 1303 mother-infant pairs attending 9 rural vaccine clinics in KwaZulu Natal, the research team used several different assays to detect or confirm HIV in dried blood spots. Overall HIV prevalence measured 28% in the mothers. That rate rose to between 34% and 40% in women between 21 and 25 years old, with the lower prevalence among women who lived farther from a major north-south highway. The researchers detected HIV in 70 infants to yield a prevalence of 6% and an estimated transmission rate of 20%. One surprise finding emerged: In children older than 1.5 months, HIV prevalence remained stable at around 23%. The researchers expected an increasing infection rate as children grew older because nearly all the women breast feed. But they suggest that this prevalence plateau could be attributable to illness and death, or to declining attendance at immunisation clinics among older children. The authors conclude that dry-blood-spot screening overcomes difficulties in follow-up and facilitates early identification, monitoring, and determination of risk factors for HIV-1 acquisition in young women and infants. Source: N.C. Rollins, M. Dedicoat, S. Danaviah, T. Page, K. Bishop, I. Kleinschmidt, H.M. Coovadia, S.A. Cassol, for the Child Health Group. Prevalence, incidence, and mother-to-child transmission of HIV-1 in rural South Africa. Lancet 2002;360:389-390.

As many as 40% of rural South African mothers have HIV infection, as do 6% of their children. 

Testing 1303 mother-infant pairs attending 9 rural vaccine clinics in KwaZulu Natal, the research team used several different assays to detect or confirm HIV in dried blood spots. Overall HIV prevalence measured 28% in the mothers. That rate rose to between 34% and 40% in women between 21 and 25 years old, with the lower prevalence among women who lived farther from a major north-south highway. The researchers detected HIV in 70 infants to yield a prevalence of 6% and an estimated transmission rate of 20%.

One surprise finding emerged: In children older than 1.5 months, HIV prevalence remained stable at around 23%. The researchers expected an increasing infection rate as children grew older because nearly all the women breast feed. But they suggest that this prevalence plateau could be attributable to illness and death, or to declining attendance at immunisation clinics among older children. The authors conclude that dry-blood-spot screening overcomes difficulties in follow-up and facilitates early identification, monitoring, and determination of risk factors for HIV-1 acquisition in young women and infants.

Source: N.C. Rollins, M. Dedicoat, S. Danaviah, T. Page, K. Bishop, I. Kleinschmidt, H.M. Coovadia, S.A. Cassol, for the Child Health Group. Prevalence, incidence, and mother-to-child transmission of HIV-1 in rural South Africa. 

Lancet 2002;360:389-390.

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