New research from South Africa shows HIV prevalence among pregnant women has reached almost 30% — its highest level to date. These statistics show that more South Africans are contracting HIV, despite the policies the government has put in place to prevent infection.
There was a 62% increase in deaths of South Africans of 15 years and older from 1997 to 2002, and a more than 50% rise in deaths in the 25 to 44 age group. The big question most South Africans are asking is why the disease continues to spread like wildfire.
Currently, the national HIV/Aids strategy relies on the Khomanani communication campaign, lifeskills programmes, preventive health services in clinics, various workplace efforts, partnership events and peer education and health services for high transmission areas.
At the recent Gauteng Aids Conference, three possible reasons were discussed for the increase in HIV/Aids. Sue le Roux, a spokesperson from Gauteng’s department of health, said that although condom use is high in South Africa and Gauteng, by itself it is insufficient.
“[Condom use] must be accompanied by a renewed emphasis on reducing sexual partners,” she said. She added that a focus on condoms appears to allow people to avoid examining their sexual behaviour.
Also, the public response towards HIV/Aids, has been increasingly diverted to care and away from prevention, she explained.
Le Roux said that feedback from South African behavioural surveys indicates that people have a basic knowledge of HIV prevention and that the youth are tired of being told the same thing.
Other important factors the department believes are contri- buting to the spread of the disease are unemployment, migrancy, poverty and sexual abuse of women.
“These social factors driving HIV are difficult to deal with, and take time,” she said. “As long as they exist, they will pose a challenge to decreasing HIV.”
But the national Department of Health says that the rate of infection is slowing down. In the absence of the HIV incidence estimates, the department has been using HIV prevalence among people under 20 as a proxy indicator for HIV incidence, which it says is an internationally recognised indicator.
“The HIV prevalence in this group has not increased over the years, as is correctly noted in the report,” the department says. The challenge now is to sustain positive sexual behaviour among the under-20s into early adulthood and beyond.
In rising to this challenge, the Department of Health has declared 2006 the year of accelerated HIV/Aids prevention.
Campaign launched to increase testing
The window period, in which patients might test negative for HIV even though they are infected, might be the answer to why South Africa’s HIV infection rates keep rising, some Aids activists have speculated.
Scott Billy, a technical counsellor from New Start, a social marketing campaign for voluntary counselling and testing of HIV/Aids, says research shows a newly infected person carries a higher risk of transmitting the disease to sexual partners. In some instances, the risk can be 10 times higher.
“But, in the window period, when a person is newly infected, not enough antibodies are produced to test positive for the disease,” he explains. “But that is not to say that one has not contracted the disease. Yet many people leave the testing room thinking they are home free.”
He says it is important for the public to listen closely to the advice of the HIV/Aids counsellor, and to return three months later for a second test to confirm one’s status. Because the message is quite complicated, Billy emphasises, it has to be delivered by a trained counsellor.
The New Start campaign aims to change the perception that HIV/Aids testing is only for the sick and encourages all South Africans to test regularly for HIV/Aids. It also wants to attract more men to voluntary counselling and testing, as government clinics see mostly female clients.
Billy says normally only 25% of men submit to tests, but through a comprehensive advertising campaign this has jumped to 52%. The aim of the campaign is to get the message out there that everyone is doing it, everyone is getting tested — couples, the healthy, the sick, pregnant mothers, young and old.
Couples are an important group to focus on, Billy says. About 13% of New Start’s clients are couples and it definitely wants to increase that rate. “Most effective counselling and testing is done when couples come in together and go through counselling jointly,” he says.