News24, 05 December 2002, Mandela-backed study throws new light on Aids

Johannesburg - KwaZulu-Natal does not, as previously believed, have the highest HIV/Aids prevalence rate in South Africa, according to a new study.

Former president Nelson Mandela released the report - South Africa's first nationally representative study of HIV prevalence - in Sandton on Thursday.

Mandela, who has become a stalwart in the fight against HIV/Aids, commissioned the Human Sciences Research Council (HSRC) to conduct the study under the auspices of the Nelson Mandela Children's Fund and the Nelson Mandela Foundation.

KwaZulu-Natal's HIV-prevalence rate for women between the ages of 15 and 49 - the group used to compare prevalence rates - was 11.7%. This was far lower than the estimated 33.5% given in the 2001 department of health survery.

The Free State's, Gauteng's and Mpumalanga's infection rates leave KwaZulu-Natal far behind. They have prevalence rates of 14.9-%, 14.7% and 14.1% respectively.

The study ranked the Western Cape fifth in terms of prevalence at 10.7%, while the Eastern Cape was found to have the lowest prevalence rate - 6.6%.

HSRC chief executive Mark Orkin said the survey provided "the most systematic and comprehensive view yet available of how HIV/Aids is affecting South Africans according to race, gender, age and geographical location".

Study marks a watershed

Until recently, most of the country's HIV/Aids prevalence estimates were based on largely unrepresentative data derived from state antenatal clinics and modelled for the wider population.

This study was based on a sample of 9 963 people drawn from households across the country, 8 428 of whom consented to be tested for HIV and submitted saliva specimens.

Mandela said that, overall, the information gained in the study marked a "watershed" in the fight against HIV/Aids.

"I am proud to say we now have the data to tackle the epidemic more vigorously."

This data referred not only to the study's new prevalence data, but also to the new data on risk-reducing factors for HIV infection. These included condom use, the impact of media campaigns and people's perceptions of HIV/Aids.

The study found that HIV prevention messages appeared to be having an impact. Among young people between the ages of 15 and 24, 57.1% of men and 46.1% of women reported condom use at their last sexual encounter - a significant increase from the results of the 1998 health department study.

The study also yielded important differential prevalence-rate figures for people living in urban informal settlements, compared with those living in urban formal settlements, farms and other rural areas.

People in urban informal settlements had an average infection rate of 28.4% while those in urban formal settlements had a 15.8% infection rate; those on farms had an 11.3% infection rate and those in other rural areas had a 12.4% rate.

According to the study's leader, Dr Olive Shisana, HSRC's executive director of social aspects of HIV/Aids, the high infection rate in large, informal settlements in the Free State, Gauteng and Western Cape was an issue to be taken into account in future town planning.

Lastly, the study found that the prevalence rate among Africans was the highest - 12.9% - while whites and coloureds had a similar 6.2% and 6.1% prevalence respectively.

The white prevalence rate was high compared with countries such as Australia, France and America, where the prevalence among whites is 1% or less.

The prevalence figure for the South African Indian community was the lowest at 1.6%.

Shisana said: "The finding that Africans have a higher-than-estimated HIV prevalence reflects the historical development of the HIV epidemic in South Africa. Vulnerability to HIV is also highest in informal settlements, and factors contributing to this include labour migration, mobility, and relocation."

Two hundred field workers collected the data for the study, but people in institutions such as prisons, boarding schools and military barracks were not included in the sample.

The HSRC collaborated with the Medical Research Council, the Centre for Aids Development, Research and Evaluation and the Agence Nationale de Recherchur le Sida in France during the study.

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