Marseille 2007
Marseille 2007
Abstract book
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Abstract #55  -  National HIV incidence estimates: an analysis of current transmission dynamics in South Africa
Session:
  50.1: Transmission and social epidemiology (Parallel) on Wednesday @ 08.30-10.30 in PR Chaired by Brenda Spencer, Helene Sylvain
Authors:
  Presenting Author:   Prof Thomas Rehle - Human Sciences Research Council, South Africa
 
  Additional Authors:  Dr Olive Shisana, Dr Victoria Pillay, Dr Khangelani Zuma, Dr Adrian Puren, Dr Warren Parker,  
Aim:
Background and Objectives: The 2005 South African national survey on HIV, Behavior and Communication included laboratory-based HIV incidence testing of blood specimens in its survey protocol which allowed for the first time a joint analysis of HIV prevalence, HIV incidence and HIV associated risk factors. This paper presents national incidence estimates stratified by age, sex and locality type, compares the HIV incidence and HIV prevalence profiles for males and females and examines the relationship between HIV prevalence, HIV incidence and socio-behavioral factors.
 
Method / Issue:
15 851 specimens tested for HIV provided an unparalleled large sample to estimate HIV incidence on a national scale for South Africa. The detection of recent infections was performed on confirmed HIV positive samples, using the BED capture enzyme immunoassay optimised for dried blood spot (DBS) specimens. BED HIV incidence calculations applied adjustment procedures that were recently revised and approved by CDC for subtype C blood specimens.
 
Results / Comments:
HIV incidence in the study population aged two years and older was 1.4%, with 571 000 new HIV infections estimated for 2005. An HIV incidence rate of 2.4% was found among individuals aged 15-49 years. HIV incidence among females peaked in the 20-29 age group at 5.6%, more than six times the incidence found in 20-29 year old males (0.9%). Among youth aged 15-24 years, females account for 90% of the recent HIV infections in this age group. Non-condom use among youth, current pregnancy and widowhood were the socio-behavioural factors associated with the highest HIV incidence rates.
 
Discussion:
The HIV incidence estimates reflect the underlying transmission dynamics that are currently at work in South Africa. High rates of incidence amongst females, amongst pregnant females, and amongst people living in informal settlements are illustrative of high levels of disproportionate risk. The findings suggest that the current prevention campaigns do not have the desired impact, particularly among young women.
 
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