Northern Cape records second-lowest HIV prevalence rate in SA

The Northern Cape had the second-lowest HIV prevalence at 8.9% in 2022, the Human Sciences Research Council (HSRC) said on Monday. 

This means an estimated 120 000 people living with HIV (PLHIV) in the province, which is 21 000 more PLHIV compared to 2017.

The information is based on the HSRC’s key findings of the Sixth South African HIV Prevalence, Incidence and Behaviour Survey (SABSSM VI) for the Northern Cape.

SAnews reported last week that the Western Cape had the lowest HIV prevalence (7.4%) in 2022 and second lowest in 2017 (8.6%).

READ | W Cape records lowest HIV prevalence rate in SA

According to the overall principal investigator of the study, the HSRC’s Professor Khangelani Zuma, the survey showed that in 2022, HIV prevalence in the Northern Cape was 3.3% among those aged 15 to 24 overall, and higher among females (5%) than males (1.8%) in this age category. 

Among those aged 25 to 49, HIV prevalence was 12.6% overall, and higher in females (14.9%) than males (9.6%). 

HIV prevalence was also higher among those residing in urban areas (9.6%) and lower among those residing in rural informal or tribal areas (7.6%) and rural formal or farms (6.2%).

“HIV prevalence peaked at 25.7% among those aged 35 to 39 years in 2022 compared to 26.1% in 2017 among those aged 40 to 44. HIV prevalence increased from 24.3% among 30 to 34-year-olds in 2017 to 25.7% among those aged 35 to 39 in 2022. 

“There was a notable downward shift in the epidemic curve in 2022 among the age categories between 20 to 34 years,” Zuma said.

Antiretroviral treatment 

Data show that antiretroviral treatment (ART) coverage in the Northern Cape increased from 54.9% in 2017 to 86.2% in 2022. 

This translates to an estimated 103 440 PLHIV in the province receiving ART in 2022.

In 2022, ART use among all PLHIV in the province was 82.6% among those between 25 and 49 years. 

Data for youth and adolescents aged between 15 and 24 years and among males aged between 25 and 49 could not be analysed owing to a small sample size.

The SABSSM VI survey, conducted between 2022 and 2023, aimed 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.

Knowledge of HIV status

Zuma expressed concern that PLHIV aged 25 to 49 accounted for the majority of PLHIV in Northern Cape who were unaware of their HIV status (62.4%), those who were aware of their HIV status but not on ART (72.7%) and those who were on ART with no VLS (73.1%).

However, adolescents and youth aged between 15 and 24 contribute disproportionally to gaps in treatment, accounting for just 8.1% of all PLHIV. 

People residing in urban areas accounted for the majority of PLHIV and most of those gaps along the clinical cascade. 

Sexual debut 

Regarding the key drivers of the HIV epidemic, Zuma noted that the Northern Cape had the second-lowest prevalence of early sexual debut among the nine provinces.

The proportion of adolescents and youth aged between 15 and 24 years who reported having sex before the age of 15 decreased from 11.4% in 2017 to 8% in 2022.

Sexual debut before the age of 15 among adolescents and youth between 15 and 24 years in 2022 was higher among males (10.2%) than females (5.1%).

Multiple sexual partners

The survey revealed that 11% of people aged 15 years and older reported having multiple sexual partners in 2022, compared to 8.4% in 2017.

The proportion of people aged 15 and older, who reported having multiple sexual partners was 11.2% higher among males compared to females (5.4%). 

The proportion who reported having multiple sexual partners was highest in urban areas, sitting at 9.2%. 

Condom use with recent sexual partner

Regarding condom use, the survey revealed that 30.4% reported using a condom with their most recent sexual partner in 2022, compared to 39.9% in 2017. 

Condom use with their most recent sexual partner among people aged 15 and older was higher among males (34.9%) than females (25.7%), and lower among those aged 25 to 49 (27.8%) compared to those aged 15 to 24 (64.3%). 

Condom use was substantially lower among those residing in rural formal or farm areas (14.6%) compared to those living in urban areas (32%). 

Condom use with their most recent sexual partner among people 15 years and older was 40.2% in Frances Baard.

Nationally, more than 70% of individuals aged 15 and older had never or sometimes used a condom with their most recent sexual partner. 

In the Northern Cape, a higher proportion (52.3%) also reported that they had never used a condom with their most recent sexual partner. Only 7.6% reported that they had used condoms almost every time.

Consistency of condom use with their most recent sexual partner among people aged 15 and older in the province was lowest among those aged 25 to 49 (15%) compared to adolescents and youth aged 15 to 24 (41.2%). 

However, less than 50% of adolescents and youth reported using a condom sometimes or never using a condom. 

“We also recommend a continued focus on increasing coverage and demand for medical male circumcision among males aged 15 years and older. We must also enhance public awareness and uptake of effective HIV prevention measures, such as regular HIV testing, condoms and PrEP [pre-exposure prophylaxis],” said Zuma. – SAnews.gov.za

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