An estimated 4,7 million South Africans - one in every nine - were infected with HIV by the end of last year, according to a government report released on Tuesday.
The estimates are contained in the National HIV and Syphilis Sero-Prevalence Survey of Women Attending Public Antenatal Clinics in South Africa, which is considered to be one of the best indications of HIV prevalence in South Africa.
A total of 16 607 women who visited public clinics for the first time during their current pregnancy were tested. The tests were conducted at 400 clinics in all nine provinces. About 24,5 percent of the women were found to have been infected with HIV by the end of last year. This figure stood at 22,4 percent in 1999, and at 22,8 in 1998.
Releasing the report in Pretoria, Health Minister Dr Manto Tshabalala-Msimang said the increase of 2000 was not significant or at all alarming.
Statistics had stabilised over the last three years, and differed distinctly from the steeply rising prevalence encountered in the early and mid-nineties, she said.
We're on top of issues. We're getting there.
Dr Lindiwe Makubalo of the Health Department said: Our belief is that we should be seeing a continuing tapering off and eventually a
decline. "However, she warned: While we are encouraged by the trends, we should not lose sight of the fact that HIV is still a very serious health problem.
Particularly encouraging was the drop in HIV infection rates among teenagers sampled, Tshabalala-Msimang said.
The infection rate among women younger than 20 decreased from 21 percent in 1998 and 16,5 percent in 1999 to 16,1 percent in 2000. This was consistent with findings from another survey that showed condom use to be higher among female teenagers than in all other age groups, the report said.
However, there was reason to be concerned about the trend among women in their early twenties, among whom the prevalence was the highest, the Minister said.
Since 1999, the infection rate for women aged 20-24 increased from 25,6 to 29,1 percent, and for the age group 25-29 the corresponding figures are 26,4 and 30,6 percent respectively.
Among women aged 30-34 the rate rose from 21,7 to 23,3 percent, while it fell from 16,2 to 15,8 percent in the age group 35-39.
The social and economic implications of the rising infection rate among women in their twenties were matters of concern, the report said.
This also significantly impacts on maternal care and child survival. The trend could indicate that the positive behaviour women started in their teens was not sustained, and that they seemed to have a sense of security and therefore dropped their guard, said Dr Rose
Mulumba. There is a clear need to preserve the gains made among teenagers through information, education and (the) communication of awareness messages, the report said.
Targeted campaigns and adapted material for adults assumed or perceived to be at lesser risk should be conceived as a matter of urgency, as women in their twenties comprise nearly 60 percent of those infected with HIV.
The HIV infection rate in KwaZulu-Natal - still the province with the highest prevalence - increased from 1999's 32,5 to 36,2 percent in 2000. In Mpumalanga the rate rose from 27,3 to 29,7 percent, and in Gauteng it climbed from 23,9 to 29,4 percent.
The 2000 rate in the Free State was 27,9 percent, North West had 22,9 percent, the Eastern Cape 20,2 percent, the Northern Province 13,2 percent, the Northern Cape 11,2 percent and the Western Cape 8,7 percent.
North West was the only province that showed a decline since 1999, while the rate in the Free State stayed the same.
The report described the increases in KwaZulu-Natal and Gauteng as significant.
... All provinces have been advised to work towards stabilisation at the lowest possible level of HIV prevalence, as this would minimise the impact of the epidemic in terms of mortality and morbidity, as well as the broader impact at the social and economic level.
The survey also indicated a syphilis infection rate of 4,9 percent. The rate had been halved over the last three years, Tshabalala-Msimang said.
The department planned to include private sector clinics as well in future surveys, Makubalo said.
However, she did not think that would dramatically change the picture. In South Africa 80 percent of pregnant women, of whom 85,2 percent were African, attend public sector antenatal clinics, according to the report.
Source: SAPA, 20 March 2001