South African Press Association - August 2, 2007
Justine Gerardy

"The overall picture suggests that HIV-prevalence in South Africa may be at a point where we should begin to witness a downward trend," Tshabalala-Msimang told a media briefing in Johannesburg.

The trends were "pleasing signs of change in the right direction", but HIV remained an important public-health challenge, she said.

The minister was releasing findings of the annual antenatal survey at government clinics across the country.

Last year saw the national HIV prevalence drop from 30,2% to 29,1% with "significant" declines in infections in young pregnant women under 24 years.

The 2006 National HIV Syphilis Prevalence Survey was the department's first expanded study to district level and involved 33 034 pregnant women.

Wide ranges were shown geographically -- with the highest prevalence shown in the Amajuba district in KwaZulu-Natal at 46% and the lowest in the Namakwa district in the Northern Cape at 5,3%.

Tshabalala-Msimang said an important finding was that infections in women under 20 years had continued to decline to 13,7% from 16,1% in 2004 and 15,9% in 2005.

Such a drop in the most recently sexually active age group suggested a decline in new infections and indicated the impact of the country's prevention programmes, she said.

"This is beginning to show that young people are indeed taking these messages seriously."

Prevalence among women between 20 and 24 years had dropped by 2,6%.

However, a rise in infections among women between 30 and 39 was of concern to the department.

Epidemiology and research chief director Lindi Makubalo said possible reasons were that infected younger women moved into older age groups and that intervention programmes were then not easily accessible to them.

The national drop suggested that the pandemic may be beginning a downward trend for the first time since 1990.

Last year's decline was "very encouraging" and needed to be carefully observed for confirmation, she said.

Provincially, KwaZulu-Natal had the highest prevalence at 39,1% and the Western Cape the lowest at 15,1%.

Infection ranges within districts were wide and as large as 17% in the Northern Cape.

Syphilis infections, an indicator of high-risk behaviour such as unprotected sex, had gone down and had shown a downward trend since 1998.

Makubalo said HIV prevalence in the rest of the population was derived from antenatal survey data using mathematical models.

The number of people estimated to have HIV was 5,41-million -- a more conservative figure than the previous 5,54-million estimated last year.

The figure was made up of 2 290 000 men, 2 860 000 women and 257 900 children.

The prevalence rate in South Africans aged 15 and older was 15,83%.

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