Research programme: Social Aspects of HIV/AIDS and Health (SAHA): News - 5 December�2002 - First nationally representative survey results of HIV prevalence)
According to South Africa's first ever nationally representative survey of HIV prevalence, 11.4% of the country's population of two years and older are living with HIV/AIDS. Some 12.8% of women and 9.5% of men tested HIV-positive.
‘The information gained in this study marks a watershed in our fight against HIV/AIDS. I am proud to say we now have the data to tackle the epidemic more vigorously,’ says former President Nelson Mandela, who commissioned the Human Sciences Research Council (HSRC) to conduct the study under the auspices of the Nelson Mandela Foundation and the Nelson Mandela Children's Fund.
The highest prevalence was amongst the 25-29 age group (28.0%), followed by the 30-34 group (24%). 15.6% are HIV-positive among people in the 15-49 age range.
The Nelson Mandela/HSRC Study on HIV/AIDS – released on 5 December 2002 in Johannesburg — is based on a representative sample of 9 963 people drawn from households across the country, 8 428 of whom consented to be tested for HIV and submitted saliva specimens.
The survey ‘provides the most systematic and comprehensive view yet available of how HIV/AIDS is affecting South Africans according to race, gender, age and geographical location’, notes HSRC CEO, Dr Mark Orkin. Apart from prevalence, the survey also investigates risk-reducing factors such as condom use, and the impact of campaigns and people's perceptions about HIV.
Among people of 15-49 years old, those living in urban informal settlements were more vulnerable to HIV/AIDS (28.4%) than those living in urban formal settlements (15.8%), farms (11.3%) or other rural areas (12.4%).
The prevalence rate amongst Africans was highest (12.9%). Whites and coloureds had closely similar prevalences (6.2% and 6.1%). The figure for Indians was 1.6%. The white prevalence rate is high compared to other countries such as Australia, France and the USA, where the prevalence among whites is 1% or less.
‘The finding that Africans have a higher estimated HIV prevalence reflects the historical development of the HIV epidemic in South Africa. Vulnerability to HIV is highest in informal areas, and factors contributing to vulnerability in these areas include labour migration, mobility, and relocation’ according to Dr Olive Shisana, Executive Director of SAHA in the HSRC and leader of the research project.
‘While some of the Mandela/HSRC study's results are comparable with those in other studies, what makes it unique is the fact that it is based on actual HIV-antibody testing. Until now HIV/AIDS prevalence estimates were based on data derived from public antenatal clinics that was modelled for wider population’, says Dr Shisana.
But antenatal data is necessarily unrepresentative. Antenatal clinics generally provide information on pregnant women who recently became sexually active, are younger than average, are mainly African, and are visiting public clinics.
By comparison, the Mandela/HSRC study yields some surprise findings from its representative nationwide sample. One is that KwaZulu-Natal (KZN) is no longer ranked as the province with the highest HIV/AIDS prevalence.
Comparing women in the age group 15-49 in the different provinces, the study shows that the KZN infection rate is 11.7% – much lower than the estimated 33.5% mentioned in the 2001 Department of Health (DoH) survey.
The reason for this discrepancy is that the antenatal survey's sample is generally drawn from health facilities along major transport routes (known to have high HIV rates), whereas this household survey included rural and urban homesteads in their correct proportions. ‘As you move away from the main roads, the HIV prevalence in KZN starts decreasing,’ Shisana explains.
It also shows that the Free State (14.9%), Gauteng (14.7%) and Mpumalanga (14.1%) have the highest prevalence rates. The Western Cape was ranked 5th with a prevalence rate of 10.7% — higher than the antenatal survey which has always found this province to have the lowest HIV prevalence rate. The household survey found that the Eastern Cape had the lowest infection rate (6.6%).
Large informal settlements are an important factor contributing towards the higher prevalence in provinces like the Western Cape, Gauteng and the Free State — aspects that should be taken into account in future planning, Shisana notes.
On media influence, the study found that HIV-prevention messages appear to be having an impact. Among young people of 15-24, 57.1% of young men and 46.1% of women reported` condom use at their last sexual encounter, reflecting appreciable increases since the Department of Health's study in 1998. Only 25.0% of young people between 15 and 17 years reported being sexually active. However, youth in informal settlements showed a significantly higher rate of sexual activity.
Two hundred fieldworkers conducted the interviews and saliva tests. People in institutions such as prisons, boarding schools and military barracks were not included in the sample.
The HSRC collaborated in the research with the Medical Research Council, Centre for AIDS Development, Research and Evaluation (CADRE), the ANRS (Agence Nationale de Recherché sur le Sida) in France, and other agencies.
