South African Press Association - September 12, 2006
Wendell Roelf

The HIV prevalence is highest in women aged 25 to 29 years, with an infection rate of 20,1% of the 8 656 people examined at 400 facilities in the province's 25 health districts.

This means that one in five pregnant women in this age group is HIV positive.

"This is really worrying if one thinks about a room full of people," said Dr Najma Shaikh, a senior specialist in the department's HIV/Aids directorate, at a media briefing where the results of the 2005 antenatal survey was made public.

The survey showed that among young adults in the 15 to 24 age group, which is a proxy for new infections, the prevalence of HIV increased from 8,6% in 2000 to 12,8% in 2005.

There was an increase in HIV prevalence in the older age groups (30 years or more), although this was not significant.

According to Shaikh, several factors such as small sample sizes, fertility levels and use of public health services could result in fluctuations.

Overall, the HIV prevalence among pregnant women attending public sector clinics was estimated to be 15,7%, about half the national prevalence of 30,2% in 2005.

The local-level surveys showed a progressive increase in the range of HIV prevalence across all areas, increasing 4,5% to 30% in 2005, up from a range of 0,6% to 22% in 2001.

This supported a key finding of the survey, that the Western Cape does not have a single epidemic, but rather a "diverse" epidemic characterised by "sub-epidemics" in various stages of development -- example, early, emerging and advanced.

"We can't have a simple, homogenous plan ... it must be customised," said Shaikh of a comprehensive prevention plan.

This nuanced fight would be tailored to fit the different needs in different districts, where Khayelitsha has a relatively mature epidemic, up from 22% in 2001 to 33% in 2005, while places such as Oostenberg, Tygerberg eastern and Cape Town central had "rapidly growing" incidences of HIV.

The highest levels of HIV infection were reported in area 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," said provincial minister Pierre Uys in a statement.

He said huge strides are being made to combat the disease, which is infecting about 27 000 people annually in the region.

Challenges of access, shortages of nurses and other health professionals, infrastructure and awareness of the disease remain, as the department seeks to expand its prevention programme.

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