A decline in new HIV infections in South Africa: estimating HIV incidence from three national HIV surveys in 2002, 2005 and 2008
Download this report
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at firstname.lastname@example.org.
Background: Three national HIV household surveys were conducted in South Africa, in 2002, 2005 and 2008. A novelty of
the 2008 survey was the addition of serological testing to ascertain antiretroviral treatment (ART) use.
Methods and Principal Findings: We used a validated mathematical method to estimate the rate of new HIV infections (HIV
incidence) in South Africa using nationally representative HIV prevalence data collected in 2002, 2005 and 2008. The
observed HIV prevalence levels in 2008 were adjusted for the effect of antiretroviral treatment on survival. The estimated
"excess" HIV prevalence due to ART in 2008 was highest among women 25 years and older and among men 30 years and
older. In the period 2002-2005, the HIV incidence rate among men and women aged 15-49 years was estimated to be 2.0
new infections each year per 100 susceptible individuals (/100pyar) (uncertainty range: 1.2-3.0/100pyar). The highest
incidence rate was among 15-24 year-old women, at 5.5/100pyar (4.5-6.5). In the period 2005-2008, incidence among men
and women aged 15-49 was estimated to be 1.3/100 (0.6-2.5/100pyar), although the change from 2002-2005 was not
statistically significant. However, the incidence rate among young women aged 15-24 declined by 60% in the same period,
to 2.2/100pyar, and this change was statistically significant. There is evidence from the surveys of significant increases in
condom use and awareness of HIV status, especially among youth.
Conclusions: Our analysis demonstrates how serial measures of HIV prevalence obtained in population-based surveys can
be used to estimate national HIV incidence rates. We also show the need to determine the impact of ART on observed HIV
prevalence levels. The estimation of HIV incidence and ART exposure is crucial to disentangle the concurrent impact of
prevention and treatment programs on HIV prevalence.
Related Research Outputs:
- The phenomenology of bodily care: caregivers' experiences with AIDS patients before antiretroviral therapies in Lesotho
- Lay counsellor-based risk reduction intervention with HIV negative diagnosed patients at HIV counselling and testing sites in a rural South African setting
- HSRC presentation to the Standing Committee on Appropriations
- Lay counsellor-based risk reduction intervention with HIV positive diagnosed patients at public HIV counselling and testing sites in Mpumalanga, South Africa
- HIV sero-status disclosure and sexual behaviour among HIV positive patients who are on antiretroviral treatment (ART) in Mpumalanga, South Africa
- Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: results from a randomized trial
- "It's important to take your medication everyday okay?": an evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa
- Recruiting and educating participants for enrollment in HIV-vaccine research: ethical implications of the results of an empirical investigation
- Is it lawful to offer HIV self-testing to children in South Africa?
- Combination HIV prevention among MSM in South Africa: results from agent-based modeling
- Initiation of antiretroviral therapy and viral suppression after home HIV testing and counselling in KwaZulu-Natal, South Africa, and Mabarara district, Uganda: a prospective, observational intervention study
- Letter to the editor: response to
- Political leadership in South Africa: HIV
- Uptake of antiretroviral therapy and male circumcision after community-based HIV testing and strategies for linkage to care versus standard clinic referral: a multisite, open-label, randomised controlled trial in South Africa and Uganda
- New insights into HIV epidemic in South Africa: key findings from the National HIV Prevalence, Incidence and Behaviour Survey, 2012
- Review of the HIV/AIDS policy, legislation, financing & implementation of programmes in Mozambique
- A review of HIV/AIDS policy, financing, legislation and programmes: South African case study: Draft
- The impact of HIV/AIDS on the health sector: national survey of health personnel, ambulatory and hospitalised patients and health facilities, 2002
- Prevention of mother to child transmission: a report of an assessment of a pilot programme in fifteen health facilities in Gauteng province
- A comparative analysis of the financing of HIV/AIDS programmes in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe, October 2003