The Human Sciences Research Council (HSRC) released the key findings of the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for Mpumalanga, revealing the highest HIV prevalence rate in South Africa.
According to the findings, Mpumalanga had the highest HIV prevalence of any province in 2022 — 17.4% — which corresponds to an estimated 890 000 people living with HIV (PLHIV) in the province.
Professor Khangelani Zuma of the HSRC, the study’s overall principle investigator, reported that the survey revealed that in 2022, the province’s HIV prevalence among adolescents aged 15 to 24 years was 7.8% overall, with males having a 1.5-fold greater prevalence (9.8%) than girls (6.3%) in the same age range.
Among adults aged 25–49 years, HIV prevalence was 26.4% overall and 1.6-fold higher among females (31.9%) than males (19.9%).
By locality, HIV prevalence was higher among those residing in rural formal/farms (21.1%) and rural informal areas (18.4%) and lower in urban areas (15.5%), but the difference was not significant.
“A concerning state is that HIV prevalence peaked at 40.8% among those aged 45–49 years in 2022 compared to 39.0% in 2017 among those aged 35–39 years, suggesting a possibility of continued new infections. There was a notable downward shift in the epidemic curve in 2022 among respondents aged 15–44 years,” said Zuma.
The data presented are for three priority districts in Mpumalanga, namely Ehlanzeni, Gert Sibande and Nkangala districts, where oversampling was undertaken to enhance the precision of the HIV prevalence estimates.
In 2022, HIV prevalence among all ages was highest in Gert Sibande (20.5%) and Ehlanzeni (16.0%) and lowest in Nkangala (13.1%).
The findings also reveal that the antiretroviral treatment (ART) coverage in Mpumalanga increased to 81.8% in 2022 from 65.4% in 2017.
This translates to an estimated 630 000 people living with HIV in the province receiving ART in 2022.
In 2022, ART use among all people living with HIV in the province was 56.4% among adolescents and youth aged 15–24 years and 83.9% among those aged 25–49 years.
It is reported that among females, ART coverage was substantially lower among those aged 15–24 years (58.6%) than those aged 25–49 years (85.2%). ART coverage among males aged 25–49 years was 81.6%, while it was 54.8% for male youth aged 15–24 years. ART coverage was 79.8% in urban areas and 79.7% in rural informal/tribal areas.
By district, ART use was lowest in Nkangala (77.9%) and Ehlanzeni (79.4%).
The SABSSM VI survey, conducted between 2022 and 2023, aimed to maintain surveillance of HIV infection and behaviours in South Africa, evaluate the progress of the South African national HIV and Aids, STI, and TB Strategic Plan, and monitor HIV indicators for national and international reporting.
The survey’s key objectives included estimating HIV prevalence and incidence, viral load suppression, and exposure to HIV-related services among adults and children.
It also assesses progress towards the 2030 UNAids 95-95 targets, HIV drug resistance, and the relationship between social and behavioural factors, intimate partner violence, and HIV infection.
The survey suggests South Africa should implement targeted interventions, especially for adolescent girls and young women, to combat the HIV epidemic by 2030.
Zuma proposes a long-term strategy for addressing the ageing HIV epidemic, including tailored interventions to address clinical gaps by district, locality, and subpopulation.
“We also recommend a continued focus on increasing coverage and demand for medical male circumcision among males aged 15 years and older. We must also enhance public awareness and uptake of effective HIV prevention measures, such as regular HIV testing, condoms, and PrEP,” said Zuma.
The Star
anita.nkonki@inl.co.za