Almost one in five (17%) of South African adults aged between 15 and 49 have HIV – a five percentage point increase from 2000. A total of 5.3 million South Africans under the age of 50 are HIV-positive, according to a study by the University of Washington’s Institute for Health Metrics and Evaluation (IHME), recently published in the journal Nature.
IHME tried to break down the number of people living with HIV across 46 African countries to help policymakers focus their efforts on fighting the epidemic.
The study found South Africa’s HIV adult prevalence rate was much higher than most other countries, including Kenya (5.6%), Nigeria (3%), Namibia (13.8%), Zimbabwe (13.5%) and Mozambique (11.9%).
But South Africa’s high rate is partly because more people are living longer with HIV due to antiretroviral therapies.
Wits University professor Francois Venter said the epidemic was not worsening.
“Seventeen percent sounds about right for South Africa. More people on HIV treatment are living longer.”
University of KwaZulu-Natal pharmacologist Andy Gray agreed.
“I do not think SA’s epidemic is getting worse. Prevalence would also be expected to increase as mortality drops because of antiretroviral therapy. More persons living with HIV are living longer,” Gray said.
“The more important figure is the incidence, or the number of new cases.”
Gray said localised data would “help us to focus on areas of greatest need and to identify ‘host-spots’ where specific groups might be missed”.
Other interesting data was:
The highest prevalence in Africa was the uMgungundlovu District Municipality in KwaZulu-Natal where Pietermaritzburg is almost three in 10 (29.7%).
The district municipality with the lowest percent of adults living with HIV is West Coast District Municipality which includes the towns of Malmesbury, Clanwilliam, Langebaan and St Helena Bay.
In Johannesburg, almost half-a-million (466,000) adult residents between the ages of 15 and 49 have HIV.
KwaZulu-Natal has the most residents in the age bracket living with HIV – 1.4 million.
The provinces with the highest prevalence rates in SA are Mpumalanga (20.9%), Free State (21.3%), and KwaZulu-Natal (24%). The Western Cape (10%), Northern Cape (11.5%) and Limpopo (13.2%) have the lowest rates.
The research also showed how few Africans have access to antiretrovirals. According to Unicef, 34% of HIV positive people in East and Southern Africa and 60% of people in West and Central Africa are not currently on treatment.
The study also highlighted how bad the epidemic is, in the face of decreased funding.
IHME’s Health Metrics Sciences assistant professor Dr. Laura Dwyer-Lindgren said: “Global funding for HIV/AIDS has declined since 2013, but our research shows the substantial burden that still exists and reveals where geographically targeted interventions might make a big difference.
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