According to South Africa's first ever nationally representative survey of HIV prevalence, 11.4% of the country's population of two years and older are living with HIV/AIDS. Some 12.8% of women and 9.5% of men tested HIV-positive.
‘The information gained in this study marks a watershed in our fight against HIV/AIDS. I am proud to say we now have the data to tackle the epidemic more vigorously,’ says former President Nelson Mandela, who commissioned the Human Sciences Research Council (HSRC) to conduct the study under the auspices of the Nelson Mandela Foundation and the Nelson Mandela Children's Fund.
The highest prevalence was amongst the 25-29 age group (28.0%), followed by the 30-34 group (24%). 15.6% are HIV-positive among people in the 15-49 age range.
The Nelson Mandela/HSRC Study on HIV/AIDS – released on 5 December 2002 in Johannesburg — is based on a representative sample of 9 963 people drawn from households across the country, 8 428 of whom consented to be tested for HIV and submitted saliva specimens.
The survey ‘provides the most systematic and comprehensive view yet available of how HIV/AIDS is affecting South Africans according to race, gender, age and geographical location’, notes HSRC CEO, Dr Mark Orkin. Apart from prevalence, the survey also investigates risk-reducing factors such as condom use, and the impact of campaigns and people's perceptions about HIV.
Among people of 15-49 years old, those living in urban informal settlements were more vulnerable to HIV/AIDS (28.4%) than those living in urban formal settlements (15.8%), farms (11.3%) or other rural areas (12.4%).
The prevalence rate amongst Africans was highest (12.9%). Whites and coloureds had closely similar prevalences (6.2% and 6.1%). The figure for Indians was 1.6%. The white prevalence rate is high compared to other countries such as Australia, France and the USA, where the prevalence among whites is 1% or less.
‘The finding that Africans have a higher estimated HIV prevalence reflects the historical development of the HIV epidemic in South Africa. Vulnerability to HIV is highest in informal areas, and factors contributing to vulnerability in these areas include labour migration, mobility, and relocation’ according to Dr Olive Shisana, Executive Director of SAHA in the HSRC and leader of the research project.
‘While some of the Mandela/HSRC study's results are comparable with those in other studies, what makes it unique is the fact that it is based on actual HIV-antibody testing. Until now HIV/AIDS prevalence estimates were based on data derived from public antenatal clinics that was modelled for wider population’, says Dr Shisana.
But antenatal data is necessarily unrepresentative. Antenatal clinics generally provide information on pregnant women who recently became sexually active, are younger than average, are mainly African, and are visiting public clinics.
By comparison, the Mandela/HSRC study yields some surprise findings from its representative nationwide sample. One is that KwaZulu-Natal (KZN) is no longer ranked as the province with the highest HIV/AIDS prevalence.
Comparing women in the age group 15-49 in the different provinces, the study shows that the KZN infection rate is 11.7% – much lower than the estimated 33.5% mentioned in the 2001 Department of Health (DoH) survey.
The reason for this discrepancy is that the antenatal survey's sample is generally drawn from health facilities along major transport routes (known to have high HIV rates), whereas this household survey included rural and urban homesteads in their correct proportions. ‘As you move away from the main roads, the HIV prevalence in KZN starts decreasing,’ Shisana explains.
It also shows that the Free State (14.9%), Gauteng (14.7%) and Mpumalanga (14.1%) have the highest prevalence rates. The Western Cape was ranked 5th with a prevalence rate of 10.7% — higher than the antenatal survey which has always found this province to have the lowest HIV prevalence rate. The household survey found that the Eastern Cape had the lowest infection rate (6.6%).
Large informal settlements are an important factor contributing towards the higher prevalence in provinces like the Western Cape, Gauteng and the Free State — aspects that should be taken into account in future planning, Shisana notes.
On media influence, the study found that HIV-prevention messages appear to be having an impact. Among young people of 15-24, 57.1% of young men and 46.1% of women reported` condom use at their last sexual encounter, reflecting appreciable increases since the Department of Health's study in 1998. Only 25.0% of young people between 15 and 17 years reported being sexually active. However, youth in informal settlements showed a significantly higher rate of sexual activity.
Two hundred fieldworkers conducted the interviews and saliva tests. People in institutions such as prisons, boarding schools and military barracks were not included in the sample.
The HSRC collaborated in the research with the Medical Research Council, Centre for AIDS Development, Research and Evaluation (CADRE), the ANRS (Agence Nationale de Recherché sur le Sida) in France, and other agencies.
posted by Dr Philippe Maslo at 11:31
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