Marcia Moyana
The Human Sciences Research Council (HSRC) released its key findings of the sixth South African National Human Immunodeficiency Virus (HIV, Prevalence, Incidence and Behaviour Survey (SABSSM VI) in Johannesburg on 29 August.
Conducted between 2022 and 2023, the survey outlined the measures that have been taken 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 household survey revealed “concerning” details about young people aged 15 to 24 years old, with early sexual debut, lack of condom usage and having unprotected sex with multiple sex partners being some of the key drivers of the HIV epidemic in those age groups.
During the release of the findings of the survey, a professor at the HSRC, Khangelani Zuma expressed his concern over the number of adolescents and young people who did not know their HIV status.
“Of 75,000 young people younger than 25 years living with HIV, very few of them are on ARVs. What is even worse is that most do not know their status and we need to do more to focus on this group because if we do not, this pool of people will continue being an unfortunate reservoir of HIV transmissions,” said Zuma.
Up to 20 percent of Gauteng’s adolescents and youths did not know their HIV status, while 13.4 percent of those who knew their status were not on treatment. The 12.1 percent of those who were on treatment were not virally suppressed.
Boys were having sex earlier with up to 17.8 percent of them starting before the age of 15 years while girls make up 7.9 percent.
“Even though young boys start sexual debut earlier than girls, the numbers are showing, they will have sexual partners within their five-year age groups. But the unfortunate part is, among young girls, they will have partners that are five to ten years older than them.”
“We know that those relationships are very risky. Older males taking advantage of young girls and not using condoms is one of the contributing factors to higher HIV infections among young girls compared to young boys”, he explained.
Zuma was also concerned about 17.1 percent of males having reported more multiple sexual partners in the 15 to 24 years old group. Out of the over 70 percent of individuals in the province who never used condoms or sometimes used them, 32.1 percent of adolescents and youth aged 15 to 24 said they had used a condom during a recent sexual encounter compared to 19.3 percent of those aged 25 to 49 years.
Gains made but more can be done
The HIV prevalence rate in the Gauteng province saw a slight decrease from 12.1 percent in 2017 to 11.9 percent in 2022. As the third province with the lowest HIV prevalence in the country, the province had over 1.72 million people who were living with HIV in 2022 compared to 1.78 million in 2017.
Another gain that has been made in the province is the uptake of ART with an estimated 1.2 million people who are living with HIV being on treatment. This increased uptake in ART resulted in up to 79.7 percent being virally suppressed, which means that they cannot transmit the virus to others.
Out of the UNAIDS target to have 95 percent of people who are living with HIV knowing their status, 85.3 percent were aware of their status. Up to 86.5 percent out of the targeted 95 percent were on ART, and an estimated 95.2 of those who were on ART were virally suppressed, slightly exceeding the 95 percent target.
Senior Advisor for Quality Improvement with CDC South Africa, Ashely Boylan said the over 20 years of partnership between the various stakeholders was yielding results but more needed to be done to improve on the progress that has been made over the years.
“With this information, we can strengthen our programs and tailor them to people who need it most. Data is knowledge, and with knowledge comes great responsibility to respond, adapt, and improve,” she said.
She added that Gauteng was one of the first provinces that will be implementing the U=U roll-out campaign which will focus on reducing HIV transmission by promoting adherence to treatment which will result in the virus being undetectable, resulting in it being untransmittable.
The end of the AIDS epidemic is in reach, and together we are stronger, and together we can see an AIDS-free generation, Boylan added.
