HIV prevalence among pregnant women attending government clinics in SA fell to 27.5% in 2022, reaching its lowest level in two decades, according to a report released yesterday by the National Institute for Communicable Diseases (NICD).
BusinessLIVE reports that NICD senior epidemiologist Tendesayi Kufa-Chakeza said the 2.5% percentage point drop in HIV prevalence since the 2019 antenatal HIV sentinel survey was “very significant”, and had been anticipated from mathematical modelling of SA’s epidemic.
“However we think the decline would have been greater were it not for the Covid-19 related disruptions in HIV testing, (starting treatment), and Pre-exposure Prophylaxis (PreP) services,” she said. Peak HIV prevalence among pregnant women was recorded in the 2015 survey, at 30.8%.
While the overall trend is good news, the 2022 survey shows just over a quarter (25.9%) of pregnant women on HIV treatment weren’t achieving viral suppression, raising the risk of transmitting the disease to their babies.
“SA still has an unacceptably high level of mother-to-child transmission of HIV during pregnancy and breastfeeding: 0.7% of babies are born with HIV and about 4% of babies are HIV-positive at 18 months,” said Bill & Melinda Gates Foundation director for HIV and TB delivery Yogan Pillay, who was not involved in the survey.
“We need to do much more to prevent mother-to-child transmission in SA, Nigeria and Mozambique, which account for 80% of Africa’s paediatric HIV burden,” he added.
The Health Department has conducted antenatal HIV surveys since 1990 to gauge the trajectory of SA’s epidemic and the effect of its interventions. SA has the world’s biggest HIV burden, with an estimated 7.5m people living with the disease, according to the 2022 survey report.
The nationally representative study included 32 828 pregnant women aged between 15 and 49 years attending 1 589 government clinics.
In line with previous studies, it found wide variation in HIV prevalence between provinces, ranging from 37.2% in KwaZulu-Natal to 16.3% in the Western Cape. The highest HIV prevalence was recorded in the uMkhanyakude district, at 44%. HIV prevalence fell in all nine provinces.
The survey found only a quarter (25.8%) of the participants made their first visit to an antenatal clinic within the first 12 weeks of their pregnancy, in line with World Health Organisation recommendations. Less than two thirds (61%) of participants had their first antenatal consultation within 20 weeks of conception, a marked drop on the 70% reported in 2019. The decline was likely due to the disruption caused by the pandemic, said Pillay.
Among the survey participants who knew their HIV status, 98.8% were on treatment, an improvement on the 96% recorded in 2019.
The proportion of pregnant women on HIV treatment who had achieved viral suppression remained constant between the two surveys, at 74.1%.
BusinessLIVE – HIV prevalence among SA’s pregnant women drops to 27.5%