The Western Cape had the lowest HIV prevalence (7.4%) in
2022 and second lowest in 2017 (8.6%).
According to the Human Sciences Research Council (HSRC),
this translates to 540 000 people living with HIV (PLHIV) in the Western Cape,
which was a decline from 560 000 PLHIV in 2017.
PICTURE
The information is based on the findings of the Sixth South
African HIV Prevalence, Incidence and Behaviour Survey (SABSSM VI) for the
Western Cape, which was released by the HSRC. 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.
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 province was higher among those aged 25 to 49 (10.8%) for
both females (14.6%) and males (5.8%).
Meanwhile, HIV prevalence was higher among females (9%)
compared to males (5.6%).
“HIV prevalence peaked at 12.9% amongst those aged 35 to 39
in 2022 from 23.4% in 2017 within the same age group. There was a decrease in
HIV prevalence in 2022 among all age groups younger than 30 to 34 years
compared to 2017, apart from the age groups zero to 14; 15 to 19, and those 50
years and older. The worsening prevalence among those younger than 24 years is
deeply concerning, as it shows continued new infections from both horizontal
and vertical transmissions,” Zuma said.
Antiretroviral treatment (ART) coverage in the Western Cape
increased to 76.8% in 2022, from 54.4% in 2017. This translates to an estimated
360 000 PLHIV in the province receiving ART in 2022. In 2022, ART use among all
PLHIV in the province was lower among those aged 15 to 49 (76.5%) compared to
other age groups. ART use was also lower among males (75.3%) compared to
females (77.1%). In addition, ART use was 76.2% amongst respondents who reside
in urban areas and 81.4% in the City of Cape Town.
The survey further revealed that in 2022, among all
provinces, the Western Cape had the seventh highest proportion of PLHIV with viral
load suppression (78.4%), having increased from 2017 (54.6%). Overall, VLS was
also lower among males (76%) compared to females (79.7%). VLS was also lower among those aged 50 and
older (69.4%) compared to other age groups.
The professor expressed concern that PLHIV between 25 and
49 years accounted for the majority of PLHIV in the Western Cape, who were
unaware of their HIV status (59.1%); aware but not on ART (64.7%), and on ART
but not VLS (66.7%). Adolescents and
youth aged between 15 and 24 contributed disproportionally to gaps in
treatment, accounting for just 9.5% of all PLHIV.
Regarding the key drivers of the HIV epidemic, Zuma noted
that in the Western Cape, there was an increase in the proportion of
adolescents and youth aged 15 to 24, who reported sex before the age of 15 in
2017 (14%), compared to 2022 (16.3%).
Sexual debut before the age of 15 among adolescents and
youth aged 15 to 24 in 2022 was higher among males (21.5%) than females
(11.3%).
The survey revealed that in the Western Cape, 6.7% of
people aged 15 and older reported having two or more sexual partners in 2022
compared to 7.6% in 2017.
The proportion of people aged 15 and older who reported
having multiple sexual partners was two-fold higher among males (8.9%),
compared to females (4.4%), and higher among those aged 15 to 24 (19.1%)
compared to other age groups.
Furthermore, the survey revealed that 22.1% reported using
a condom with their most recent sexual partner in 2022 compared to 26.6% in
2017, representing a 4.5% decline. Condom use with their most recent sexual
partner among people who are 15 years and older was higher among those 15 to 24
years (39.9%) and in the urban areas (22.5%), while it was similar by sex. A
higher proportion also reported that they had never or sometimes (81.4%) used a
condom with their most recent sexual partner. Only 13.4% reported that they had
used condoms almost every time.
Consistency of condom use with their most recent sexual
partner among people aged 15 in the province was higher among youth aged 15 to
24 (24%).
Mpumalanga has the highest HIV prevalence at 17.4% in 2022,
which translates to an estimated 890 000 (PLHIV) in the province, followed by
KwaZulu-Natal.
Done by: Mitchum George