Uys, regarding 2005 Western Cape HIV antenatal survey
12 September 2006
The HIV prevalence amongst pregnant women attending public sector clinics in
the Western Cape was estimated to be 15,7% in 2005, approximately half of the
national prevalence of 30,2%. However, the local level surveys in the Western
Cape revealed significant heterogeneity in the HIV prevalence (ranging from 4,5
- 33%) with the existence of sub-epidemics that closely follow or have exceeded
the national epidemic.
The HIV prevalence was high in women aged 25 - 29 years with an infection
rate of 20,1%. This means that one in every five pregnant women aged 25 - 29
years who attended the public sector clinics was HIV positive.
These are some of the results from the Western Cape 2005 HIV antenatal
surveys, conducted by the Western Cape Department of Health in collaboration
with national Department of Health.
The HIV among young adults in the 15 - 24 year age group, which is a proxy
for new infections, increased from 8,6% in 2000 to 12,8% in 2005, although most
of this increase took place between 2000 and 2001. The marginal decline in HIV
prevalence observed in the 20 years age group, and the 20 - 24 years age group
for 2004 - 2005 was not significant and therefore it would be premature to
interpret this marginal decline as stabilisation.
There was an increase in HIV prevalence in the older age groups (30 years or
more) although it is not significant. Several factors may be attributed to this
change namely, real change or as the result of fluctuation in the rates due to
cohort shifts, small sample size, change in age of sexual debut, fertility
levels and in utilisation of public health services.
It would be important therefore to closely monitor HIV trends in these
cohorts over the next few years and further investigate these findings with
local level socio-demographic and behavioural surveys.
The local-level surveys showed a progressive increase in the range of HIV
prevalence across the areas, namely, a range of 0,6 - 22% for the year 2001
increased to 4,5 - 33% in 2005. This suggests that there is no single epidemic
in this province and that there are sub-epidemics manifesting as early,
emerging and advanced epidemics.
The highest levels of HIV infection were reported in areas in the Cape
Metropole area, as well as in the relatively more urbanised areas in the
non-metropole areas, such as Knysna/Plettenberg Bay, Stellenbosch, Caledon and
Hermanus.
On the basis of the variation in the magnitude and growth of the HIV
epidemic, it is clear that the approach to developing an HIV strategy for this
province would take into account the local variation and trends. The Western
Cape Department of Health has made huge strides in providing treatment access
over the past few years. However, the Department recognises that providing
treatment only is not sufficient to turn the tide of the epidemic. The Western
Cape Department of Health therefore has committed to expand the prevention
programme through the expanded availability to voluntary HIV testing, improved
access to reproductive health services, focused prevention interventions for
HIV and Sexually Transmitted Infections (STI) with groups at increased risk and
the early detection and treatment of STIs. The Department will continue to
expand curative care as it is recognised that HIV treatment can create a more
effective environment for prevention. Prevention on the other hand, is critical
for the sustainability of curative programmes.
Enquires: Pierre Uys
Cell: 082 455 5144
Herman v. d. Westhuizen
Cell: 082 772 9161
Issued by: Department of Health, Western Cape Provincial Government
12 September 2006
