A new national report includes, for the first time, the HIV prevalence rate among men who have sex with men (MSM) in South Africa and reveals that new infection rates among teenagers aged 15-19 have decreased.

These findings emerge from the new third national HIV prevalence, incidence and communication survey, which was conducted in 2008 and released this week.

Until recently, the HIV prevalence among MSM – rated as a high risk group – in South Africa remained undocumented, but the study estimates that around 9% of MSM are HIV positive.

It notes however that “three studies presented on preliminary data collected respectively in Cape Town, Johannesburg and Durban and in Soweto, Gauteng have all consistently yielded results showing that the HIV-prevalence rates among MSM range from 12.6% to 47.2% among different subpopulations”.

“For the first time, the report provides information on high-risk groups, defined in this study as people who drink excessively, those who take drugs, men who have sex with men and people with disabilities as well as women aged 20-34 and men aged 25-49. More attention should be paid to these categories…” said Dr Olive Shisana, CEO of the Human Sciences Research Council (HSRC) and one of the two principal investigators of the study.

The study adds that further research on the burden of HIV among MSM is currently being conducted in South Africa, “and it points to a high prevalence”.

According to the report, the country’s HIV epidemic has levelled off at a prevalence of 10.9%, with 5.2 million people estimated to be living with HIV in 2008. HIV prevalence has also declined among children aged 2-14, from 5.6% in 2002 to 2.5% in 2008.

“This latest survey provides us with an opportunity to understand the HIV epidemic over time, and there are promising findings of a changing pattern of HIV infection among children and youth”, said Shisana.

Professor Thomas Rehle, the other principal investigator of the study, emphasised that “we may witness for the first time a decrease in HIV incidence among teenagers”.

Dr Shisana stressed that there are still major challenges that would need coordinated, concerted and intensive effort to complement and sustain the achievements to date. “Our efforts in the coming period need to focus on key drivers of the epidemic,” said Shisana.

Challenges include the high level of HIV prevalence among females aged 25-29 (33%) and the significant rise in the rate of people having multiple sexual partners, which increases the risk of infection.

Professor Leickness Simbayi, the study’s co-principal investigator, added that there is a need for a clear and unambiguous emphasis on teenagers having older partners, and on all sexually active people limiting the number of sexual partners that they have.

“Interventions need to be targeted to the particular issues in each province, and communication programmes need to focus on expanding their reach and intensifying their messages.”

The report recommends that HIV testing be routinely offered to all patients at health facilities, and that options for safe child bearing be expanded for people in the 20-34 year age group.

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