FALL IN NUMBER OF NEW CASES OF HIV SPARKS SURPRISE IN SOUTH AFRICA

FALL IN NUMBER OF NEW CASES OF HIV SPARKS SURPRISE IN SOUTH AFRICA

Amid mounting concern that progress in fighting the global AIDS epidemic is stalling, campaigners were given a boost from a surprising quarter this week.

Confounding expectations, South Africa — home to the world’s largest population of people living with HIV — has recorded a significant decline in the number of people contracting the virus.

A major national survey conducted by the Human Sciences Research Council, South Africa’s main official statistician, found that the number of new HIV infections had dropped by 44 percent since the last major study in 2012.

The findings came as UNAIDS, the body set up by the United Nations to tackle the epidemic, warned that a global effort to bring the disease under control was “slipping off track”.

In its latest report, also published this week, UNAIDS warned that although fewer people were dying, thanks to a rise in treatment rates, the fight against HIV was at a “precarious point” because progress in cutting new infections internationally has slowed.

“The success in saving lives has not been matched with equal success in reducing new HIV infections,” Michael Sidibe, executive director of UNAIDS, said. “New HIV infections are not falling fast enough.”

UNAIDS found that new HIV infections were actually on the rise in 50 countries, doubling in eastern Europe and Central Asia. It reported 1.8 million new HIV infections globally in 2017, representing a decline of just 18 percent since 2010 — a much lower slow down than hoped.

But, supporting the findings of South Africa’s new national survey, UNAIDS noted that the reduction of new infections had been strongest in eastern and southern Africa, which had seen an average decline in new cases of 30 percent since 2010. In contrast, far less progress had been made in West Africa, particularly Nigeria — where numbers had declined by only five percent.

There were only 231,000 new cases in South Africa last year, according to the HSRC survey.

Some experts had expected South Africa to show a slower rate of decline and even Sandile Buthelezi, chief executive of the South African National AIDS Council, confessed to being surprised by the survey’s findings.

But although South Africa appeared to have bucked the international trend, Dr Buthelezi said that within the five year reporting period the rate of decline in new infections had begun to plateau.

As a result, South Africa — like the rest of the world — looks unlikely to meet a UNAIDS global target to record fewer than 500,000 new HIV infections a year by 2020. South Africa had pledged to cut numbers to 88,000 and Dr Buthelezi conceded that South Africa was “very far from our target”.

“What this report tells us is that we are going in the right direction but we need to double our efforts,” he said.

“From what was released today we are confident that we are doing something right but I think we can do better and we need to move faster”.

Of the 37m people around the world living with HIV, more than a fifth — 7.9m, according to the survey — live in South Africa.

The number of HIV positive South Africans has risen significantly over the years, from 12.2 percent of the population in 2012 to 14 percent today. This, however, is primarily because fewer people are dying of AIDS and other HIV-related diseases thanks to greater access to anti-retroviral medication that suppresses the growth of HIV.

The decline in new cases of HIV has also largely been attributed to anti-retroviral drugs, which make it harder for those already infected with the virus to transmit it to others.

South Africa was slow to embrace anti-retroviral therapy, in part because Thabo Mbeki, the country’s president from 1999 to 2008, denied for a long time any link between HIV and AIDS.

South Africa now has the largest anti-retroviral medication programme in the world, but even so more than 3m people still receive no treatment at all.

Some of those unaware they are HIV positive, but others refuse treatment — even though it is free — for reasons researchers and campaigners say they do not yet fully understand, although denial and stigma form part of the explanation.

Among the survey’s most worrying conclusions is the continued disproportionate prevalence of HIV among younger women. More than a quarter of South African women aged 15 to 49 live with HIV, compared to 14.8 percent of men.

Among young adults aged 20 to 24, the figure is even starker: three times as many women have HIV as men.

Rape and sexual violence, widespread in South Africa, account for as much as a quarter of new HIV infections among young women, campaigners say.

But an even more significant factor, is the widespread practice of younger women engaging in sexual relations with older men.

These age-disparate relationships are often transactional, and are largely blamed on South Africa’s high youth unemployment rate, which stands at more than 50 percent.

With little hope of finding a job, or forming a financially-viable relationship with their age-mates, young women often seek economic stability by pairing up with older, richer men, known colloquially as “blessers”.

Not only are older men more likely to be HIV positive than their younger peers, they are also less likely to use condoms.

It is only when South Africa can address societal issues that keep the young poor and marginalised that real progress in containing HIV can be made, campaigners say.

“Structural interventions that address issues like poverty, drug abuse, keeping girls in schools — these have as much impact as medical interventions and will allow us to move much faster,” Dr Buthelezi said.

“The success in saving lives has not been matched with equal success in reducing new HIV infections,” Michael Sidibe, executive director of UNAIDS, said. “New HIV infections are not falling fast enough.”

Approximately 1.8m people contracted HIV last year around the world — but only 231,000 of those were in South Africa, according to the survey.

Some experts had expected South Africa to show a slower rate of decline and even Sandile Buthelezi, chief executive of the South African National AIDS Council, confessed to being surprised by the survey’s findings.

But although South Africa appeared to have bucked the international trend, Dr Buthelezi said that within the five-year reporting period the rate of decline in new infections had begun to plateau.

As a result, South Africa — like the rest of the world — looks unlikely to meet a UNAIDS global target to record fewer than 500,000 new HIV infections a year by 2020. South Africa had pledged to cut numbers to 88,000 and Dr Buthelezi conceded that South Africa was “very far from our target”.

“What this report tells us is that we are going in the right direction but we need to double our efforts,” he said.

“From what was released today we are confident that we are doing something right but I think we can do better and we need to move faster,” he said.

Adrian Blomfield / Telegraph

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