Small, but real surprises in antenatal survey
The 2010 antenatal survey measuring HIV prevalence among first time pregnant women shows that the country’s HIV prevalence is at 30.2%. The Health Department says this is a slight increase of 0.8% from 29.4% last year, but points out that the difference is not statistically important, saying that the prevalence is still stable as in the last three years.
The survey also found that HIV prevalence among the high risk group of young women aged 15 ‘ 24, is not declining. HIV prevalence in this group is 21.3%. This is concerning. Another concern is that the prevalence is growing among the age group that is considered relatively safe ‘ the 30 to 34 year-old women, whose majority is in stable relationships. Prevalence has increased from 41.5% in 2009 to 42.9% last year in this group of women. This calls for policy intervention, says Health Minister, Dr Aaron Motsoaledi.
‘The question is faithfulness. That’s the part that we need to look at. We need to ask nurses or special groups of people to be trained to sit with married couples and talk to them in churches, everywhere, about this problem. We need to focus on them because all these years we were focusing on young people ‘ and we think we are making a big in-road on young people’, Motsoaledi says.
But ‘what about the married couples? What do we do for them?’, he wonders.
The finding drew reaction from UNAIDS’s Senior Monitoring and Evaluation Officer, Henry Damisoni.
‘One of the things being encouraged is actually couples’ counseling. The men and women should come together, get the news together and plan their lives moving forward together. Medical male circumcision’¦ that’s one of the things that has to be scaled up. But, even if you are circumcised as a man that does not give you a license that you can sleep around with women without actually using condoms and hope that you will be protected’.
‘The bottom line is we have to at combinations of HIV prevention interventions. We have gone beyond an era where a single intervention programme can be expected to give us the intended results’, Damisoni said.
The survey included 121 young adolescent girls between 10 and 14. It was found that 11 or 9.4% of them had HIV.
Health Minister, Dr Aaron Motsoaledi, says this ‘shows that we must really go down into schools ‘ right from primary schools. That’s what this study shows. We need to include younger and younger children, meaning we need to go down to primary schools, meaning the Department of Basic Education, Department of Social Development, Ministry of Women’¦ need to work together and integrate’.
‘The hostility which we experienced earlier this year when we spoke about HIV/AIDS counseling in schools, we believe, is misplaced, while our studies are showing that regardless of what parents think and what other groups think, there are problems there in schools ‘ starting in primary schools’, he adds.
A myriad of factors drive HIV infection in different age groups, but many of them are not clear.
‘The drivers of the epidemic are very different amongst different age groups. And, therefore, what drives the epidemic amongst children and infants is different from what is driving the epidemic amongst young adolescents and old adolescents and adults. And that needs in-depth epidemiological surveys to actually understand what is driving the epidemic’, according to Dr Thabang Mosala, project manager of the antenatal survey.
Prevalence levels vary across provinces, with KwaZulu-Natal still bearing much of the burden at 39.5%, which is the same as last year’s. The Gauteng province has moved one notch up from the list of the worst affected provinces.
‘As with all the other years the provinces that are bad are always KZN, followed by Mpumalanga, then, Free State. This time Gauteng is number 4 when it used to be number 5 because North West, for reasons that we must still discover, has actually gone down. So, we still note that, as we have done with the past four of five years, KZN is still the highest and the lowest is still Western Cape’, Minister Motsoaledi says.
Similarly, prevalence levels vary across the country’s 52 health districts. Districts recording high levels of between 30% – 40% have increased from 14 in 2009 to 21 in 2010. But, overall, Motsoaledi says, with a national prevalence level of 30.2%, the prevalence of HIV infection has remained stable over the last few years.
‘We can’t report that we have gone down. We haven’t. But we can’t report that we have gone significantly up. It simply means this tsunami of HIV’¦ we are just holding it back with our hands. We have not yet turned it back in any significant way. We’re just holding it back for it not to advance’, he says.
Over 32 000 pregnant women in more than 14 000 public sector health facilities participated in the 2010 antenatal survey.
Author
Free to Share
Related
