SOUTH AFRICA: National survey finds young women most at risk of HIV/AIDS
Photo: IRIN  |
| The survey revealed that socio-economic factors play a key role in the spread of HIV/AIDS |
JOHANNESBURG, 1 December 2005 (PlusNews) - Over one in 10 South Africans are living with HIV, with young African women in informal settlements being at highest risk of HIV infection, a new study has found.
The survey was commissioned by the Nelson Mandela Foundation and conducted by South Africa's Human Sciences Research Council (HSRC) in partnership with the Medical Research Council (MRC) and the Centre for AIDS Development Research and Evaluation (CADRE).
The study's breakdown of HIV prevalence by age, race and geographic location indicated that young African women living in informal settlements in KwaZulu-Natal and Mpumalanga provinces are at most risk.
"Socio-economic factors create vulnerability," said Prof Thomas Rehle of the HSRC, one of the study's authors. "Race per se is not a risk factor."
The results revealed that overall HIV prevalence had dropped slightly, from 11.4 percent to 10.8 percent, since the first survey in 2002.
Prevalence among young people aged 15-24 had risen slightly from 15.6 percent to 16.2 percent, but the increase was much more pronounced among women in that age group, jumping from 12 percent in 2002 to 16.9 percent in 2005. According to the survey, young women are four times more likely to be HIV positive than men of the same age.
The second national household-level survey to be conducted in South Africa, it gives researchers an opportunity to assess trends and patterns in the country's epidemic.
Rehle noted that prevalence rates appeared to be levelling off, but that only the results of a third study, due to be carried out in 2008, would confirm whether South Africa was following the pattern in Uganda and Kenya, where the epidemic appears to have already peaked.
"Now is a very critical time, to see if we keep at this plateau or if we see a decline in prevalence in future years," Rehle remarked.
However, he cautioned that an eventual decline in prevalence might not indicate significantly fewer infections but, rather, more deaths resulting from AIDS - even with increased access to antiretroviral drugs, mortality rates from HIV/AIDS are only expected to peak in South Africa in the next five years.
Of the more than 23,000 people who took part in the survey - more than twice the number that participated in the 2002 survey - nearly 16,000 respondents agreed to be tested for HIV. New technological developments have made it possible to identify infections that had occurred in the last six months, meaning that, for the first time, it was possible to estimate the rate of new infections. According to Rehle, the addition of HIV incidence testing "will significantly improve our understanding of the current dynamics of HIV transmission in South Africa".
In an analysis of incidence rates, young women were again identified as the most vulnerable group, accounting for 87 percent of recent HIV infections in the 15-24 age group.
The study included a detailed questionnaire surveying respondents' levels of knowledge and awareness about HIV/AIDS, their use of condoms and voluntary counselling and testing (VCT) services, their attitudes towards people living with HIV, and their levels of risky sexual behaviour.
Most disturbing to the researchers was the finding that 66 percent of respondents believed they were not at risk of contracting HIV. Of those, more than half tested positive.
"That means we have more than two million people walking the streets of South Africa who think they are not infected, which means they are probably infecting others," commented the study's principal investigator, Dr Olive Shisana of the HSRC.
While access to and use of condoms and VCT services has increased overall, a troubling 57 percent of women in the 15-24 age group reported never having used contraception of any kind. The level of engagement in risky sexual behaviours, such as having multiple partners, was still worryingly high.
Although young men aged 15-24 are most likely to use a condom, they are also the group most likely to have had more than one partner in the past year.
The survey also found that although basic HIV/AIDS awareness was high, there were still serious gaps in knowledge about what behaviours put people at most risk, especially among older age groups. The researchers expressed disappointment at the impact of expensive awareness raising campaigns, and advocated the need for such campaigns to go beyond merely encouraging condom use and to focus more on risk factors. They also identified a need for campaigns to target age groups besides the youth.
Reacting to findings in the study that stigmatisation of people with HIV/AIDS appeared to be decreasing - nearly half the respondents said they saw nothing wrong with marrying a person with HIV - the authors recommended encouraging more people to disclose their status to their partners.
According to the survey findings, the majority of South Africans believed the government was committed to the fight against HIV/AIDS, but said not enough resources were being allocated. Asked whether they would support the introduction of a special tax to help fund HIV/AIDS treatment and prevention, nearly half the employed respondents said they would.
Shisana confirmed that the government had been briefed on the survey findings. "They were receptive, which gives us hope that they will take the information seriously," she said.
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