Sunday Times (Johannesburg) - November 27, 2005

HIV/Aids statistics are inexact and will always be contested. But the pattern of infections emerging from communities involved in demographic studies is proving to be remarkably consistent with the annual antenatal statistics South Africa uses to track the epidemic.

Large population-based surveys in Hlabisa and Vulindlela in KwaZulu-Natal, for example, find similar rates of infection to those reported by the national annual antenatal survey, or worse.

The antenatal surveys are the most consistent indicator of how HIV/Aids is developing in South Africa, even though they calculate national prevalence among adults from pregnant women.

UNAIDS highlighted in its annual update this week that the epidemic had evolved with "astonishing speed" in South Africa. "National adult HIV prevalence of less than one percent in 1990 soared to almost 25% within 10 years," it declared.

The 2004 antenatal survey found 29.5% of pregnant women attending government clinics were HIV positive.

An age analysis found 30.8% of girls between 20 and 24 were living with the disease. At Vulindlela, testing of girls in the same age category found more than half (55%) of them were positive.

Other small studies presented at South Africa's second-ever Aids conference this year painted the same picture ¡ of an epidemic raging unabated.

While South Africa's Aids treatment roll-out is making an impact in a few provinces, only about 70000 of half a million people needing antiretrovirals were receiving them by mid-2005. Civil society organisations this week announced a campaign to make sure at least 200000 people were on treatment by mid-2006.

For the first time, the Congress of South African Trade Unions, the South African Council of Churches and the Treatment Action Campaign have joined forces to stop the spread of HIV/Aids and will work together in the next year to expand prevention and accelerate treatment.

What statistics do show is that prevention campaigns seem to have done little so far to slow down the rate of new infections, estimated at about 1600 a day. HIV/Aids clinicians say they find these projections intimidating.

Yet it is possible to stop the spread of the disease, as countries like Uganda, Senegal, Brazil and Thailand have demonstrated. In 1990 Brazil had a similar prevalence to South Africa. Now South Africa's antenatal infection rate stands at 29.5%, while Brazil's remains at less than one percent.

Armed with the latest facts from the new household survey, South Africa needs strong leadership and united action from the government and civil society to defeat the epidemic.

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