The AIDS epidemic in South Africa may have already peaked, suggests a new study. The nation has more people with HIV/AIDS than any other country in the world.
The new research presents a less bleak picture than previous studies. It suggests South Africa鈥檚 AIDS epidemic is likely to have peaked in 2002, when 4.7 million of its 45 million people had the deadly disease.
Thomas Rehle, an independent US researcher, and Olive Shisana of South Africa鈥檚 Human Sciences Research Council (HSRC), say the epidemic may now level off as fewer new infections occur. Their predictions are based on an epidemiological model they developed using data from HIV surveys of South Africa鈥檚 ante-natal clinics.
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The model鈥檚 projections suggest that the annual number of AIDS-related deaths will rise to a peak of about 487,000 in 2008, then fall to 470,000 in 2010. A USAID report in 2002 suggested that in 2010, there would be over 900,000 deaths a year with 38 per cent of South Africa鈥檚 sexually active adult population being HIV positive.
The epidemic鈥檚 apparent slowdown may be the result of HIV/AIDS education and prevention programs leading to changes in sexual behaviour, as well as the fact that death is reducing the number of HIV-positive people.
鈥淢uch uncertainty鈥�
But Rehle and Shisana stress there is 鈥渟till much uncertainty鈥� and Rehle told Reuters: 鈥淔ive million infections is still a huge burden for any country.鈥�
The Joint United Nations Programme on HIV/AIDS disputes the findings of the study. 鈥淲e believe that there is currently no evidence that prevalence has peaked,鈥� says Peter Ghys, manager of epidemic and impact monitoring at UNAIDS.
鈥淚ndeed, the most recent round of surveillance data among pregnant women indicate that 26.5 per cent of women were HIV-positive in 2002, compared to 24.8 per cent in 2001, 24.5 per cent in 2000 and 22.4 per cent in 1999,鈥� he says.
Ghys told New Scientist that the prevalence rates generated by Rehle and Shisana may be at the low end because of the low response rate of 40 per cent in the HIV surveys.
Antiretroviral therapy
The surveys were South Africa鈥檚 first national study on HIV prevalence, conducted by the HSRC and the Nelson Mandela Foundation in 2002, and were basis for the model developed by Rehle and Shisana.
The most critical age group in determining the future scale of the epidemic is the 15-to-49 band. New infections in this group have already fallen sharply says the study, from 4.2 per cent per year in 1997 to 1.7 per cent in 2003. Overall HIV prevalence this age group is also projected to fall, from a peak of 17.3 per cent in 2001 to 15.2 per cent in 2010.
鈥淲e hope this will be borne out by other sources,鈥� says Thomas Yocum, a spokesman for the UK鈥檚 National AIDS Trust. He stresses the importance of sustaining the measures used to combat the virus.
In particular, he told New Scientist: 鈥淲e have to be hopeful that the South African government will increase the use of antiretroviral therapy more rapidly to continue to fight the epidemic. We only have to look to Brazil, one of the best examples in the developing world, to see how successful these types of efforts can be.鈥�
