Cape Town - A survey by the Human Sciences Research Council (HSRC) has revealed that South Africa's HIV/AIDS epidemic has stabilised and there are signs of a declining prevalence among children and teenagers.
According to the National HIV Prevalence, Incidence and Communication Survey, conducted in 2008, the HIV prevalence has levelled off at 10.9 percent for people aged two and older.
There were an estimated 5.2 million people living with HIV in the country in 2008, according to the survey, which was conducted from June 2008 to March 2009. It is the third in a series of national population based surveys conducted to help monitor the country's response as a nation to the HIV/AIDS epidemic.
South Africa is currently implementing the largest antiretroviral treatment programme in the world.
The study also showed that South Africa has seen a decline in new HIV infections among teenagers aged between 15 and 19 as well as a lowered prevalence of 10.9 percent among children aged between 2 and 14, from 5.6 percent in 2002 to 2.5 percent in 2008.
There are also promising findings of a changing pattern of HIV infection among children and youth, said Chief Executive Officer at the HSRC and one of the principal investigators of the study, Dr Olive Shisana.
"The good news is that the change in HIV prevalence in children is likely attributable to the successful implementation of several HIV-prevention interventions," said Dr Shisana.
These interventions are related to addressing HIV in early childhood, programmes such as the prevention of mother-to-child transmission in the Western Cape, where the largest decline of 6 percentage points occurred.
Another one of the principal investigators of the study, Professor Thomas Rehle noted that the country may witness for the first time a decrease in HIV incidence among teenagers.
"Indirect HIV incidence estimates were mathematically derived from single year age prevalence in 15 to 20 year olds. This method is best applicable in younger age groups when the effect of AIDS related mortality on HIV prevalence levels is still minimal," Professor Rehle said.
The research also revealed that HIV prevalence among adults aged 15 and 49 has declined between 2002 and 2008 in the Western Cape, Gauteng, Northern Cape and the Free State, with the largest decline of 7.9 percentage points in the Western Cape.
The survey also revealed that the percentage of people in the age group 15 and 49 who reported awareness of their HIV status has doubled from 2005 to 2008.
"This is attributable to multisectoral communication and programmes that promoted knowledge of HIV status and the substantial increase in the availability of voluntary counselling and testing services (VTC) over the period," the report noted.
According to the report, the proportion of the population who reported using a condom at their last sexual encounter was particularly high among young people aged 15 and 24 years from 57 percent in 2002 to 87 percent in 2008 among young males and from 46 percent to 73 percent among young females.
This trend was also obvious in condom use among people between the 25 and 49 age group, where condom use among males aged 25 and 49 at last sex had nearly doubled and tripled among females of the same age group.
This may indicate a shift in power relations between males and females, but also an understanding of the value of condoms as an important prevention measure, Dr Shisana said.
There was also an increase in the population reached, by at least one national HIV communication programme between 2005 and 2008, with 90 percent youth reporting that they had been reached by at least one programme.
It, however, noted that although reach of the main national HIV and AIDS communication programmes increased over time, the government's Khomanani Programme had the lowest reach in comparison to other programmes.
Reach of all programmes was low for people aged 50 years and older, with 37.8 percent of people in this age group not being reached by any programme.
Co-investigator of the study, Dr Warren Parker, said communication programmes were not reaching all sectors of the population. He noted that the lack of reach into older age groups had been raised repeatedly in previous studies, yet nearly four out of 10 people aged 50 years and older are not reached by any programme.
The persistent high level of HIV prevalence among females aged 25 and 29 over the period of three surveys and an increase of intergenerational sex among female teenagers aged 15 and 19, were among the challenges found during the survey.
The report found that having many sexual partners, which increases risk of exposure to HIV, had increased markedly between 2002 and 2008.
"Among males aged 15 and 49 having more than one sexual partner in the past year increased from 9.4 percent in 2002 to 19.3 percent in 2008, while among females the increase was from 1.6 percent to 3.7 percent," the report revealed.
The report recommended that HIV testing be routinely offered to all patients at health facilities and that options for safe child bearing are expanded for people in the 20 to 34 year age group.
In his State of the Nation Address last week, President Jacob Zuma set a target of having 80 percent of HIV-positive people in the country on antiretroviral treatment by 2011 and also to aim to reduce the rate of new HIV infections by 50 percent by 2011.
He said government had to work together with stakeholders to improve the implementation of the Comprehensive Plan for the Treatment, Management and Care of HIV and AIDS which aims to reduce the rate of new HIV infections by 50 percent by the year 2011.
"We have set ourselves the goals of further reducing inequalities in health care provision, to boost human resource capacity, revitalise hospitals and clinics and step up the fight against the scourge of HIV and AIDS, TB and other diseases," he said.
