Limpopo has one of the lowest HIV prevalence rates of all the nine provinces. According to the latest South African HIV Prevalence, Incidence and Behaviour Survey, 8.9% of people in the province were living with HIV in 2022. This is down from 10.1% in 2017.

This means there’s an estimated 570,000 people living with HIV in the province, a decrease from 580,000 in 2017.  

In 2022 HIV prevalence in Limpopo was disproportionately higher among the 25-49 age group. Prevalence among women in this population was 22.3%, much higher than the 17% recorded in men of the same age group. 

Professor Khangelani Zuma from the Human Sciences Research Council and a principal investigator of the survey says the 50-54 age group has the highest prevalence at 29.4%, down from a peak of 36.9% in 2017 among those aged 40-44 years. 

“There was a decrease in HIV prevalence in 2022, except among those aged 0-14 years, 35-39 years and 50-54 years compared to 2017,” states  Zuma during a presentation of the provincial breakdown of the survey in Polokwane.  

ART coverage 

South Africa has the largest HIV treatment programme in the world, with nearly 6 million people on antiretroviral therapy (ART).   

In 2022 Limpopo’s ART coverage increased to 80.8% from 62.8% in 2017, closely mirroring the national estimates. This translates to around 430,000 people living with HIV in the province receiving treatment, an increase from 290,000 in 2017.

More women (84.0%) were on ART while coverage among men was (73.1%) in 2022. ART coverage was the lowest among those living in urban areas (79.7%) than in other localities. 

Vhembe district recorded the lowest ART (76.4%) coverage, followed by Capricorn district (80.8%).

In 2022, Limpopo had one of the lowest proportion of people living with HIV who achieved viral load suppression at 77.0% up from 60.8% in 2017. Viral load suppression was lower among women (76.6%) than men (77.8%) with a more significant disparity in rural, informal or tribal areas where women had a viral load suppression rate of 75.2% compared to 83.9% among men.

The study warns that low levels of viral load suppression reflect a high risk of HIV transmission during unprotected sexual acts. 

The numbers in the population aged 25-49 are particularly alarming.

Most people living with HIV who don’t know their status are in the 25-49 age group. This age group accounts for 65% of people with HIV who don’t know their status. This same age group accounts for 63.3% of people who know their HIV positive status but are not on ART. And 65.9% of those who have not achieved viral suppression are in this age group. 

Adolescents and youth aged 15-24 disproportionately contribute to gaps in treatment making up only 4.8% of all people living with HIV, yet accounting for 15% of those unaware of their status. They make up 13.3% of those who are aware of their HIV status but not on ART, and 11.4% of those on ART but not virally suppressed. 

Recommendations

The survey calls for targeted interventions for age groups most affected by HIV, particularly adolescent girls and young women. 

Zuma recommends that addressing health inequalities and targeting specific districts and localities with higher HIV prevalence, lower ART uptake coverage, and low viral suppression is crucial for effective programme planning and implementation in the province.

“We also recommend that HIV prevention and management targeted interventions, which foster a sustained reduction in HIV prevalence over time, should be continuously strengthened,” adds Zuma. – Health-e News